Survey of pediatricians and family physicians assesses HPV vaccine delivery practices

A new national survey of pediatricians and family physicians examines and compares how providers are recommending and communicating about human papillomavirus (HPV) vaccine, their current delivery practices, reported refusal/deferral rates and associated factors, and perceived barriers to vaccination. Findings from the survey will be presented during the Pediatric Academic Societies (PAS) 2019 Meeting, taking place on April 24—May 1 in Baltimore.

"This was a national survey of pediatricians and family physicians assessing their practices regarding HPV vaccine delivery and their perceptions of the effect of changes from a three to a two-dose recommendation for adolescents younger than 15 years of age," said Allison Kempe, MD, one of the authors of the study. "Our data are very encouraging in showing substantial progress over the past five years in the percent who report strongly recommending to 11 to 12-year-olds. Our findings also point out important areas for improvement in vaccine delivery, especially in how physicians introduce discussions about the vaccine and in the use of standing orders or alerts in the medical record."

Despite a recommendation for routine HPV vaccination of adolescents for over 10 years, vaccination series completion rates remain less than 50% in the U.S. A variety of approaches to increase coverage have been proposed, focused at the practice or provider level, but approaches currently being used in primary care are not well described.

Although the majority of physicians strongly recommend HPV vaccine at 11 to 12 years old, data suggest areas for improvement in strength and style of recommendation and in practice-based delivery methods. The findings suggest that physicians reporting high refusal rates may be anticipating and accommodating refusals by altering recommendation strength and style.

Dr. Kempe added, "The findings also suggest that, from the physicians' perspective, the two-dose schedule could result in meaningful increases in HPV vaccination initiation and completion among adolescents, leading to greater protection against HPV-associated cancers in the U.S."