In a national sample, many pediatricians and primary care physicians reported communicating about HPV vaccination with parents in ways that likely discourage them from getting their children vaccinated.
Melissa B. Gilkey, PhD, assistant professor of population medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston, noted that although HPV vaccination is an effective, safe, and easy way to prevent certain cancers and other conditions, very few U.S. adolescents get vaccinated in a timely manner.
Prior research has shown that a health care provider’s recommendation is the single biggest influence on whether parents decide to get the HPV vaccine for their adolescents. Given their influence, understanding how providers communicate about HPV vaccination is critical for getting more adolescents vaccinated, she explained.
Gilkey and colleagues, including Noel Brewer, PhD, the study’s senior author and an associate professor of health behavior at the University of North Carolina, conducted a national online survey of U.S. pediatricians and family physicians in 2014, in which they measured five indicators of HPV vaccine recommendation quality. These indicators included two for timeliness (recommend vaccination by ages 11 to 12 versus older or not at all, for girls and for boys), and one each for consistency (recommend for all versus to those considered to be at risk), urgency (recommend same-day vaccination versus otherwise), and strength of endorsement (saying that the vaccine is “very” or “extremely” important versus less so).
Gilkey and colleagues found that 27 percent of physicians across the country reported that they do not strongly endorse HPV vaccination, and 26 percent and 39 percent reported that they do not provide timely recommendations for vaccinating girls and boys, respectively. About 59 percent of the physicians recommended HPV vaccination more often for adolescents who they perceived to be at higher risk for getting an HPV infection, as opposed to recommending it routinely for all adolescents. Only 51 percent of physicians recommended same-day vaccination at the time of visit.
The researchers found that the quality of recommendation was higher among physicians who began discussion by saying the child is due for vaccination rather than giving parents information about vaccination or asking them if they had questions about vaccination. Recommendation quality was lower among physicians who were uncomfortable with discussing sexually transmitted infections or who believed that parents thought HPV vaccination was not important.
“Physicians have a lot of influence on whether adolescents receive the HPV vaccine. Our findings suggest that physicians can improve their recommendations in three ways: by recommending HPV vaccination for all 11- to 12-year-olds and not just those who appear to be at risk; by saying the HPV vaccine is very important; and by suggesting vaccination on the day of the visit rather than at a later date,” Gilkey said.
