Physician support of HPV vaccination school-entry requirements

Figures & data

Table 1. Physician and practice characteristics (N = 775).

	n	%
Demographic characteristics
Female	250	32
Medical specialty
Pediatrics	410	53
Family medicine	365	47
Years practicing medicine
<20 years	351	45
≥20 years	424	55
Patients ages 11-17 seen per week
< 10	129	17
10-24	350	45
> 24	296	38
Practice characteristics
Private practice
No	115	15
Yes	650	85
Number of physicians
1	115	15
2-4	283	36
5-9	217	28
≥10	160	21
Vaccines provided that are financed by VFC
0-9%	290	37
10-49%	273	35
50% or greater	152	20
Not sure	60	8
Regularly stocks HPV vaccine
No	73	9
Yes	702	91
Dismisses families who continue to refuse adolescent vaccines^1
No	684	88
Yes	91	12
Region
Northeast	184	24
Midwest	165	21
South	274	35
West	152	20

Note. VFC=Vaccines for Children program. HPV=human papillomavirus

¹ Have a policy to dismiss patients or families who continue to refuse Tdap, meningococcal, or HPV vaccination.

Table 2. Physician support of HPV vaccination school-entry requirements (N = 775).

“Some states are trying to pass laws that would require all 11 and 12 year-olds to get HPV vaccine before they are allowed to start sixth grade.”		“I think these laws are a good idea.”
		Agree (%)	Neither agree nor disagree (%)	Disagree (%)	Total (%)
	Agree	163 (21)	65 (8)	139 (18)	367 (47)
“It is okay to have these laws only if parents can opt out if they want to.”	Neither agree nor disagree	60 (8)	59 (8)	38 (5)	157 (20)
	Disagree	143 (18)	16 (2)	92 (12)	251 (32)
	Total	366 (47)	140 (18)	269 (35)	775 (100)

Note. 74% (n=570) of physicians agreed with some form of HPV vaccination school-entry requirement (47% [first column total; Response of “agree” to “I think these laws are a good idea.”] + 8% [Response of “neither agree nor disagree” to “I think laws these laws are a good idea” and “agree” to “It is okay to have these laws only if parents can opt out if they want to”] + 18% [Response of “disagree” to “I think laws these laws are a good idea” and “agree” to “It is okay to have these laws only if parents can opt out if they want to”]). May not sum to totals because of rounding. HPV=human papillomavirus.

Table 3. Correlates of physician support of HPV vaccination school-entry requirements (N = 775).

	# of respondents who agreed with the statement “I think these laws are a good idea”/ Total in category (%)	Bivariate OR (95% CI)	Multivariable OR (95% CI)
Physician attitudes about HPV vaccines
Requirements for Tdap vaccine make HPV vaccine seem less important
Did not agree	50/198 (25)	Ref	Ref
Agree	316/577 (55)	3.58 (2.50-5.14)	3.33 (2.26-4.90)
Relative importance of HPV vaccine to physicians^1
Less important	138/392 (35)	Ref	Ref
As or more important	228/383 (56)	2.71 (2.02-3.62)	2.30 (1.65-3.18)
Perceived relative importance of HPV vaccine to parents^1
Less important	299/646 (46)	Ref	—
As or more important	67/129 (52)	1.25 (0.86-1.83)	—
Quality of current HPV vaccine recommendation practices
Low	146/418 (35)	Ref	Ref
High	220/357 (62)	2.99 (2.23-4.01)	2.06 (1.45-2.93)
Used presumptive style for HPV vaccine recommendation
No	227/539 (42)	Ref	Ref
Yes	139/236 (59)	1.97 (1.44-2.69)	1.30 (0.95-1.81)
HPV vaccine conversations uncomfortablebecause of having to talk about sex
Did not agree	239/526 (45)	Ref	—
Agree	127/249 (51)	1.25 (0.92-1.69)	—
Takes more time to discuss HPV vaccine^1
No	147/338 (43)	Ref	—
Yes	219/437 (50)	1.31 (0.98-1.74)	—
Pharmacists provision of HPV vaccine benefits adolescents past due
Did not agree	204/470 (43)	Ref	Ref
Agree	162/305 (53)	1.48 (1.11-1.97)	1.31 (0.95-1.81)
Physician characteristics
Sex
Male	256/525 (49)	Ref	—
Female	110/250 (44)	0.83 (0.61-1.12)	—
Medical subspecialty
Pediatrics	195/410 (48)	Ref	—
Family medicine	171/365 (47)	0.97 (0.73-1.29)	—
Years practicing medicine
<20 years	149/351 (42)	Ref	Ref
≥20 years	217/424 (51)	1.42 (1.07-1.89)	1.49 (1.09-2.04)
Patients ages 11-17 seen per week
<10	65/129 (50)
10-24	157/350 (45)	0.80 (0.54-1.20)	—
≥25	144/296 (49)	0.93 (0.61-1.41)	—
Practice characteristics
Private practice
Yes	306/650 (47)	Ref	—
No	60/115 (52)	1.26 (0.85-1.88)	—
Number of physicians
1	48/115 (42)	Ref	—
2-4	135/283 (48)	1.27 (0.82-1.97)	—
5-9	99/217 (46)	1.17 (0.74-1.85)	—
≥10	84/160 (53)	1.54 (0.95-2.50)	—
Vaccines provided that are financed by VFC
0-9%	138/290 (48)	Ref	—
10-49%	125/273 (46)	0.93 (0.67-1.30)	—
≥50%	78/152 (51)	1.16 (0.78-1.72)	—
Not sure	25/60 (42)	0.79 (0.45-1.38)	—
Regularly stocks HPV vaccine
No	33/73 (45)	Ref	—
Yes	333/702 (47)	1.09 (0.67-1.78)	—
Region
Northeast	82/184 (47)	Ref	—
Midwest	81/165 (49)	1.20 (0.89-1.59)	—
South	128/274 (47)	1.09 (0.75-1.59)	—
West	75/152 (49)	1.21 (0.79-1.86)	—
Dismisses families who continue to refuse adolescent vaccines^2
No	325/684 (48)	Ref	—
Yes	41/91 (45)	0.91 (0.58-1.41)	—

Note. VFC=Vaccines for Children program; HPV=human papillomavirus; Ref = Referent group; Dashes (–) indicate the variable was not included in the multivariable model because it was not statistically significant at the bivariate analysis.

¹ Relative to Tdap and meningococcal vaccines

² Clinics with a ‘yes’ answer have a policy that may dismiss patients or families if they continue to refuse any or all of the following vaccines: Tdap, meningococcal, HPV.