Factors impacting HPV vaccination: lessons for health care professionals

Abstract

HPV infection leads to significant morbidity and mortality worldwide. The HPV vaccine is currently licensed and recommended for adolescents and young adults in many countries. Nonetheless, coverage levels remain low, especially in settings using a clinic-based rather than school-based delivery model. Health care professionals (HCPs) have the potential to strongly impact HPV vaccine acceptability and uptake, yet often fail to discuss and/or strongly recommend HPV vaccination. This article reviews the myriad factors that influence HPV vaccination, focusing, in particular, on those relevant to HCP communication with patients and families. It also provides a historical framework and highlights recent evidence related to HPV vaccination that may be valuable for these conversations. Lastly, it discusses strategies targeting HCPs and their practices that may increase HPV vaccination initiation and completion rates globally.

Keywords::

• adolescent
• communication
• health care professional
• HPV
• vaccination

Financial & competing interests disclosure

AM Hofstetter is an investigator on two investigator-initiated studies funded by Merck Sharp & Dohme Corp and the Pfizer Medical Education Group. SL Rosenthal is an unfunded investigator on the latter study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• HPV vaccination coverage levels remain suboptimal in many countries, particularly those using a clinic-based delivery model.

• Health care professional (HCP) communication with patients and families about HPV vaccination has a strong positive impact on HPV vaccine acceptability and uptake.

• Many HCPs fail to discuss and/or strongly recommend HPV vaccination.

• Limited knowledge and misconceptions about adolescent sexual health, HPV infection and the HPV vaccine among parents and HCPs may serve as important barriers to HPV vaccination.

• Educational interventions targeting HCPs and additional strategies that HCPs may employ within their practices could be beneficial in improving HPV vaccine uptake and completion.

• Particular attention should be given to populations at risk of underimmunization and HPV infection and/or associated complications, that is, individuals in developing countries, racial/ethnic minorities and patients with chronic medical conditions.

• Lessons learned from the introduction of the HPV vaccine may be valuable when introducing other vaccines targeting sexually transmitted infections.