HPV Vaccine Delivery Practices by Primary Care Physicians

Area of Science:

• Vaccinology
• Public Health
• Pediatric Medicine

Background:

• Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers.
• Understanding physician practices and attitudes towards HPV vaccine delivery is essential for optimizing public health strategies.
• The recent shift to a 2-dose HPV vaccination schedule may impact completion rates and physician recommendations.

Purpose of the Study:

• To evaluate human papillomavirus (HPV) vaccine delivery practices among pediatricians and family physicians (FPs).
• To assess physicians' experiences and attitudes regarding the 2-dose HPV vaccination schedule.
• To identify factors associated with HPV vaccine refusal or deferral in adolescents.

Main Methods:

• A national survey of pediatricians and FPs was conducted via internet or mail from July to September 2018.
• Multivariable regression analysis was employed to determine factors linked to high refusal or deferral rates (≥50%) in 11- to 12-year-old patients.
• Response rate was 65%, including 302 pediatricians and 228 FPs.

Main Results:

• Pediatricians showed higher rates of strong HPV vaccine recommendations and presumptive style discussions compared to FPs.
• Refusal or deferral rates for 11- to 12-year-olds were higher among FPs than pediatricians.
• Physicians not strongly recommending the vaccine, not using a presumptive style, and anticipating patient resistance were associated with higher refusal/deferral rates.
• A majority of physicians (89% pediatricians, 79% FPs) believe the 2-dose schedule has increased HPV series completion.

Conclusions:

• While most physicians strongly recommend the HPV vaccine, opportunities exist to enhance recommendation and delivery strategies.
• The 2-dose HPV vaccination schedule is perceived by physicians to improve adolescent series completion rates.
• Targeted interventions focusing on recommendation and communication styles may further improve HPV vaccine uptake.