Provider Confidence and Perceived Barriers when Recommending the Human Papillomavirus Vaccine to Parents

Provider recommendation for the HPV vaccine is considered a critical determinant of vaccine uptake compared to other interventions such as parent education. However, providers cite continued barriers to discuss the vaccines with parents including sexual concerns and other misconceptions. The purpose of this mixed methods study was to evaluate physician knowledge and comfort discussing the vaccine with parents and perceived barriers to vaccine uptake among pediatric residents and attending physicians at a university-affiliated county health clinic. Physicians completed surveys guided by HPV Roundtable information to assess HPV vaccine knowledge, comfortability, and parental barriers to administration. A total of 28 pediatric physicians (20 residents and 8 attendings) completed the survey. HPV vaccine knowledge was high among providers in this study, with 75% of providers reporting high confidence. The majority of physicians in this study reported being comfortable or very comfortable talking to parents about the HPV vaccine (82.1%), recommending the HPV vaccine (89.3%), and recommending the HPV vaccine specifically to hesitant parents (82.1%). Attendings were more comfortable than residents talking to (p = .009) and recommending the vaccine to parents (p = .002). However, physicians reported parents' sexual concerns, vaccine safety, and misconceptions as the predominant barriers. These findings suggest that persistent stigma about the HPV vaccine as prevention for sexually transmitted infection, rather than the HPV vaccine as cancer prevention persist. Findings from this study suggest the need for HPV vaccine education for parents and provider training on targeted communication strategies.