Initiating Human Papillomavirus Vaccination at Age 9: Strategies for Success From 5 US Health Systems

Area of Science:

• Public Health
• Vaccinology
• Health Systems Research

Background:

• Human papillomavirus (HPV) infection remains a significant public health concern due to persistent high prevalence.
• Suboptimal HPV vaccination rates contribute to the ongoing burden of HPV-related diseases.
• Initiating HPV vaccination at age 9 is a key strategy to improve coverage and reduce long-term health impacts.

Purpose of the Study:

• To explore successful strategies for routine human papillomavirus (HPV) vaccination initiation at age 9 in US health systems.
• To identify and share best practices for increasing HPV vaccination rates nationwide.
• To understand interventions that facilitate early HPV vaccination uptake.

Main Methods:

• A mixed-methods study guided by the Consolidated Framework for Implementation Research was conducted across 5 diverse US health systems.
• Surveys (n=497) and interviews (n=10) were used to gather data from healthcare professionals including pediatricians, nurses, and administrators.
• Quantitative and qualitative analyses, including content analysis and data reduction, were applied to identify common themes and successful interventions.

Main Results:

• Successful interventions for initiating HPV vaccination at age 9 included data sharing on vaccination rates, securing leadership and staff buy-in, optimizing electronic health records, and providing provider/staff training.
• Early patient and family education was identified as a crucial component for successful implementation.
• Diverse participants, including clinicians and health system leaders, contributed to identifying effective practices.

Conclusions:

• Initiating human papillomavirus (HPV) vaccination at age 9 is feasible in US health systems.
• Successful implementation requires identifying and addressing barriers at multiple levels: patient/family, provider/staff, and organizational.
• Multitiered interventions are essential for effectively implementing and sustaining HPV vaccination programs.