Improving pharmacy-based HPV vaccine delivery through communication training: Findings from a pilot feasibility study

Human papillomavirus (HPV) vaccination coverage among U.S. adolescents remains below national targets. Community pharmacies are highly accessible vaccination venues, but staff need to enhance practical skills to identify vaccine-eligible adolescents and communicate effectively with parents.

To evaluate the acceptability and feasibility of a team-based HPV vaccine communication training for pharmacy staff.

We used a single-group pre/post-test design in 3 community pharmacies in Washington State between December 2022 and May 2023. The prerecorded online vaccine communication training integrated vaccine eligibility forecasting with 5A's counseling and Announcement Approach recommendation language. Pharmacy staff involved in adolescent immunizations completed baseline (n = 18) and follow-up (n = 13) online surveys assessing behavioral outcomes related to adolescent HPV vaccination before and after completing the training. Adolescent vaccination counts were audited for pre- (February-May 2022) and post-implementation (February-May 2023) periods.

The proportion of staff reporting strong HPV vaccine recommendations increased from 22% preimplementation to 67% postimplementation (P = 0.016). The proportion of staff recommending HPV vaccination starting at ages 9-12 increased from 33% to 50% for both female and male adolescents, though this was not statistically significant (P = 0.324). Self-efficacy improved for personal interactions (mean 2.8 to 3.4; P = 0.004), goal setting (2.7 to 3.5; P = 0.004), and addressing hesitancy (2.6 to 3.3; P = 0.010). Postimplementation, staff rated the acceptability (mean 4.1/5), appropriateness (4.0/5), and feasibility (4.1/5) of pharmacy-based HPV vaccination favorably. Vaccination audits showed increased HPV doses at one pharmacy (2 doses to 20 doses) and no change at the other pharmacy (1 dose to 1 dose). The third pharmacy did not administer any adolescent vaccinations during the postimplementation period.

A team-based HPV vaccine communication training was acceptable and feasible and improved staff-reported HPV recommendation behaviors, with heterogeneous short-term changes in HPV vaccination delivery. Larger multisite studies with longer observation periods are needed to evaluate effects on vaccination uptake.