Using non-primary care clinical settings to increase HPV vaccination uptake: a scoping review

Despite evidence that over 90% of HPV-associated cancers can be prevented by the HPV vaccine, vaccination rates remain suboptimal. Specialty clinics that do not traditionally offer HPV vaccination, present an opportunity to improve vaccine uptake among adults. This scoping review evaluates the potential impact of HPV vaccination interventions on HPV-vaccination rates and acceptance in non-primary care settings.

Using the Arksey and O'Malley's scoping review framework, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR), Ovid MEDLINE, Embase, and Web of Science were queried to include articles published in US from 2006 to 2024 using search terms related to "human papillomavirus vaccination" and "specialty clinics".

Out of the 1752 studies identified, 10 studies met the inclusion criteria. Sample size ranged from 50 to 3709 participants and age range was 18-45 years. Settings included otolaryngology, obstetrics and gynecology, family planning, and substance health outpatient clinics. Baseline vaccination rate ranged from 5.2% to 47%. Five studies were interventional, evaluating the effects of patient counseling, pharmacist-physician education, free vaccination or mailed reminders on HPV vaccination rates. The interventions resulted in increases in vaccination rate with a range of 5.6% to 16%.

For adults eligible for HPV vaccination, specialty outpatient clinics may present a unique opportunity to discuss and deliver HPV vaccination, given that providers in these settings also treat HPV-associated diseases and are well equipped to engage in shared decision making with patients. Future research should focus on the acceptability, feasibility, and effectiveness of implementation of an HPV vaccination program in these settings.