Assessment of emergency department patient interest in human papillomavirus vaccination

Cancer interventions focused on primary prevention have largely ignored the emergency department (ED). Expanding risk-based ED vaccination to include human papillomavirus (HPV) vaccination as primary cancer prevention is aligned with existing ED-based population health efforts. Our objective was to estimate patient willingness to obtain HPV vaccination in the ED.

This cross-sectional survey enrolled a representative sample of consenting, randomly approached, adult patients aged 18-64 years at an urban academic ED and affiliated community ED. The primary outcome was the proportion who had not received prior HPV vaccination based on self-report or electronic medical record documentation and their willingness to be vaccinated during an ED visit if HPV vaccination was available. We secondarily assessed HPV knowledge, documentation of HPV vaccination status, and access to routine clinical care for primary prevention interventions.

Of 216 patients randomized for approach, 65 (30%) were enrolled, 51 (76%) of whom had no self-report or EMR documentation of prior HPV vaccination. Of those 51 patients, 37 (73%) would have been willing to receive ED-based HPV vaccination if it were available. The average HPV knowledge score was 8.1 out of 13 (62%). Of the enrolled patients, 55 (85%) reported having a place of usual care other than the ED or urgent care to obtain preventive care.

The majority of respondents were not previously vaccinated against HPV, but were willing to receive ED-based vaccination. These results support the opportunity for additional studies designed to explore operationalization and feasibility of ED-based HPV vaccination strategies.