HPV Vaccine Delivery Practices by Primary Care Physicians

Details

• Alternative Title:
  Pediatrics
• Personal Author:
  Kempe, Allison ; O’Leary, Sean T. ; Markowitz, Lauri E. ; Crane, Lori A. ; Hurley, Laura P. ; Brtnikova, Michaela ; Beaty, Brenda L. ; Meites, Elissa ; Stokley, Shannon ; Lindley, Megan C.
• Description:
  Back and Objectives:
  
  To examine, among pediatricians (Peds) and family physicians (FPs): 1) HPV vaccine delivery practices; 2) delivery experiences; and 3) attitudes regarding new 2-dose HPV vaccination schedules.
  
  Methods:
  
  We surveyed nationally representative networks of Peds and FPs by internet/mail from 7/2018–9/2018. Multivariable regression (MV) assessed factors associated with refusal/deferral rates of ≥50% among 11–12 y.o. patients.
  
  Results:
  
  Response rate was 65% (302 Peds; 228 FPs included). Peds strongly recommending HPV vaccine ranged from 99% for ≥15 y.o.(among females) to 83% (males) for 11–12 y.o patients; FPs ranged from 90% (females) for ≥15 y.o. to 66% (males) for 11–12 y.o. (p<.0001 between specialties). 65% of Peds and 42% of FPs always/almost always used presumptive style when discussing HPV vaccine (p<.0001). Overall, 40% used standing orders and 42% had electronic alerts. Proportion reporting ≥50% refusal/deferral among Peds was 19% for female and 23% for male 11–12 y.o.; FPs reported 27% and 36%, respectively. In MV (both genders), refusal/deferral was associated with physicians not “strongly recommending” to 11–12 y.o., not using a presumptive style, perceiving less resistance introducing at 13 than 11–12 y.o. and anticipating an uncomfortable conversation when recommending to 11–12 y.o. 89% of Peds and 79% of FPs reported more adolescents <15 y.o. are completing the HPV series now that only 2 doses are recommended.
  
  Conclusions:
  
  Although most physicians strongly recommend HPV vaccine to 11–12 y.o., our data identifies areas for improvement in recommendation and delivery methods. Most physicians perceive the 2-dose schedule is resulting in higher HPV completion rates.
  
  
• Subjects:
  Adolescent Age Factors Article Attitude Of Health Personnel Child Communication Female Health Care Surveys Health Knowledge, Attitudes, Practice Humans Male Middle Aged Papillomavirus Infections Papillomavirus Vaccines Pediatricians Physicians, Family Physicians, Primary Care Practice Patterns, Physicians' Regression Analysis Sex Factors Vaccination Refusal

  More +
• Source:
  Pediatrics. 144(4)
• Pubmed ID:
  31527175
• Pubmed Central ID:
  PMC8297056
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 IP001072/IP/NCIRD CDC HHSUnited States/ ; U01IP001072/ACL/ACL HHSUnited States/
• Volume:
  144
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7b2dc63d94dca340fdd02bdc8809d93cffa5ab3dbe537cabb4db9497e305a49d
• Download URL:
  https://stacks.cdc.gov/view/cdc/108285/cdc_108285_DS1.pdf
• File Type:
  [PDF - 2.28 MB ]