HPV vaccine recommendations by age: A survey of providers in federally qualified health centers

Impact of visit characteristics on intention to recommend HPV vaccine: An experiment with US health care professionals

OBJECTIVE

Presumptive recommendations that assume parents want to vaccinate can increase human papillomavirus (HPV) vaccine uptake. We sought to examine how visit characteristics affect health care professionals' (HCPs) intention to use this evidence-based recommendation style.

METHODS

In 2022, we conducted an online experiment with 2527 HCPs who had a role in adolescent vaccination in the United States. Participants read 1 of 8 randomly assigned vignettes about a well-child visit. Using a 2 × 2 × 2 between-subjects factorial design, the vignettes varied the following visit characteristics: patient age (9 vs. 12-year-old), prior parental vaccine refusal (yes vs. no), and time pressure on the HCP (low vs. high). HCPs reported on their intention to use a presumptive HPV vaccine recommendation, as well as on related attitudes, subjective norms, and self-efficacy. Analyses used 3-way analysis of variance and parallel mediation.

RESULTS

Participants were pediatricians (26%), family/general medicine physicians (22%), advanced practitioners (24%), and nursing staff (28%). Overall, about two-thirds of HCPs (64%) intended to use a presumptive recommendation. Intentions were higher for older children (b = 0.23) and parents without prior vaccine refusal (b = 0.39, both p < 0.001). Time pressure had no main effect or interactions. HCPs' attitudes and self-efficacy partially mediated effects of patient age and prior vaccine refusal (range of b = 0.04-0.28, all p < 0.05).

CONCLUSION

To better support visits with younger children and parents who have refused vaccines, HCPs may need more training for making presumptive recommendations for HPV vaccine. Reinforcing positive attitudes and self-efficacy can help HCPs adopt this evidence-based recommendation style.

Mothers' perceptions and attitudes about HPV vaccination initiation among 9- and 10-year-olds

HPV vaccination has potential to prevent 90% of HPV-associated cancers. The Advisory Committee on Immunization Practices recommends HPV vaccination for 11- and 12-year-olds, but vaccine initiation can start at age 9. The purpose of this study was to explore perceptions about starting HPV vaccination at a younger age to inform future interventions that promote initiation at ages 9 and 10 years. This was part of a larger study about vaccine hesitancy among racially/ethnically diverse parents of adolescents in the Greater Newark Area of New Jersey. We thematically analyzed transcripts from 16 interviews with English- and Spanish-speaking mothers who had at least one child ≤ 10 years. Analyses focused on perceptions of HPV-related disease risk, attitudes toward HPV vaccination need, and vaccine confidence specifically for 9- and 10-year-olds. Few parents with young adolescents reported receiving vaccination recommendations, and only one reported series initiation before age 11. Mothers' hesitation about younger HPV vaccination initiation revolved around: 1) low perceived necessity among English-speaking mothers due to young adolescents not being sexually active, 2) concerns about potential side effects associated with vaccinating prepubescent adolescents, and 3) a desire for adolescents to be old enough to provide assent. Participants were not opposed to younger initiation but wanted and relied on pediatricians to inform them about vaccination for younger adolescents. These findings suggest mothers are willing to vaccinate at younger ages after clear provider recommendations. Equipping providers with evidence about vaccine safety and cancer prevention communication strategies may promote initiation and timely completion at younger ages.

Knowledge, Attitudes, and Perceptions Towards Human Papillomavirus (HPV) Vaccination Among Adult Women in Primary Health Care Centers in Makkah, Saudi Arabia

BACKGROUND

Human papillomavirus (HPV) is linked to cervical cancer, which is prevalent in Saudi Arabia. While HPV vaccines are effective, their coverage remains low in low- and middle-income countries. Public awareness of HPV vaccination is also limited. The study examines public awareness of cervical cancer, HPV, the HPV vaccine, and factors that hinder vaccine uptake.

OBJECTIVES

To assess the levels of knowledge, attitudes, and perceptions towards HPV vaccination among women aged 16 years and above in Makkah, Saudi Arabia.

METHODS

An analytical cross-sectional study was conducted using an interview questionnaire. A stratified sampling technique was used to select a representative sample of 534 female patients aged 16 years and older who visited primary healthcare centers in Makkah. The interview questionnaire included questions related to sociodemographic characteristics, knowledge about HPV vaccination, attitudes and perceptions toward HPV vaccination, and sources of information about HPV infection and vaccines. The data were analyzed using descriptive statistics and chi-square tests.

RESULTS

The majority of participants were aged between 21 and 40 years (76.4%), Saudi (90.3%), and had a higher education level (73.4%). Only a small proportion (1.9%-39%) of participants correctly answered most of the questions related to HPV vaccination, while a few questions were answered correctly by a larger proportion (41.6%-59.6%), highlighting the need for educational programs to increase awareness about the HPV vaccine. The internet and social media were the most prevalent sources of information about HPV infection and vaccines (48.4%). A majority of participants expressed willingness to receive the HPV vaccine if offered by the healthcare sector at no cost (65.5%). Concerns included fear of injection (27.7%), cost (23.2%), and potential refusal from family or community (9.7%). A significant proportion believed that there is a need for educational sessions to increase awareness about the HPV vaccine in their community (82.8%) and that increased knowledge about HPV vaccines would lead to greater acceptability (83.9%). Age, nationality, marital status, number of children, educational status, occupation, and average monthly income were significantly associated with knowledge about HPV vaccination (p < 0.05). Age and educational status were significantly associated with attitudes towards HPV vaccination (p < 0.05).

CONCLUSION

The lack of knowledge about HPV vaccination among adult women in Makkah, Saudi Arabia, is concerning, as it may result in low vaccine uptake rates and an increased incidence of HPV-related diseases. Therefore, targeted educational programs and awareness campaigns are crucial to enhance knowledge and promote the uptake of the HPV vaccine. These programs should be designed to provide accurate information about the prevalence of HPV, its associated risks, and the benefits of vaccination.