Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;24(11):1673-9.
doi: 10.1158/1055-9965.EPI-15-0326. Epub 2015 Oct 22.

Quality of physician communication about human papillomavirus vaccine: findings from a national survey

Melissa B Gilkey  1 , Teri L Malo  2 , Parth D Shah  3 , Megan E Hall  3 , Noel T Brewer  2
Affiliations

Quality of physician communication about human papillomavirus vaccine: findings from a national survey

Melissa B Gilkey et al. Cancer Epidemiol Biomarkers Prev. 2015 Nov.

Abstract

Background: Improving the quality of physicians' recommendations for human papillomavirus (HPV) vaccination is critical to addressing low coverage. Thus, we sought to describe HPV vaccine communication practices among primary care physicians.

Methods: Pediatricians and family physicians (n = 776) completed our national online survey in 2014. We assessed the quality of their HPV vaccine recommendations on strength of endorsement (i.e., saying the vaccine is important), timeliness (recommending it by ages 11-12), consistency (recommending it routinely vs. using a risk-based approach), and urgency (recommending same-day vaccination).

Results: A sizeable minority of physicians reported that they do not strongly endorse HPV vaccine (27%) or deliver timely recommendations for girls (26%) or boys (39%). Many physicians (59%) used a risk-based approach to recommending HPV vaccine, and only half (51%) usually recommended same-day vaccination. Overall recommendation quality was lower among physicians who were uncomfortable talking about HPV vaccine or who believed parents did not value it. Quality was higher among physicians who began discussions by saying the child was due for HPV vaccine versus giving information or eliciting questions.

Conclusion: Many physicians in our national sample reported recommending HPV vaccine inconsistently, behind schedule, or without urgency. These practices likely contribute to under-immunization among adolescents, and may convey ambivalence to parents.

Impact: As one of the first studies to assess multiple aspects of recommendation quality, these findings can inform the many state and national initiatives that aim to improve communication about HPV vaccine so as to address the persistent underuse of a powerful tool for cancer prevention.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The remaining authors (Melissa Gilkey, Teri Malo, Parth Shah, and Megan Hall) have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Distribution of composite scores for HPV vaccine recommendation quality (n=776).
Figure 2
Figure 2
Risk groups physicians target for HPV vaccination, among those using a risk-based recommendation approach (n=460).
See this image and copyright information in PMC

Comment in

References

    1. President’s Cancer Panel Annual Report. Accelerating HPV vaccine uptake: urgency for action to prevent cancer. A report to the President of the United States from the President’s Cancer Panel. Bethesda, MD: National Cancer Institute; 2014.
    1. Stokley S, Jeyarajah J, Yankey D, Cano M, Gee J, Roark J, et al. Human papillomavirus vaccination coverage among adolescents, 2007–2013, and postlicensure vaccine safety monitoring, 2006–2014--United States. MMWR Morb Mortal Wkly Rep. 2014;63:620–624. - PMC - PubMed
    1. Crowe E, Pandeya N, Brotherton JM, Dobson AJ, Kisely S, Lambert SB, et al. Effectiveness of quadrivalent human papillomavirus vaccine for the prevention of cervical abnormalities: case-control study nested within a population based screening programme in Australia. BMJ. 2014;348:g1458. - PMC - PubMed
    1. Ali H, Donovan B, Wand H, Read TR, Regan DG, Grulich AE, et al. Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ. 2013;346:f2032. - PubMed
    1. Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep. 2014;63:1–30. - PubMed

Publication types

Substances