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. 2025 Apr 2:51:126867.
doi: 10.1016/j.vaccine.2025.126867. Epub 2025 Feb 15.

Implementation of mid-adult HPV vaccination guidelines into clinical practice

Erika L Thompson  1 , Idara N Akpan  2 , Sarah Alkhatib  2 , Jessica Grace  3 , Gregory D Zimet  4 , Ellen M Daley  5 , Justin Luningham  6 , Christopher W Wheldon  7
Affiliations

Implementation of mid-adult HPV vaccination guidelines into clinical practice

Erika L Thompson et al. Vaccine. .

Abstract

Background: This study investigates the implementation of the 2019 U.S. guideline recommending shared clinical decision-making (SCDM) for HPV vaccination among mid-adults (ages 27-45) by health care providers.

Methods: A quota sample of 600 health care providers serving mid-adults in the U.S. was surveyed on their practices regarding HPV vaccination and the implementation of the SCDM guideline. The survey collected descriptive statistics and conducted bivariate analyses.

Results: Approximately 47 % of providers often or always engaged in shared clinical decision-making for HPV vaccinations, and 50 % offered the HPV vaccine, which significantly varied by provider type (p < 0.01). OB/GYNs had the highest frequency of always offering the vaccine (26 %), compared to family medicine (10 %) and internal medicine (12.5 %) providers. The major barriers identified were limited time (67 %) and perceived inadequate patient insurance coverage (65 %).

Conclusions: Despite approval of the shared clinical decision-making guideline for mid-adult HPV vaccination, implementation is inconsistent across different provider types, influenced by specific patient demographics. The identified barriers, including time constraints and insurance issues, impede uniform adoption of the guideline. Future initiatives should focus on tailored interventions for different provider disciplines to promote consistent and equitable health care delivery.

Keywords: Adults; Guideline implementation; HPV vaccination; Physicians.

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Conflict of interest statement

Declaration of competing interest The authors have disclosed the following conflicts of interest. ELT has served as a consultant and speaker for Merck, Inc. for HPV vaccination work unrelated to this project. Unrelated to this project, GDZ has served as a consultant to Merck, Inc. for HPV vaccination work and has served on external advisory boards for Moderna and Pfizer. In addition, he has received investigator-initiated funding from Merck administered through Indiana University.

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