Human papillomavirus vaccine series follow-through: comparison of four clinics in an academic medical center

AbstractObjectiveThe Centers for Disease Control & Prevention (CDC) recommends that the human papillomavirus (HPV) vaccine series be initiated at ages 11–12 years, but many children never follow-through with the series. By examining differences in clinic-specific vaccine series follow-through rates across four clinics, we aimed to identify best practices related to communication around the vaccine and pathways to follow-through.MethodsWe used the electronic medical record (EMR) to retrospectively analyze HPV vaccine follow-through at four clinic settings. We limited the sample to children ages 11–17 who received a dose of the vaccine series at any of the clinics between January 2015 and June 2018. The primary outcome was follow-through of the HPV vaccine series within 18 months of initiation.ResultsA total of 3,813 patients were included in this study, 29% of which followed through with the HPV vaccine series. There was significant variability of vaccine follow-through among the clinics (p<0.001), with the Med/Peds clinic having the highest rate of follow-through (32%). After adjusting for confounding variables, multivariable analysis found that Med/Peds and Family Medicine had higher odds of HPV vaccine series follow-through than the Pediatrics clinic.ConclusionsWe found that the likelihood of vaccine series follow-through was highest when the series was started in the Med/Peds and Family Medicine clinics, compared to Pediatrics and Adolescent Medicine. These results suggest that further qualitative research is needed to understand what communication strategies are most effective at facilitating HPV vaccine uptake among adolescents, and how the most effective strategies can be shared among clinics.

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Vaccine Hesitancy and Differential Susceptibility to Media Coverage: A Critical Documentary Led to Substantial Reductions in Human Papillomavirus Vaccine Uptake in Denmark

Medical Decision Making ◽

10.1177/0272989x211003589 ◽

2021 ◽

pp. 0272989X2110035

Author(s):

Maria Knoth Humlum ◽

Niels Skipper ◽

Peter Rønø Thingholm

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Media Coverage ◽

Differential Susceptibility ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Human Papillomavirus Vaccine ◽

Policy Makers ◽

Quasi Experimental ◽

Papillomavirus Vaccine

Objectives To investigate whether negative media coverage of the human papillomavirus (HPV) vaccine led to a decrease in the uptake of the first dose of the HPV vaccine (HPV1) in Denmark and, importantly, whether some groups of individuals were more susceptible to negative media coverage. Methods We measured HPV vaccine uptake of 12-year-old girls born in 2001 to 2004 using Danish administrative data. A quasi-experimental design was employed to assess whether a documentary that was critical of the HPV vaccine and aired in March 2015 affected HPV uptake. Results The documentary led to a quick and substantial decrease in the monthly propensity to vaccinate, which dropped 3 percentage points—or about 50%—in response to the documentary. Responses differed substantially across subgroups, and girls from families with high socioeconomic status (SES) were more susceptible to the negative media coverage. Conclusions Susceptibility to negative media coverage varied substantially across subgroups, highlighting the need for policy makers to appropriately target and differentiate initiatives to improve vaccine compliance rates.

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Predictors of Human Papillomavirus Vaccine uptake or intent among parents of preadolescents and adolescents

Journal of Nursing Education and Practice ◽

10.5430/jnep.v7n6p35 ◽

2017 ◽

Vol 7 (6) ◽

pp. 35 ◽

Cited By ~ 2

Author(s):

Kimberlee Dayal ◽

Sarah Robinson ◽

Jessica Schoening ◽

Mary Catherine Smith ◽

Son Chae Kim

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Parental Education ◽

Hpv Vaccination ◽

College Education ◽

Vaccine Effectiveness ◽

Vaccine Uptake ◽

Human Papillomavirus Vaccine ◽

Hpv Knowledge ◽

Hpv Vaccine Uptake

Aim: The aim of this study was to examine predictors of human papillomavirus (HPV) vaccine uptake or intent among parents of pre-adolescents and adolescents.Methods: A cross-sectional descriptive study was conducted among parents of girls aged 9 to 18 years, visiting two primary care clinics in central Texas from September to November 2015. Pearson’s product-moment correlation procedures and path analyses based on Health Belief Model were performed.Results: Path analysis showed that provider recommendation for HPV vaccination (β = 0.37; p < .001) and perceived HPV vaccine harm (β = -0.48; p < .001) had statistically significant direct effects on HPV vaccine uptake or intent. The perceived HPV vaccine effectiveness was directly influenced by HPV knowledge (β = 0.39; p < .001), empowerment in parent-provider relationships (β = 0.30; p = .006) and parental college education (β = 0.23; p = .039).}Conclusions: Together with parental empowerment fostering an equal partnership with providers, targeted education to improve parental HPV knowledge may convince them of the HPV vaccine effectiveness. This, in turn, may help them put the perceived HPV vaccine harm in proper perspective and allow them to make informed decisions regarding the timely HPV vaccination of their children. Because provider recommendation is one of the most important contributing factors for HPV vaccine uptake or intent, parental education and recommendations from nurses will help reduce the knowledge gaps and empower parents to make the timely decisions to vaccinate their children.

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Challenges to Human Papillomavirus Vaccine Acceptability among Women in South India: An Exploratory Study

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-1650 ◽

2021 ◽

Author(s):

Pooja Shah ◽

Veena Shetty ◽

Maithri Ganesh ◽

Avinash K. Shetty

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Exploratory Study ◽

Social Stigma ◽

Hpv Vaccination ◽

Scale Up ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Human Papillomavirus Vaccine ◽

Barriers And Challenges

Cervical cancer is the second leading cause of cancer and one of the leading causes of cancer-related death in women in India. Human papillomavirus (HPV) vaccine uptake in India is low due to cost, low awareness of HPV, social stigma, and other factors. We assessed the awareness, attitudes, and beliefs regarding HPV and HPV vaccination and explored the barriers and challenges to HPV vaccine intent among women in Mangalore, India. An exploratory study was conducted using two focus group discussions (FGDs) and six in-depth one-on-one interviews. FGD-1 comprised nine women aged 18 to 26 years, and FGD-2 comprised seven women aged 27 to 45 years. The FGDs were recorded, transcribed, and analyzed using thematic content analysis. Themes identified were limited knowledge of HPV and vaccine, stigma associated with receiving HPV vaccine, vaccine safety concerns, and cost as a barrier to receiving vaccine. Participants expressed desire for physician and government recommendation of the HPV vaccine to validate vaccine intent. Contrasting themes between the two FGDs include support for vaccination at a younger age and lower perception of stigma and judgment in the 18- to 26-year-old group; however, participants in the 27- to 45-year-old group support vaccination at an older age and endorse greater fear of stigma and judgment associated with obtaining vaccination. Education regarding HPV-associated diseases and the HPV vaccine for the general public, physicians, and government officials in conjunction with lowering vaccine cost, improving vaccine access, and encouraging strong physician recommendations are key strategies to scale up HPV vaccine implementation in India.

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Vaccipack, A Mobile App to Promote Human Papillomavirus Vaccine Uptake Among Adolescents Aged 11 to 14 Years: Development and Usability Study

JMIR Nursing ◽

10.2196/19503 ◽

2020 ◽

Vol 3 (1) ◽

pp. e19503

Author(s):

Anne M Teitelman ◽

Emily F Gregory ◽

Joshua Jayasinghe ◽

Zara Wermers ◽

Ja H Koo ◽

...

Keyword(s):

Human Papillomavirus ◽

Technology Acceptance ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Behavioral Model ◽

The United States ◽

Mobile App ◽

Vaccine Uptake ◽

Human Papillomavirus Vaccine ◽

Vaccination Rates

Background More than 90% of human papillomavirus (HPV)-related cancers could be prevented by widespread uptake of the HPV vaccine, yet vaccine use in the United States falls short of public health goals. Objective The purpose of this study was to describe the development, acceptability, and intention to use the mobile app Vaccipack, which was designed to promote uptake and completion of the adolescent HPV vaccine series. Methods Development of the mobile health (mHealth) content was based on the integrated behavioral model (IBM). The technology acceptance model (TAM) was used to guide the app usability evaluation. App design utilized an iterative process involving providers and potential users who were parents and adolescents. App features include a vaccine-tracking function, a discussion forum, and stories with embedded messages to promote intention to vaccinate. Parents and adolescents completed surveys before and after introducing the app in a pediatric primary care setting with low HPV vaccination rates. Results Surveys were completed by 54 participants (20 adolescents aged 11 to 14 years and 34 parents). Notably, 75% (15/20) of adolescents and 88% (30/34) of parents intended to use the app in the next 2 weeks. Acceptability of the app was high among both groups: 88% (30/34) of parents and 75% (15/20) of adolescents indicated that Vaccipack was easy to use, and 82% (28/34) of parents and 85% (17/20) of adolescents perceived the app to be beneficial. Higher levels of app acceptability were found among parents with strong intentions to use the app (P=.09; 95% CI –2.15 to 0.15). Conclusions mHealth technology, such as Vaccipack, may be an acceptable and nimble platform for providing information to parents and adolescents and advancing the uptake of important vaccines.

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Human Papillomavirus Vaccine Predictors Among U.S. Adults Aged 18 to 45 by Sexual Orientation

Western Journal of Nursing Research ◽

10.1177/0193945919836448 ◽

2019 ◽

Vol 41 (12) ◽

pp. 1761-1789 ◽

Cited By ~ 2

Author(s):

JaHyun Kang ◽

Kyounghae Kim

Keyword(s):

Human Papillomavirus ◽

Sexual Orientation ◽

Educational Attainment ◽

Hpv Vaccine ◽

Sexual Minorities ◽

Hpv Vaccination ◽

Vaccine Uptake ◽

Human Papillomavirus Vaccine ◽

Higher Educational ◽

Higher Educational Attainment

Despite increased incidence rates of human papillomavirus (HPV)-associated cancers among sexual minorities, their HPV vaccine uptake remains suboptimal. This cross-sectional, correlational study aimed to investigate factors associated with HPV vaccination among a nationally representative sample of U.S. young adults by sexual orientation. We used the 2014 to 2017 Behavioral Risk Factor Surveillance System data for adults aged 18 to 45 years. HPV vaccination initiation was associated with being female and Hispanic, having higher educational attainment, and having ever been tested for HIV, whereas completion was associated with being female and non-Hispanic White and having higher educational attainment. Compared with those who reported identifying as straight, the lesbian or gay respondents were found to have been less likely not to complete the series. Providers should play a crucial part in addressing missed opportunities for HPV vaccination by implementing culturally competent communication strategies to empower sexual minorities to make informed HPV vaccine decisions.

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Vaccipack, A Mobile App to Promote Human Papillomavirus Vaccine Uptake Among Adolescents Aged 11 to 14 Years: Development and Usability Study (Preprint)

10.2196/preprints.19503 ◽

2020 ◽

Author(s):

Anne M Teitelman ◽

Emily F Gregory ◽

Joshua Jayasinghe ◽

Zara Wermers ◽

Ja H Koo ◽

...

Keyword(s):

Human Papillomavirus ◽

Technology Acceptance ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Behavioral Model ◽

The United States ◽

Mobile App ◽

Vaccine Uptake ◽

Human Papillomavirus Vaccine ◽

Vaccination Rates

BACKGROUND More than 90% of human papillomavirus (HPV)-related cancers could be prevented by widespread uptake of the HPV vaccine, yet vaccine use in the United States falls short of public health goals. OBJECTIVE The purpose of this study was to describe the development, acceptability, and intention to use the mobile app Vaccipack, which was designed to promote uptake and completion of the adolescent HPV vaccine series. METHODS Development of the mobile health (mHealth) content was based on the integrated behavioral model (IBM). The technology acceptance model (TAM) was used to guide the app usability evaluation. App design utilized an iterative process involving providers and potential users who were parents and adolescents. App features include a vaccine-tracking function, a discussion forum, and stories with embedded messages to promote intention to vaccinate. Parents and adolescents completed surveys before and after introducing the app in a pediatric primary care setting with low HPV vaccination rates. RESULTS Surveys were completed by 54 participants (20 adolescents aged 11 to 14 years and 34 parents). Notably, 75% (15/20) of adolescents and 88% (30/34) of parents intended to use the app in the next 2 weeks. Acceptability of the app was high among both groups: 88% (30/34) of parents and 75% (15/20) of adolescents indicated that Vaccipack was easy to use, and 82% (28/34) of parents and 85% (17/20) of adolescents perceived the app to be beneficial. Higher levels of app acceptability were found among parents with strong intentions to use the app (<i>P</i>=.09; 95% CI –2.15 to 0.15). CONCLUSIONS mHealth technology, such as Vaccipack, may be an acceptable and nimble platform for providing information to parents and adolescents and advancing the uptake of important vaccines.

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Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk–benefit balance

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.17.17-00816 ◽

2018 ◽

Vol 23 (17) ◽

Cited By ~ 22

Author(s):

Dominique Rey ◽

Lisa Fressard ◽

Sébastien Cortaredona ◽

Aurélie Bocquier ◽

Arnaud Gautier ◽

...

Keyword(s):

Human Papillomavirus ◽

Elderly People ◽

Perceived Risk ◽

Multivariable Analysis ◽

Vaccine Uptake ◽

World Health ◽

Vaccine Hesitancy ◽

Human Papillomavirus Vaccine ◽

French Population ◽

Cross Sectional

Background Vaccine hesitancy (VH) is prominent in France. Objectives: This study aimed to estimate the prevalence and socio-demographic correlates of VH in sub-groups of the French population and to investigate the association of VH with both vaccine uptake and perceived risk–benefit balance (RBB) for four vaccines. Methods: During the 2016 Health Barometer – a national cross-sectional telephone survey in a representative sample of the French population – parents of 1–15 year-old children, parents of 11–15 year-old girls and elderly people aged 65–75 years were asked about VH (using three questions adapted from the World Health Organization definition), vaccine uptake and perceived RBB for measles and hepatitis B (children’s parents), human papillomavirus (girls’ parents) and seasonal influenza (elderly people) vaccines. Results: A total of 3,938 parents including 959 girls' parents – and 2,418 elderly people were interviewed. VH prevalence estimates were 46% (95% confidence interval (CI): 44–48) among parents, 48% (95%CI: 45–51) among girls’ parents and 35% (95% CI: 33–36) among elderly people, with higher estimates associated with high education level, children’s age (10–15 years), and, for the elderly, poor perception of health status. VH was associated with uncertainty about and/or an unfavourable perception of vaccines’ RBB for the four vaccines and with lower self-reported vaccine uptake, except for human papillomavirus vaccine in girls. Results were confirmed by multivariable analysis. Conclusion: Further research is needed to study the association between VH and vaccine uptake for other vaccines, and to design and validate measurement tools to monitor VH over time.

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Human Papillomavirus Vaccine Frequency for University of Kansas Medical Center Pediatric Patients

Kansas Journal of Medicine ◽

10.17161/kjm.v9i1.8593 ◽

2019 ◽

Vol 9 (1) ◽

pp. 1-5

Author(s):

Mariana Theodoro ◽

Andrew Demo ◽

Cara Katzer ◽

Clinton Katzer ◽

Pam Shaw ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Pediatric Patients ◽

Medical Center ◽

Hpv Vaccination ◽

Vaccine Dose ◽

Retrospective Chart Review ◽

Human Papillomavirus Vaccine ◽

University Of Kansas ◽

Kansas Medical

Background. Human papillomavirus (HPV) vaccination is recommendedfor all adolescents aged 11 to 12 years, but coveragein Kansas is exceptionally poor. To understand local coverage, receiptof the 3-dose HPV vaccine series among pediatric patients atthe University of Kansas Medical Center (KUMC) was evaluated. Methods. All patients aged 11 to 12 years who were seen by aKUMC primary care provider (family medicine and pediatrics)in 2013 were included in the retrospective chart review. Recordswere reviewed through December 31, 2014 to capture the numberof HPV doses received, and receipt of other recommendedvaccines (tetanus-diphtheria-pertussis and meningococcal conjugate).Pearson’s chi-squared tests were used to evaluate relationshipsbetween HPV vaccination and patient characteristics. Results. Of the 261 eligible females and 243 eligible males, 71.2%received ≥ 1 HPV vaccine dose, 55.2% received ≥ 2 doses, and39.3% completed the HPV vaccine series (3 doses). Although vaccineinitiation was slightly lower in males compared to females(67.1% vs. 75.1%, p = 0.047), no difference in vaccine completionwas seen between males and females (37.0% vs. 41.7%, p = 0.319).Over 80% of patients received other concurrently recommendedvaccines (Tdap: 81.7%, meningococcal: 81.3%). HPV series completionoccurred more often among Spanish-speaking femalescompared to English-speaking females (59.5% vs 37.7%; p < 0.01).Conclusions. The proportion of adolescents who received theHPV vaccination at KUMC is substantially higher than nationaland state estimates, but there is room for improvement forboth initiation and series completion. KS J Med 2016;9(1):1-5.

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Creditable Health Information? An Analysis of Human Papillomavirus Vaccine Messages on YouTube

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2021/v7i130205 ◽

2021 ◽

pp. 8-16

Author(s):

Angela Chia-Chen Chen ◽

Elizabeth Reifsnider ◽

Lihong Ou ◽

Steven Samrock ◽

Renuka Vemuri ◽

...

Keyword(s):

Human Papillomavirus ◽

Health Information ◽

Hpv Vaccine ◽

Medical Center ◽

Health Belief ◽

Primary Vaccination ◽

Hpv Infection ◽

Human Papillomavirus Vaccine ◽

Transmitted Infection ◽

Youtube Videos

Aims: Human papillomavirus (HPV) infection is the most common sexually transmitted infection globally. Vaccination is effective in preventing HPV-associated cancers and is recommended for children at ages 11-12; however, the vaccination rate is suboptimal. Credible information about HPV vaccine in social media will help the public make effective healthcare decisions. This study analyzed YouTube videos about HPV vaccine. Study Design: Descriptive study. Place and Duration of Study: Videos in English posted on YouTube during 2006-2020. Methodology: We used purposive sampling to select and conduct a quantitative content analysis of 151 YouTube videos that met the criteria. An instrument including video characteristics and theoretical constructs of the Health Belief Model was used to code the videos. Three researchers independently coded the data; another three verified the accuracy. The team discussed discrepancies until reaching a consensus. We conducted descriptive and inferential statistics. Results: The major source of videos were medical centers/hospitals (26%), government (22%), media (20%), and consumers (15%). About 80% of the videos were positive in tone. Information covered included vaccine knowledge (85.4%), benefits (81.5%), severity if infected (79.5%), susceptibility (60.9%), and barriers (37.7%). The primary vaccination barriers were lack of knowledge of HPV and vaccine (12.6%), worries about adverse events/safety of vaccine (14.6%) and its side effects (9.3%). Videos in neutral tone had the highest number of views, likes and dislikes. Negative tone was mostly found in videos made by consumers and media while positive tone was found in videos made by governmental agencies and medical center/hospital. Conclusion: Despite YouTube being a popular avenue to disseminate health information and influence care, the HPV-related information on YouTube is mixed. Anecdotal health information without scientific support can mislead individuals’ decision in vaccination. Educational videos with comprehensive and accurate HPV information addressing barriers are imperative to promote vaccination and prevent HPV-related cancers.

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An economic and disease transmission model of human papillomavirus and oropharyngeal cancer in Texas

Scientific Reports ◽

10.1038/s41598-021-81375-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chengxue Zhong ◽

Li Xu ◽

Ho-Lan Peng ◽

Samantha Tam ◽

Li Xu ◽

...

Keyword(s):

Public Health ◽

Human Papillomavirus ◽

Oropharyngeal Cancer ◽

Hpv Vaccine ◽

Health Benefits ◽

Incidence Rates ◽

Vaccine Uptake ◽

Males And Females ◽

Quality Adjusted Life ◽

The U.S

AbstractIn 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.

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