Assessing Human Papillomavirus Awareness and the Role of Oropharyngeal Squamous Cell Carcinoma Education on Improving Intention to Vaccinate

Abstract

Objectives/Hypothesis: The current state of the U.S. public's knowledge of the relationship between human papillomavirus (HPV) and HPV vaccinations to oropharyngeal squamous cell carcinoma (OPSCC) is unknown. Our objective was to 1) assess the general population's knowledge of human papillomavirus (HPV) and willingness to vaccinate, and 2) assess whether targeted education on HPV-related OPSCC can change intentions to vaccinate.Study Design: Online cross-sectional survey.Methods: An online, cross-sectional survey utilizing U.S. census-derived quotas to represent the U.S. population was distributed and analyzed to 517 adults in 2020.Results: Exactly 72.7% of participants stated that they had or would vaccinate their child against HPV and were designated as "vaccinators." In multivariate regression, Black individuals were less likely to be vaccinators (OR 0.51 [95% CI 0.27-0.94]), but those who were aware of HPV's role in OPSCC were more likely to vaccinate ). Knowledge about vaccination side-effects, eligibility, and mechanisms of HPV spread was low. Only 30.6% of the sample reported understanding the role of HPV in OPSCC. Of these, 43.0% gained this knowledge exclusively from nonhealthcare professional sources, like television. When presented with four short HPV-OPSCC-centered facts (HPV's role in OPSCC etiology, prevalence of infection, clinically silent course, and vaccine preventative effects), 54.0% of "nonvaccinators" indicated a willingness to change their minds.Conclusions: General knowledge about HPV, HPV's role in OPSCC, and the vaccine remains low in the general population. There are racial disparities in willingness to vaccinate within this sample, but these may be overcome by effective education on HPV-related OPSCC.

Feasibility of Instituting a Clinical Otolaryngology Human Papillomavirus (HPV) Vaccination Program

“…27 This study also revealed 36% of patients selected an Otolaryngologist as their ideal way to be educated on HPV's role in OPSCC. 27 Otolaryngology practices, including those with an imbedded Audiology practice who see a significant number of eligible patients, are a unique position to speak to HPV related diseases, see a large volume of both adolescent male and female patients who are due for HPV POCV, may be able to give a strong recommendation for vaccination, and facilitate its administration to decreased MO and increase community vaccination rates. One consideration for Oto-HNS providers is whether adding vaccination capabilities would place a significant burden on the clinic to make vaccination fiscally or logistically unviable.…”

“…8 Consequently, this new knowledge has not yet fully permeated the medical community, resulting in understandably low awareness of the role of HPV vaccination in head and neck cancer prevention among both patients and providers. 27 Another probable reason for this sex-mediated vaccine discrepancy could be the continuity of care that female patients have with OBGYN providers, who are frequently equipped to administer the HPV vaccine. Finally, targeted marketing campaigns associating the HPV vaccine with protection from cervical cancer, which strongly associates the risk of malignancy with the sexual transmission in females and typically does not address the risk to males, may also have played a role in low vaccination rates among males.…”

“…Importantly, the relationship between HPV infection and oropharyngeal cancer is a relatively new discovery; indeed, the HPV vaccine did not receive FDA approval for the prevention of head and neck cancers until 2020 8 . Consequently, this new knowledge has not yet fully permeated the medical community, resulting in understandably low awareness of the role of HPV vaccination in head and neck cancer prevention among both patients and providers 27 . Another probable reason for this sex‐mediated vaccine discrepancy could be the continuity of care that female patients have with OBGYN providers, who are frequently equipped to administer the HPV vaccine.…”

“…A clinical interventions bundle, including offering no‐cost HPV vaccination, initiated at an OBGYN clinic resulted in statistically significant increases in patients both initiating and completing the HPV vaccination series, with an increase of 29.7% and 20.3% respectively 25 . A 2021 study by Torabi et al demonstrated that only 30.6% of patients understood the relationship between HPV infection and OPSCC, and that learning about this relationship may increase vaccine uptake 27 . This study also revealed 36% of patients selected an Otolaryngologist as their ideal way to be educated on HPV's role in OPSCC 27 .…”

“…A 2021 study by Torabi et al demonstrated that only 30.6% of patients understood the relationship between HPV infection and OPSCC, and that learning about this relationship may increase vaccine uptake 27 . This study also revealed 36% of patients selected an Otolaryngologist as their ideal way to be educated on HPV's role in OPSCC 27 . Otolaryngology practices, including those with an imbedded Audiology practice who see a significant number of eligible patients, are in a unique position to speak to HPV related diseases, see a large volume of both adolescent male and female patients who are due for HPV POCV, may be able to give a strong recommendation for vaccination, and facilitate its administration to decreased MO and increase community vaccination rates.…”