Human Papillomavirus Vaccinations: Provider Education to Enhance Vaccine Uptake

Abstract

Human papillomavirus (HPV) is the number one sexually transmitted infection (STI) worldwide. The Centers for Disease Control and Prevention (CDC) approximated that 92% of HPV-related cancers might be prevented by receiving the HPV 9-valent vaccine (Gardasil 9). The 2-dose HPV vaccine for children ages 11 to 12 years provides almost 100% protection against strains affiliated with cervical, vaginal, and vulvar cancers. Provider education is essential to decrease clinical knowledge deficits and increase vaccination uptake. Evidence-based provider recommendations expressed to eligible individuals improves vaccination rates. Evidence-based approaches for vaccine-hesitant parents involve using the presumptive announcement approach, asking for and addressing main concerns, and trying again if the parent initially declines. Seventy percent of parents who initially decide not to get their child vaccinated later agree to the vaccine or schedule a follow-up appointment. The CDC guidelines for HPV vaccinations, including the catch-up and adult guidelines, are reviewed. A clinical vignette with case scenarios and a Q&A quiz are included.

Challenges in the Diagnosis and Individualized Treatment of Cervical Cancer

“…With an annual regression rate of 15–23% and a regression rate of 55% in 4–6 years, CIN II is less likely to progress to cervical cancer. In contrast, CIN III has an annual progression rate to invasive carcinoma of 0.2–4% [ 6 ].…”

“…A prophylactic effect of the HPV vaccination with regard to vaccine-type-specific anogenital diseases has also been shown in women and men aged 14–45 years [ 9 ]. The Centers for Disease Control and Prevention (CDC) in the United States recommends a routine HPV vaccination at the age of 11 or 12 years, with the possible start of vaccination at the age of 9 years, a catch-up vaccination to the age of 26 years and a possible vaccination for adults from the age of 27 to 45 years [ 6 ].…”

“…A persistent high-risk HPV infection may cause invasive cervical, vulvar, vulvovaginal, penile, anal, oropharyngeal, or head and neck cancer [2]. The developmental phase from HPV infection to cervical cancer is about 20 years [6]. HPV types most commonly responsible for the development of cervical carcinoma include the high-risk HPV types 16,18,45,31,33,58,52,35,59,56,6,51,68,39,82, 73, 66 and 70.…”

“…The developmental phase from HPV infection to cervical cancer is about 20 years [6]. HPV types most commonly responsible for the development of cervical carcinoma include the high-risk HPV types 16,18,45,31,33,58,52,35,59,56,6,51,68,39,82, 73, 66 and 70. Cervical cancer arises from the CIN I-III lesions, which are also classified as low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL) and adenocarcinoma in situ (ACIS) [2].…”