Human Papillomavirus Vaccine Uptake in Texas Pediatric Care Settings: A Statewide Survey of Healthcare Professionals

Abstract

The purpose of this study was to identify barriers to and facilitators of human papillomavirus (HPV) vaccination in children aged 9–17 years across Texas. A literature review informed the development of a web-based survey designed for people whose work involves HPV vaccination in settings serving pediatric patients. The survey was used to examine current HPV vaccine recommendation practices among healthcare providers, barriers to HPV vaccination, reasons for parent/caregiver vaccine refusal, staff and family education practices, utilization of reminder and recall systems and status of vaccine administration (payment, ordering and stocking). 1132 responses were received representing healthcare providers, administrative and managerial staff. Respondents identified perceived barriers to HPV vaccination as parental beliefs about lack of necessity of vaccination prior to sexual debut, parental concerns regarding safety and/or side effects, parental perceptions that their child is at low risk for HPV-related disease, and parental lack of knowledge that the vaccine is a series of three shots. Of responding healthcare providers, 94% (n= 582) reported they recommend the vaccine for 9–12 year olds; however, same-day acceptance of the vaccine is low with only 5% (n=31) of providers reporting the HPV vaccine is “always” accepted the same day the recommendation is made. Healthcare providers and multidisciplinary care teams in pediatric care settings must work to identify gaps between recommendation and uptake to maximize clinical opportunities. Training in methods to communicate an effective HPV recommendation and patient education tailored to address identified barriers may be helpful to reduce missed opportunities and increase on-time HPV vaccinations.

Parental knowledge gaps and barriers for children receiving human papillomavirus vaccine in the Rio Grande Valley of Texas

“…Although the survey of Texas healthcare practitioners reports HPV vaccination recommendations at 94%, 34 this percentage is much lower in this study. There was a nearly even split on whether healthcare providers had recommended or not recommended the HPV vaccine to the study sample.…”

“…[31][32][33] A recent survey of Texas healthcare providers found that 94% self-reported giving a consistent recommendation of HPV vaccination to 9-12-year-old children of both sexes. 34 Factors associated with vaccine uptake Factors shown to be positively associated with parents' uptake of HPV vaccines for their children include: (1) healthcare providerphysician recommendation and parents' trust in healthcare providers, 20,21,25,26,33 (2) mother as HPV vaccine decision-maker versus both parents, 20 (3) parents' vaccine beliefs, attitudes, and intentions, 20,35 (4) preventive healthcare utilization for child, 28 (5) insurance / costhealth insurance coverage of HPV vaccination, 28 (6) parents' HPV risk history, 20 7parents' HPV-related knowledge and awareness, 28 and (8) sociodemographic factorsurban versus rural location and child's age. 20,21,25,26,33 For those who have chosen to not vaccinate against HPV, parents cite lack of knowledge and worry about the side effects or safety of the vaccine as the primary reasons for vaccine hesitancy.…”

Human Papillomavirus Vaccine Program

“…(Leib et al, 2011). Javaid et al (2017) conducted a study on the barriers to the Gardasil vaccine. The researchers sent surveys via email to medical facilities in the state of…”

“…A descriptive statistics analysis was conducted using the survey software, Qualtrics. Javaid et al (2017) found that parental perceptions about HPV, parental knowledge, and safety concerns were barriers affecting Gardasil vaccine rates (Javaid et al, 2017).…”

“…Parents often consider the medical advice given to them by their primary care provider the best for their children's health decisions. Parents may rely on the primary care providers' medical advice to make decisions about medical care, including preventative care such as vaccines (Javaid et al, 2017).…”