Identifying and Overcoming Perceived Barriers of Providers towards HPV Vaccination: A Literature Review

Abstract

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States associated with nearly 26,000 cases of cancer annually. With the recent addition of Gardasil 9, three vaccines are now licensed by the Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices (ACIP) for HPV prevention. While providers are the preferred source in educating individuals on HPV and HPV vaccination, low uptake percentages indicate that providers are missing valuable opportunities to educate and strongly recommend HPV vaccination. It is critical to examine perceived barriers and attitudes among providers related to HPV and HPV vaccination to identify factors that influence vaccination coverage. This paper aims to expand provider knowledge and awareness of factors that may facilitate an increase in HPV vaccination coverage and subsequent cancer prevention.

Why don’t adolescent girls in a rural Uganda district initiate or complete routine 2-dose HPV vaccine series: Perspectives of adolescent girls, their caregivers, healthcare workers, community health workers and teachers

“…Sub- optimal knowledge of the vaccine among similar stakeholders has been reported by other studies conducted in Sub-Saharan Africa [ 22 ]. What is troubling though, is that the consistently reported low knowledge levels is among healthcare workers and VHTs who have been identified as the most trusted source of vaccine information [ 23 ]. Only a few of the interviewed healthcare workers reported attending a condensed one-day training about the vaccine weeks before its introduction in the district and not many VHTs reported formal training about the vaccine.…”

Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study

“…A number of reasons such as exclusion from services covered by universal health insurance and the low patronage of reproductive health services by adolescent girls may be cited [25][26][27]. However, the cost of HPV vaccines is a well-known barrier to vaccine accessibility in Sub-Saharan Africa and more innovative pricing solutions are constantly sought [25,28,29]. The large-scale deployment of vaccines with a broad coverage of common HPV types in a single-dose regimen could represent a sustainable, cost-effective, preventive strategy and potentially increase uptake of vaccination [30].…”

Clinician and Parent Perspectives on Educational Needs for Increasing Adolescent HPV Vaccination

“…For parents, certain barriers are well established in the literature including absence of provider recommendation, cost, and lack of education on HPV vaccine [4,5]. Parents also have misperceptions that the vaccination promotes sexual activity [6].…”

“…Parents also have misperceptions that the vaccination promotes sexual activity [6]. For providers, barriers include lack of knowledge about the vaccine and its related diseases, misperceptions of parental objections and lack of time to discuss vaccine with patients [4]. Both parents and clinicians demonstrate knowledge gaps regarding the prevalence of HPV and disease burden, was well as vaccine safety and long term efficacy [7] New evidence suggests that the decision to vaccinate against HPV is extremely complex and multifactorial.…”