Implementation barriers and considerations for recommending and administering the human papillomavirus (HPV) vaccination in oncology settings

Waters, Austin R.; Weir, Charlene R.; Kramer, Heidi; Berghuijs, Karely M van Thiel; Wu, Yelena P.; Kepka, Deanna; Kirchhoff, Anne C.

doi:10.1007/s11764-023-01391-4

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…Our findings were consistent with another recent qualitative study of oncology providers. 26 In this study, providers cited educational barriers plus complicated post-treatment HPV vaccination guidelines as a barrier to their capability to administration. They also identified time concern barriers in addition to clinical workflow integration concerns.…”

Section: Discussionmentioning

confidence: 96%

Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration

Miller

Rahim

Coven

et al. 2023

Human Vaccines & Immunotherapeutics

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Rates of Human papilloma virus (HPV) vaccination among pediatric survivors of cancer and patients with sickle cell disease are lower than the national average. While recent attention has focused on patient HPV vaccine hesitancy and refusal, less is known about provider-level and system-level barriers to vaccinations in pediatric hematology/oncology (PHO) populations. Applying thematic analysis to qualitative interviews with 20 pediatric hematology/oncology physicians and nurse practitioners, we examine their views regarding HPV vaccination, with a focus on access and barriers to providing HPV vaccination in PHO practices. Results demonstrated that despite 90% of interviewees supporting HPV vaccination in their population, the number of pediatric hematology/oncology providers who reported that they counsel about HPV or provide HPV vaccination was 45%, even in stem cell and sickle cell clinics, where other childhood vaccines are commonly provided. Clinicians identified provider-level, clinic-level, and system-level barriers to giving the HPV vaccination, including but not limited to time/flow constraints, lack of resources, and continued education regarding the HPV vaccine. These barriers impede the ability for pediatric hematology/oncology providers to counsel and provide HPV vaccination to this specialized population.

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Section: Discussionmentioning

confidence: 96%

Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration

Miller

Rahim

Coven

et al. 2023

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…Several studies have shown that the strongest predictor of HPV vaccine non-initiation is lack of provider recommendation [30,22,31]. In cancer survivors, other reasons for HPV vaccine refusal include vaccine hesitancy, disinterest in the vaccine, or lack of knowledge of vaccine safety in the context of cancer history [25,32]. A secondary analysis of vaccine-naïve cancer survivors who refused participation in a clinical trial on the HPV vaccine expressed worry about long-term safety and side-effects, potential cancer relapse, and the desire to avoid additional medical interventions or needles that are not deemed "necessary" [25].…”

Section: Discussionmentioning

confidence: 99%

Human Papillomavirus Vaccine Uptake among Adolescent Survivors of Hematopoietic Stem Cell Transplant

Morrison,

Myers,

Streich-Tilles

2024

Preprint

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Purpose To characterize the rate of human papillomavirus (HPV) vaccine uptake in the adolescents after hematopoietic stem cell transplant (HSCT). Methods This retrospective study evaluated the vaccine history of adolescent HSCT patients ≥ 11 years of age transplanted between 2015 and 2022 at a tertiary care medical center. Logistic regression was used to examine bivariate associations between HPV vaccine uptake and covariates including demographic factors, indication for and type of HSCT, receipt of HPV vaccine prior to transplant, and receipt of other vaccines after transplant. Results Among 119 (n = 53 female; n = 66 male) eligible patients, 66 (55.5%) received ≥ one dose of the HPV vaccine after HSCT. Among those who initiated vaccination, 45/66 (68.2%) completed two or more doses. Of 69 patients who were eligible to receive the vaccine prior to HSCT, 19/36 (52%) were vaccinated both before and after HSCT, compared to 14/33 (42%) who did not receive the vaccine before HSCT but chose to be vaccinated after HSCT. No statistically significant difference was identified between those who did and did not initiate HPV vaccination after HSCT among covariates examined. Conclusions Rate of HPV vaccine uptake after HSCT was lower compared to the general U.S. adolescent population and lower than the rate of other recommended vaccines. Receiving HPV vaccine prior to HSCT was not associated with HPV re-uptake after HSCT. Implications for Cancer Survivors: HPV vaccination continues to be suboptimal in HSCT survivorship and should be a targeted goal for improvement in preventing secondary malignancy in this high-risk population.

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“…In one study, only 30% of PCPs felt confident in their knowledge about immunizations for childhood cancer survivors, which is concerning because PCPs may be missing opportunities for immunizing this vulnerable population [ 78 ]. Clinicians also reported concerns about vaccine safety, costs associated with providing the vaccine or low reimbursement rates, and beliefs that the HPV vaccine is less important than other vaccines [ 41 , 70 , 79 , 80 ]. Oncologists also report feeling overburdened by busy clinic schedules and difficulties in adjusting the workflow in oncology practice to be able to administer the HPV vaccine [ 41 , 70 ].…”

Section: Barriers To Hpv Vaccinationmentioning

confidence: 99%

Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors—Opportunity to Address Gaps in Cancer Prevention and Survivorship

Kluczynski,

Rodriguez,

McGillicuddy

et al. 2024

Vaccines

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The risks of secondary cancers associated with human papillomavirus (HPV) infection are as much as three times higher for survivors of pediatric, adolescent, and young adult cancer (PYAC) compared to the general population. Despite this, HPV vaccination rates among PYAC survivors remain low. Whereas pediatric oncology providers endorse HPV vaccination of PYAC survivors, many lack the resources or opportunities to intervene. The responsibility of HPV vaccination, therefore, falls to primary care providers and practices. This article provides an overview of the challenges with HPV vaccination that are distinct to PYAC survivors and discusses potential strategies to increase HPV vaccine coverage in this population.

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Implementation barriers and considerations for recommending and administering the human papillomavirus (HPV) vaccination in oncology settings

Cited by 4 publications

References 26 publications

Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration

Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration

Human Papillomavirus Vaccine Uptake among Adolescent Survivors of Hematopoietic Stem Cell Transplant

Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors—Opportunity to Address Gaps in Cancer Prevention and Survivorship

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