Clinician Recommendations Could Boost Teens’ HPV Vaccination Rates

Strong and consistent clinician recommendations might help improve human papillomavirus (HPV) vaccination rates among teenagers, particularly among boys, according to an analysis of survey data among parents of teens (abstract 318). The findings were presented at a poster session of the 2018 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, held March 24–27 in New Orleans, Louisiana.

The reasons for forgoing HPV vaccination vary between males and females. Boys more frequently forgo the vaccine-in part because they are less likely than girls to receive a strong clinician recommendation to be vaccinated, reported lead study author Anna L. Beavis, MD, MPH, of the Kelly Gynecologic Oncology Service at Johns Hopkins Hospital in Baltimore, Maryland, and colleagues.

More than 31,000 HPV-associated cancers are diagnosed annually in the United States, a third of them among males. The US Food and Drug Administration approved the HPV vaccine for girls and women in 2007 and boys and men in 2010, but vaccination rates remain “suboptimal and lower than other Westernized nations,” the authors reported.

HPV vaccination series completion rates in the United States have yet to meet the federal government’s Healthy People 2020 goal of 80%, they noted.

The researchers analyzed 2015 data from the Centers for Disease Control and Prevention National Immunization Survey–Teen phone surveys. Surveyors asked parents of boys and girls aged 13 to 17 years about their teenagers’ vaccination histories and decision-making. A subset of the reported vaccination histories was verified by clinicians.

HPV vaccination initiation and series completion rates were significantly lower for boys than girls (63% vs 50% and 42% vs 28%, respectively; all P values < .05), the authors reported. Providers had recommended vaccination to 77% of girls and their parents, compared with only 60% of boys (P < .05).

Asked why they had not pursued HPV vaccination, parents of teen boys were significantly more likely than the parents of girls to report that it had not been recommended by the clinician, that their school did not require it, or that they did not think it was needed.

The parents of girls were more likely to report that they did not seek vaccination because their daughters were not yet sexually active, they were concerned about safety and side effects, or because of religious concerns.

The findings show that public health messaging about HPV vaccination needs to improve understanding of the vaccine and to focus on information differently tailored to the needs of the parents of boys vs parents of girls, the researchers believe.

“In parents of males, providing a recommendation would likely be highly impactful, while in parents of females addressing the safety and side effects of the vaccine, as well as the timing before sexual activity, could help increase [vaccination] rates,” they concluded.