HPV vaccine recommendations not as strong as previously thought

The controversy surrounding the safety and efficacy of the HPV vaccines are not the only issues parents and physicians struggle with when it comes to recommending it for their children.  A survey conducted by Pediatrics, the journal for the American Academy of Pediatrics, uncovered a range of attitudes among physicians related to administering the HPV vaccine to female adolescents. Forty two percent of pediatricians and 54 percent of family physicians considered it necessary to discuss sexuality before recommending HPV vaccine, though few physicians thought that vaccination would encourage earlier or riskier sexual behavior among teens.  Parent opposition to HPV vaccination for moral or religious reasons was perceived as definitely or somewhat a barrier by 23 percent of pediatricians and 33 percent of family physicians.


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Daley, M., et al. Human Papillomavirus Vaccination Practices: Survey of US Physicians 18 Months After Licensure, Pediatrics, Published online August 2, 2010

OBJECTIVES The goals were to assess, in a nationally representative network of pediatricians and family physicians, (1) human papillomavirus (HPV) vaccination practices, (2) perceived barriers to vaccination, and (3) factors associated with whether physicians strongly recommended HPV vaccine to 11- to 12-year-old female patients.

METHODS In January through March 2008, a survey was administered to 429 pediatricians and 419 family physicians.

RESULTS Response rates were 81% for pediatricians and 79% for family physicians. Ninety-eight percent of pediatricians and 88% of family physicians were administering HPV vaccine in their offices (P < .001). Among those physicians, fewer strongly recommended HPV vaccination for 11- to 12-year-old female patients than for older female patients (pediatricians: 57% for 11- to 12-year-old girls and 90% for 13- to 15-year-old girls; P < .001; family physicians: 50% and 86%, respectively; P < .001). The most-frequently reported barriers to HPV vaccination were financial, including vaccine costs and insurance coverage. Factors associated with not strongly recommending HPV vaccine to 11- to 12-year-old female patients included considering it necessary to discuss sexuality before recommending HPV vaccine (risk ratio: 1.27 [95% confidence interval: 1.07–1.51]) and reporting more vaccine refusals among parents of younger versus older adolescents (risk ratio: 2.09 [95% confidence interval: 1.66–2.81]).

CONCLUSIONS Eighteen months after licensure, the vast majority of pediatricians and family physicians reported offering HPV vaccine. Fewer physicians strongly recommended the vaccine for younger adolescents than for older adolescents, and physicians reported financial obstacles to vaccination.

Key Words: human papillomavirus vaccine • physicians • attitudes • practices • survey

Abbreviations: HPV = human papillomavirus


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