Addressing Low HPV Vaccination Rates: Physicians May Need to Step-Up Recommendation Practices

Considered to be one of the most common sexually transmitted infections, human papillomavirus (HPV) infection affects an estimated 26.8% of females aged 14 years to 59 years. This statistic includes low-risk HPV, which can cause genital warts and other nonmalignant conditions, as well as high-risk HPV, which can cause cervical cancer. Furthermore, it has been shown that up to 70% of all cervical cancers worldwide are caused by 2 high-risk strains of HPV. And while a vaccine is available to prevent the spread of the disease, research has shown that only 9.9% of women older than 18 years receive the vaccination.

So why aren’t young women taking advantage of this potentially life-saving vaccine? To better understand this question, Dr Rebecca B. Perkins, assistant professor in the department of obstetrics and gynecology at Boston University School of Medicine, and colleagues examined women’s attitudes toward vaccination and the impact of physician endorsement on women’s willingness to accept the vaccine. They presented their findings at the 59th Annual Clinical Meeting of the American Congress of Obstetricians and Gynecologists.

Perkins and colleagues looked at 136 women aged 18 years to 22 years who presented at urban clinics. The patients were ethnically diverse and included African Americans (33%), Haitians (36%), Latinas (14%), and Caucasians (16%). While the women overwhelmingly (90%) noted that they would accept vaccination if their physician offered it, only 48% actually received HPV vaccination.

The researchers also examined the women’s attitudes toward vaccinations and their attitudes and acceptance of their physician’s recommendations. The participants consistently reported that they would follow their physician’s recommendations; in fact, the researchers found that only 12% reportedly had ever declined a recommended vaccine. Similarly, 90% of the women reported that they were comfortable discussing vaccines with their physicians, and 92% of the women said they preferred receiving vaccine-related information directly from their physicians. The rates did not differ among the various ethnicities.

To determine the reason for the disparity between willingness to obtain the vaccine and actual vaccination rates, the researchers reviewed the women’s medical records. In most cases where vaccination was not obtained despite the woman’s interest, Perkins and associates noted that the physician failed to offer the vaccine or deferred it.

The clinical ramifications of this study are potentially monumental for this patient population. “Our cohort of low-income, minority, young women appears willing to accept HPV vaccination, but physicians may not be offering it to them appropriately,” Perkins and colleagues concluded. “In order to increase HPV vaccination rates among women 18-22, physicians may need to change their behavior.” 

More Information

Complete HPV Immunization Rates Low in the United StatesHPV Vaccine – Questions & Answers

Related Content

A Semi-Qualitative Study of Attitudes to Vaccinating Adolescents Against HPV Without Parental ConsentResource Center: Gynecologic OncologyPoll

References

Perkins RB, Wilbur MB, Pierre-Joseph N. The patient is not the problem: reasons for low HPV vaccination rates in women ages 18-22. ACOG Annual Meeting. Poster 129. May 1, 2011.

National Cancer Institute at the National Institutes of Health. Study Estimates Overall HPV Prevalence in U.S. Women. March 2007. www.cancer.gov/cancertopics/causes/hpv/hpv-prevalence0308.