Providers' Attitudes and Perceived Barriers to HPV Vaccination among Women 18-26 Years of Age

Background/Significance: Two human papillomavirus (HPV) vaccines are approved for the prevention of high-risk HPV types 16 and 18 for females between 9 and 26 years old. Physician attitudes toward HPV vaccination are an important component in successful immunization of women. Several studies have focused on adolescent HPV vaccination, but there is little information regarding women aged 18 to 26. Objectives/Purpose: To identify and compare primary care practitioners' attitudes, practices, and barriers to HPV vaccination of women between the ages of 18 and 26. Methods: This project was a qualitative study. In-depth, in-person interviews were conducted among family medicine, internal medicine, and OB/GYN practitioners and office managers in Monroe County, NY. These practitioners came from community clinics, university health centers, private and hospital-based practices. Results: Thirty-four practitioners and eight office managers were interviewed in the summer of 2010. Frequency of counseling about the HPV vaccine ranged from never to “at every patient visit.” The largest perceived barriers among practitioners were financial, patient fear of vaccines and compliance with the vaccination schedule. Other common themes that arose were confusion about vaccination guidelines and varying beliefs, among specialties, about responsibility for administration of vaccines. Discussion/Conclusion: Although the vaccine is recommended for women aged 18-26 as well as adolescents, there is confusion about who is responsible for vaccine administration and vaccine schedule recommendations among providers who care for young women. More education and support is necessary for practitioners who administer vaccinations less routinely than pediatricians.