Primary care physicians' attitudes toward prescription of human papillomavirus (HPV) vaccination

The HPV vaccine can greatly reduce infection and cervical cancer death rates. However, use remains low and not always accepted. We surveyed 301 primary care physicians nationally to assess their attitudes about vaccination for young females. Respondents were mostly male (55%), White (72%), and averaged 21 years practice experience post-graduation (range 2-57 years). We used latent class analysis (LCA) to identify sub-groups of physicians based on their responses to eight questions regarding adherence barriers to HPV vaccination recommendations. Concerns included vaccine cost, reimbursement, logistical problems, patient's adherence to follow-up vaccinations, effectiveness doubts, safety concerns, age of patient, and potential influence on patient's sexual behavior. A binary measure was used to code responses (1=significant; 0=otherwise). Overall, most participants considered these barriers “not significant” except for vaccine cost. However, LCA findings indicated three different groups in terms of attitudes held. Group 1 (49% of respondents) included relatively more males (56%) and tended to have suburban practices (58%) with an average of 6 physicians. Their only significant concerns included vaccine cost (0.89) and reimbursement problems. Group 2 (45%), with an average of 9 physicians/clinic practice, considered none of these issues as “significant” (0.01-0.24), whereas Group 3 (6%) found all concerns “significant” (0.82-0.99). Group 3 participants were more likely to be minority (61%), practicing in urban (61%) and small clinics (3 physicians). There were no significant group differences in practice type (family physicians vs. pediatricians), practice experience, and electronic health record adoption. Findings indicated that primary care physicians held different opinions about HPV vaccination.