Correlates of physicians' HPV vaccine recommendations for male patients: A national study

Background: Physician recommendation influences human papillomavirus (HPV) vaccine uptake for females, yet little is known about physicians' recommendations for males. This study aimed to examine the prevalence and correlates of physicians' HPV vaccine recommendations to males ages 11-12, 13-17, and 18-26 years. Methods: National samples of family physicians and pediatricians were selected from the AMA Physician Masterfile (n=1,219). In April 2011, physicians were surveyed about HPV vaccine recommendations and their personal, practice, and patient characteristics. Physicians reported the frequency with which they recommended HPV vaccination to male patients in each age group (“always” [>75% of the time] vs. other). Correlates of vaccine recommendation were identified using multivariable logistic regression. Results: 406 family physicians (56.7% response rate) and 322 pediatricians (70.2%) returned completed surveys. The percentage of physicians “always” recommending vaccination was 10.8% for ages 11-12, 12.9% for ages 13-17, and 13.2% for ages 18-26. Pediatrician specialty and self-reported early adoption of new vaccines were associated with HPV vaccine recommendation to all age groups. Physician race and patient payment method were associated with recommendation to ages 11-12, whereas patient race was associated with recommendation to ages 13-17 and 18-26. Conclusions: Physicians' consistent HPV vaccine recommendation to males was low just prior to the Advisory Committee on Immunization Practices' change in guidelines from permissive to routine vaccination. Interventions to increase vaccine recommendations to all patient age groups may need to target family physicians. Additionally, identifying and supporting early adopters may help diffuse HPV vaccination guidelines and encourage later adopters to follow guidelines.