Overcoming barriers to adherence to HPV vaccination recommendations.

Human papillomavirus (HPV) is a critical factor in the development of cervical cancer and can lead to genital warts and other clinical sequelae. Two vaccines against HPV have been developed recently that have shown to be safe and effective. The use of HPV vaccines holds promise for alleviating the burden of illness related to HPV infection. However, barriers specific to HPV vaccines, as well as barriers related to adolescent vaccination in general, may pose challenges to widespread implementation. Among these are: (1) lack of knowledge among the US population about HPV transmission and its relation to cervical cancer and other anogenital diseases; (2) parental concerns about vaccines in general and about vaccinating minors against sexually transmitted diseases; (3) financing by the government and private insurers for newly recommended vaccines; (4) challenges related to adolescents' healthcare-seeking behavior and health insurance coverage; and (5) barriers related to the dynamics of HPV infection (eg, protection against only certain types of HPV, duration of immunity, immunization schedules). Addressing these concerns will be critical in effective implementation of HPV vaccines and, potentially, vaccines, against other sexually transmitted diseases.