Susan T Vadaparampil1, Teri L Malo2, Jessica A Kahn3, Daniel A Salmon4, Ji-Hyun Lee5, Gwendolyn P Quinn6, Richard G Roetzheim7, Karen L Bruder8, Tina M Proveaux4, Xiuhua Zhao5, Neal A Halsey4, Anna R Giuliano9. 1. Health Outcomes and Behavior Program, Tampa, Florida; Center for Infection Research in Cancer, Tampa, Florida; Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida. Electronic address: susan.vadaparampil@moffitt.org. 2. Health Outcomes and Behavior Program, Tampa, Florida. 3. Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio. 4. Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Biostatistics Department, Moffitt Cancer Center, Tampa, Florida. 6. Health Outcomes and Behavior Program, Tampa, Florida; Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida. 7. Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida. 8. Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida. 9. Center for Infection Research in Cancer, Tampa, Florida; Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida.
Abstract
BACKGROUND: Physician recommendation is a key predictor of human papillomavirus (HPV) vaccine uptake. Understanding factors associated with recommendation is important for efforts to increase current suboptimal vaccine uptake. PURPOSE: This study aimed to examine physician recommendations to vaccinate female patients aged 11-26 years, in 2009 and 2011, at 3 and 5 years postvaccine licensure, respectively. A second aim was to identify trends in factors associated with vaccine recommendation for ages 11 and 12 years. METHODS: Nationally representative samples of physicians practicing family medicine, pediatrics, and obstetrics and gynecology were randomly selected from the American Medical Association Physician Masterfile (n=1538 in 2009, n=1541 in 2011). A mailed survey asked physicians about patient and clinical practice characteristics; immunization support; and frequency of HPV vaccine recommendation ("always" ≥75% of the time vs other). Analyses were conducted in 2012. RESULTS: Completed surveys were received from 1013 eligible physicians (68% response rate) in 2009 and 928 (63%) in 2011. The proportion of physicians who reported always recommending HPV vaccine increased significantly from 2009 to 2011 for patients aged 11 or 12 years (35% vs 40%, respectively; p=0.03), but not for patients aged 13-17 years (53% vs 55%; p=0.28) or 18-26 years (50% vs 52%; p=0.52). Physician specialty, age, and perceived issues/barriers to vaccination were associated with vaccine recommendation for patients aged 11 or 12 in both years. CONCLUSIONS: Results suggest a modest increase in recommendations for HPV vaccination of girls aged 11 or 12 years over a 2-year period; however, recommendations remain suboptimal for all age groups despite national recommendations for universal immunization.
BACKGROUND: Physician recommendation is a key predictor of human papillomavirus (HPV) vaccine uptake. Understanding factors associated with recommendation is important for efforts to increase current suboptimal vaccine uptake. PURPOSE: This study aimed to examine physician recommendations to vaccinate female patients aged 11-26 years, in 2009 and 2011, at 3 and 5 years postvaccine licensure, respectively. A second aim was to identify trends in factors associated with vaccine recommendation for ages 11 and 12 years. METHODS: Nationally representative samples of physicians practicing family medicine, pediatrics, and obstetrics and gynecology were randomly selected from the American Medical Association Physician Masterfile (n=1538 in 2009, n=1541 in 2011). A mailed survey asked physicians about patient and clinical practice characteristics; immunization support; and frequency of HPV vaccine recommendation ("always" ≥75% of the time vs other). Analyses were conducted in 2012. RESULTS: Completed surveys were received from 1013 eligible physicians (68% response rate) in 2009 and 928 (63%) in 2011. The proportion of physicians who reported always recommending HPV vaccine increased significantly from 2009 to 2011 for patients aged 11 or 12 years (35% vs 40%, respectively; p=0.03), but not for patients aged 13-17 years (53% vs 55%; p=0.28) or 18-26 years (50% vs 52%; p=0.52). Physician specialty, age, and perceived issues/barriers to vaccination were associated with vaccine recommendation for patients aged 11 or 12 in both years. CONCLUSIONS: Results suggest a modest increase in recommendations for HPV vaccination of girls aged 11 or 12 years over a 2-year period; however, recommendations remain suboptimal for all age groups despite national recommendations for universal immunization.
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