How Retail Clinicians Can Ensure HPV Vaccine Series Completion

March 17th 2016

The 3-dose human papillomavirus vaccine series is recommended for all children aged 11 years and older, but miscommunication between health care providers and patients is preventing series completion for many.

The 3-dose human papillomavirus (HPV) vaccine series is recommended for all children aged 11 years and older, but miscommunication between health care providers and patients is preventing series completion for many.

In a recent study published inHuman Vaccines and Immunotherapeutics, researchers from Boston Medical Center interviewed the parents of 65 girls who had received at least 1 dose of the HPV vaccine. Of these children, 28 had completed the series, while the remaining 37 had not.

When the parents of those in the latter group were asked why their children had not finished the series, 65% of them responded that they were waiting on the clinic to contact them to schedule the remaining doses. Inconveniences such as long commutes to the clinic prevented the completion of the series for another 24% of respondents, while only 4 parents had decided to stop the vaccination process entirely.

The research team also interviewed 27 health care providers about their plans to ensure that patients completed the series. Although 52% indicated that they tell parents when the next doses are due, they also said they expect parents to schedule the follow-up visits themselves.

Comparatively, 41% of providers made an effort to schedule the second dose when the first dose was administered, and 7% planned to immunize patients when they returned for a different appointment.

None of the providers suggested that the need for 3 doses was a barrier to completion. Additionally, more than two-thirds of the parents interviewed believed that the benefits of HPV vaccination outweighed the risks.

With parentsincreasingly choosingto take their children to retail clinics instead of pediatricians, retail clinicians are ideally placed to ensure that children are appropriately vaccinated against HPV.

“What we've learned is that there is a great opportunity to close the non-completion gap by improving education and dialogue between providers and parents about scheduling future visits to finish the 3-dose vaccination series,” said lead study author Rebecca Perkins, MD, MSc, in a press release.

For instance, many of the interviewed providers pointed to the lack of electronic reminder systems as a reason for the incomplete vaccine series, so the study authors recommended that clinicians implement these systems in their clinics. A similar conclusion was reached in aseparate studypublished in theJournal of American Board of Family Medicine, which determined that patients aged 9 to 18 years were 10 times more likely to complete their HPV vaccine series when treated in clinics utilizing an electronic health record system that delivered electronic reminders.

“We found that simply alerting patients and providers during an office appointment increased uptake and completion of the HPV vaccine series,” stated the study’s lead author, Mack Ruffin IV, MD, MPH.

This approach can also be used to initiate HPV vaccination. According to areviewpublished inJournal of the American Medical Association: Pediatrics, clinics that used mail and telephone reminders had a 27% success rate in influencing parents to vaccinate their children against HPV, compared with a 21% success rate among clinics that did not use these reminders.

“By implementing a reminder system, we hope that more children will complete the vaccination series, which can help improve the overall health of our next generation,” Dr. Perkins said.

Dr. Perkins and her colleagues also advised clinicians to schedule follow-up appointments as soon as a child receives the first dose of the HPV vaccine.

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