Human papillomavirus vaccination practices: a survey of US physicians 18 months after licensure.
OBJECTIVE
The objectives of this study were to assess, in a nationally representative network of pediatricians and family physicians, (1) human papillomavirus (HPV) vaccination practices, (2) perceived barriers to vaccination, and (3) factors associated with whether physicians strongly recommended HPV vaccine to 11- to 12-year-old female patients.


METHODS
In January through March 2008, a survey was administered to 429 pediatricians and 419 family physicians.


RESULTS
Response rates were 81% for pediatricians and 79% for family physicians. Ninety-eight percent of pediatricians and 88% of family physicians were administering HPV vaccine in their offices (P<.001). Among those physicians, fewer strongly recommended HPV vaccination for 11- to 12-year-old female patients than for older female patients (pediatricians: 57% for 11- to 12-year-old patients and 90% for 13- to 15-year-old patients; P<.001; family physicians: 50% and 86%, respectively; P<.001). The most-frequently reported barriers to HPV vaccination were financial, including vaccine costs and insurance coverage. Factors associated with not strongly recommending HPV vaccine to 11- to 12-year-old female patients included considering it necessary to discuss sexuality before recommending HPV vaccine (risk ratio: 1.27 [95% confidence interval: 1.07-1.51]) and reporting more vaccine refusals among parents of younger versus older adolescents (risk ratio: 2.09 [95% confidence interval: 1.66-2.81]).


CONCLUSIONS
Eighteen months after licensure, the vast majority of pediatricians and family physicians reported offering HPV vaccine. Fewer physicians strongly recommended the vaccine for younger adolescents than for older adolescents, and physicians reported financial obstacles to vaccination.
Daley
Matthew F
MF
Department of Pediatrics, University of Colorado, Aurora, CO, USA. matthew.f.daley@kp.org
Crane
Lori A
LA
Markowitz
Lauri E
LE
Black
Sandra R
SR
Beaty
Brenda L
BL
Barrow
Jennifer
J
Babbel
Christine
C
Gottlieb
Sami L
SL
Liddon
Nicole
N
Stokley
Shannon
S
Dickinson
L Miriam
LM
Kempe
Allison
A
D000293:Adolescent; D000328:Adult; D002648:Child; D005194:Family Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008007:Licensure, Medical; D008297:Male; D053918:Papillomavirus Vaccines; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D055815:Young Adult
D053918:Papillomavirus Vaccines