title: Physicians' human papillomavirus vaccine recommendations, 2009 and 2011.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Vadaparampil
authors.affiliation: Health Outcomes and Behavior Program, Tampa, Florida.
authors.forename: Teri L
authors.initials: TL
authors.lastname: Malo
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
authors.affiliation: Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Salmon
authors.affiliation: Biostatistics Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Health Outcomes and Behavior Program, Tampa, Florida; Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
authors.affiliation: Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.affiliation: Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Bruder
authors.affiliation: Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Tina M
authors.initials: TM
authors.lastname: Proveaux
authors.affiliation: Biostatistics Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Neal A
authors.initials: NA
authors.lastname: Halsey
authors.affiliation: 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.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017589:Immunization Programs; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines