title: Recommendations and administration of the HPV vaccine to 11- to 12-year-old girls and boys: a statewide survey of Georgia vaccines for children provider practices.
abstract: OBJECTIVE
  This study explores the prevalence and provider- and practice-related correlates of physician recommendation and administration of the quadrivalent human papillomavirus (HPV) vaccine, Gardasil, to 11- to 12-year-old girls and the intention to recommend the HPV vaccine to 11- to 12-year-old boys in Georgia. The study also describes physician knowledge about and barriers to HPV vaccination.
  
  
  METHODS
  This cross-sectional study was conducted from December 2010 to February 2011. The study sample was drawn using the Georgia Vaccines for Children (VFC) provider list as a sampling frame and probability 1-stage cluster sampling with counties as clusters. The final analytic sample was restricted to 206 provider locations. Weighted percentages and corresponding statistics were calculated accounting for selection probabilities, nonresponse, and the cluster sample design.
  
  
  RESULTS
  Among Georgia VFC providers attending to 11- to 12-year-old girls, 46% had always recommended that their patients get the HPV vaccination and 41% had vaccinated their female patients. Among Georgia VFC providers attending to 11- to 12-year-old boys, 20% would always recommend that their male patients get vaccinated.Physicians most frequently endorsed costs of stocking the vaccine (73%), upfront costs (69%), vaccination (68%), and insurance reimbursements (63%) as barriers to their HPV vaccination practices.
  
  
  CONCLUSIONS
  Despite the Advisory Committee on Immunization Practices' recommendations on HPV vaccination, the prevalence of recommending and administering the HPV vaccine to female and male patients, aged 11 to 12 years, by VFC providers is an ongoing challenge in Georgia.
authors.affiliation: 1Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA; and 2Coastal Health District, Savannah, GA.
authors.forename: John S
authors.initials: JS
authors.lastname: Luque
authors.forename: Yelena N
authors.initials: YN
authors.lastname: Tarasenko
authors.forename: Betty T
authors.initials: BT
authors.lastname: Dixon
authors.forename: Robert L
authors.initials: RL
authors.lastname: Vogel
authors.forename: Stuart H
authors.initials: SH
authors.lastname: Tedders
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia; D058015:Health Communication / Q000379:methods*; D006282:Health Personnel; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines