Barriers to HPV Vaccination in Women at a Federally Qualified Health Center [ID: 1377846

Abstract

INTRODUCTION: Human papillomavirus (HPV) vaccination significantly decreases the rate of HPV-related diseases; however, vaccine uptake is limited in the United States. New York State set a goal of 80% HPV vaccination by 2023. First-dose rates at our Federally Qualified Health Center (FQHC) in 2021 were 68% in girls aged 13–19 years and 31% in women aged 20–29 years. Little research surrounding barriers to HPV vaccination in adults exists. METHODS: An anonymized survey was distributed to providers at a network of FQHCs using REDCap. Question domains included provider demographics, provider attitudes, and practices. Questions were subdivided by patient age group. Descriptive statistics were analyzed. RESULTS: Our response rate was 15%. Respondent specialties included family practice (49%), women's health (27%), pediatrics (13%), and internal medicine (11%). Frequency of vaccine recommendation decreased as patient age increased. Most common barriers for vaccination included previous vaccination, parental or patient objection, and lack of time for counseling. Additional barriers in the 19–45 age group included concerns about efficacy and cost. Common reasons for patient refusal included objection to vaccination, feeling low risk for infection, lack of knowledge, and side effect concerns. CONCLUSION: The expansion of HPV vaccination eligibility to include women aged 27–45 in 2018 provided an opportunity to protect more patients against HPV-related diseases. Patient and provider knowledge about HPV risk and vaccine efficacy can limit the implementation. Significant barriers for vaccine administration included the lack of provider engagement, knowledge about the vaccine, and time for counseling. This study underscores the need for provider and patient education about the benefits of HPV vaccination, especially in the 19–45 age group.