Challenges related to human papillomavirus (HPV) vaccine uptake in Minnesota: clinician and stakeholder perspectives

Nicholas Yared,Emily Groene,Matthew Flory,Estee Welo,Molly Malone,Inari Mohammed,Nicole E Basta,Shalini Kulasingam,Keith J Horvath

doi:10.1007/s10552-021-01459-5

Abstract

BackgroundHuman papillomavirus (HPV) vaccination rates among adolescents are increasing in Minnesota (MN) but remain below the Healthy People 2020 goal of 80% completion of the series. The goal of this study was to identify messaging and interventions impacting HPV vaccine uptake in MN through interviews with clinicians and key stakeholders.MethodsWe conducted semi-structured key participant interviews with providers and stakeholders involved in HPV vaccination efforts in MN between 2018 and 2019. Provider interview questions focused on messaging around the HPV vaccine and clinic-based strategies to impact HPV vaccine uptake. Stakeholder interview questions focused on barriers and facilitators at the organizational or state level, as well as initiatives and collaborations to increase HPV vaccination. Responses to interviews were recorded and transcribed. Thematic content analysis was used to identify themes from interviews.Results14 clinicians and 13 stakeholders were interviewed. Identified themes were grouped into 2 major categories that dealt with messaging around the HPV vaccine, direct patient–clinician interactions and external messaging, and a third thematic category involving healthcare system-related factors and interventions. The messaging strategy identified as most useful was promoting the HPV vaccine for cancer prevention. The need for stakeholders to prioritize HPV vaccination uptake was identified as a key factor to increasing HPV vaccination rates. Multiple providers and stakeholders identified misinformation spread through social media as a barrier to HPV vaccine uptake.ConclusionEmphasizing the HPV vaccine’s cancer prevention benefits and prioritizing it among healthcare stakeholders were the most consistently cited strategies for promoting HPV vaccine uptake. Methods to combat the negative influence of misinformation about HPV vaccines in social media are an urgent priority.

Highlights

The Human papillomavirus (HPV) vaccine is recommended for administration to all adolescents in the USA for the prevention of HPV-related cancers and anogenital warts [1]
Upon completion of content analysis, we identified three larger thematic categories addressing messaging and interventions impacting HPV vaccine uptake
These three thematic categories included messaging pertaining to patient–clinician interactions around the HPV vaccine (Table 3), concerns around external messaging sources not involving direct patient–clinician interactions (Table 4), and interventions related to healthcare system-related factors (Table 5)

Summary

Introduction

The HPV vaccine is recommended for administration to all adolescents in the USA for the prevention of HPV-related cancers and anogenital warts [1]. In Minnesota, data from the Minnesota Department of Health (MDH) indicate that the rate of uptake of the HPV vaccine among adolescents aged 13 to 17 in 2018 was 76.7% for one dose and 58.1% for completion of the series [3]. While these uptake rates compared favorably to the USA as a whole (68.1% for receipt of at least one dose and 51.1% for completion of the series), they remain below the Healthy People 2020 goal [3]. The goal of this study was to identify messaging and interventions impacting HPV vaccine uptake in MN through interviews with clinicians and key stakeholders. Multiple providers and stakeholders identified misinformation spread through social media as a barrier to HPV vaccine uptake. Methods to combat the negative influence of misinformation about HPV vaccines in social media are an urgent priority

Objectives

Methods

Results

Conclusion