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Addressing HPV vaccination concerns

March 11, 2020

(Boston, MA) -Research from the Harvard Pilgrim Health Care Institute finds a promising avenue for addressing vaccine hesitancy around HPV vaccine. The study, "Tailored Messages Addressing HPV Vaccination Concerns Improves Behavioral Intent Among Mothers: A Randomized Controlled Trial," appears in the xx issue of the Journal of Adolescent Health.

The HPV vaccine is highly effective in preventing infection against certain types of HPV that can lead to cervical, oropharyngeal, and anal cancers. However, HPV vaccine coverage in pre-teens and young teens remains sub-optimal, with only 61% of 13-year-old girls and 64% of 13-year-old boys in the U.S. initiating the vaccine series, with wide variation across states. Parental hesitancy is one reason for low vaccination coverage. In fact, vaccine hesitancy in general has been identified as one of the top ten global health threats by the WHO, which suggests the strong need for work addressing this issue. When recommending HPV vaccine, the current guidelines suggest clinicians use a presumptive, bundled messaging approach, in which a provider presumes that the parent is ready to vaccinate and states that the child is "due" for all age-appropriate vaccines at the 11-12 year old well-visit appointment, including HPV vaccine. However, this approach, by itself, may not be the most effective strategy for parents with specific concerns about the HPV vaccine.

In a large web-based randomized controlled trial of mothers with concerns about the HPV vaccine, investigators compared the impact of implementing the current guideline alone and in combination with tailored messages on HPV vaccination intent. These mothers, all of whom did not intent to vaccinate their 11-14 year-old child within the next 12 months, were randomized to one of three groups: a) "control" which watched a bundled recommendation video; b) "top concern" which watched the control video plus a video tailored to their top HPV vaccine concern; or c) "all concerns" which watched the control video plus videos on the top 5 most common HPV vaccine concerns.

Study results found that tailored messages addressing all of the specific concerns of vaccine hesitant mothers improved HPV vaccination intent, and tailored messages addressing the top concern marginally improved intent; these improvements were not observed in the control group.

"We found that a presumptive, bundled messaging approach, by itself, may not be the most effective strategy for increasing HPV vaccine uptake in pre-teens and young teens who have parents with specific concerns about the vaccine," said co-lead author Catherine Panozzo, PhD, Assistant Professor of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School. Adds Dr. Panozzo,, "our findings contribute to the growing body of literature suggesting that tailored recommendations may be essential for improving HPV vaccination acceptance among hesitant parents".

Regarding future directions, co-lead author, Dr. Katharine Head, Assistant Professor of Communication Studies at Indiana University School of Liberal Arts, commented, "We suggest that future studies determine whether these improvements in HPV vaccination intent can translate to actual improvements in HPV vaccination in clinic settings. In fact, our team is working to integrate these messaging strategies into a clinical intervention to test this very hypothesis."
About Harvard Pilgrim Health Care Institute's Department of Population Medicine

The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it was the first medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and teaching.

More Information

Tailored Messages Addressing HPV Vaccination Concerns Improves Behavioral Intent Among Mothers: A Randomized Controlled Trial is co-authored by investigators from: Indiana University School of Liberal Arts, Department of Communication Studies; Department of Family & Community Health, University of Pennsylvania School of Nursing; Vaccine Education Center, Children's Hospital of Philadelphia/ Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania/ Philadelphia Department of Public Health, Division of Disease Control; Department of Pediatrics, Indiana University School of Medicine.

Harvard Pilgrim Health Care Institute

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