Extra Messages About HPV Shots Boost Vaccination Rates: Study

Children whose parents received a reminder notification that their child was due for vaccination against human papillomavirus were 56% more likely to get the potentially life-saving shot, a new study shows.

A Mayo Clinic-led research team worked with six primary care clinics in Minnesota to analyze differences in HPV vaccination rates of 9,242 children, ages 11 and 12, based on how the children's parents and their doctors were reminded that the children were due for the vaccine. The parents were sent reminders in the mail, and the providers received audit charts via intra-office mail showing how many of their patients had been vaccinated. 

The parent reminders led to nearly 35% of eligible children getting a dose of the HPV vaccine, and the provider feedback led to 30% of patients getting a shot of the vaccine. When the researchers analyzed both efforts combined, the vaccination rate was 40%, which was significantly higher than the typical HPV vaccination rate of 22% among children whose parents or providers didn't get the extra communications. The study only looked at whether children got at least one dose of the vaccine, which is typically given in a series spaced up to a year apart. The results were published this week in the journal JAMA Pediatrics.

The findings are important because childhood vaccination rates have been on the decline, and the vaccination rate for HPV is among the lowest of all routine childhood vaccines. It's estimated that 94% of cancers caused by HPV could be prevented through vaccination, the authors of an editorial that came with the journal article noted. The study ran from 2018 to mid-2022, meaning that some of the vaccination efforts occurred during the height of the pandemic, when childhood vaccination rates reached alarming lows.

Vaccination against HPV protects against certain kinds of cancer, such as cervical and throat cancers, and the protection works best when the vaccine is given during adolescence. Nearly everyone will be exposed to HPV at some point in their lives, according to the CDC. The virus spreads via intimate skin-to-skin contact such as through having sex, so the vaccine is recommended to be given early in life before people become sexually active. Most people who have HPV don't know that they have it, which makes it difficult to prevent the spread of the virus.

The childhood vaccination rate for HPV has typically been higher among girls than boys. The researchers found that the audit results sent to medical providers resulted in a higher rate of vaccination among boys. 

Another promising finding of the study was that the improved vaccine uptake may have happened among children of vaccine-hesitant parents. Most of the clinics in the study began recommending HPV vaccination when children were 9 years old, which is the youngest age children can get the typical two-dose series. Since the study tracked vaccination efforts for 11- and 12-year-olds, "children of parents who were vaccine hesitant or less likely to pursue vaccination may have been over-represented in our trial, suggesting further value of these interventions," the authors wrote.

"Our study investigated both parent- and provider-facing interventions," lead author Lila Finney Rutten, PhD, chair of the Mayo Clinic Division of Epidemiology, said in a statement. "By targeting parents and providers, we achieved much higher improvements in HPV vaccine uptake than the use of these strategies in isolation."

Sources

JAMA Pediatrics: "Multilevel Implementation Strategies for Adolescent Human Papillomavirus Vaccine Uptake: A Cluster Randomized Clinical Trial," "What Health Systems Can Do Now to Improve Human Papillomavirus Vaccination."

CDC: "Human Papillomavirus (HPV)."

Mayo Clinic News Network: "Mayo Clinic researchers demonstrate nearly 20% boost in adolescent HPV vaccination rates using comprehensive strategy."

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Cite this: Extra Messages About HPV Shots Boost Vaccination Rates: Study - Medscape - Nov 27, 2023.