HPV vaccination

A new study published in the Journal of Adolescent Health reviews methods to improve HPV vaccination.


Human Papilloma Virus (HPV) is a group of viruses that cause warts and cancer. There are 150 different reported strains of the HPV. Since it is transmitted through skin to skin contact, it is considered a sexually transmitted disease (STD). It is particularly dangerous because it causes cancer of the mouth, throat, anus, and rectum. After an individual acquires the virus, symptoms may not be evident, but it can still infect an individual the carrier is intimate with. Usually, most HPV strains resolve without causing any health issues, but some more virulent strains cause genital warts and cancer. Infection can be prevented by an HPV vaccine. The HPV vaccine protects individuals against 9 of the most dangerous strains, the most important being 16 and 18. It is known to protect against vulvar, vaginal, anal, and to some extent oral cancers.

The HPV vaccine was introduced in 2006. However, it’s the rate of immunisation has not reached target levels. Researchers set out to improve the method of distribution and determine if it would increase the rate of immunisation among younger individuals. The results of the study were published in the Journal of Adolescent Health. Between the first quarter of 2015 and the first quarter of 2016, interventions were made in the following three areas: in-person provider and staff education; quarterly feedback to providers; and patient reminder and recall notices.

Interventions introduced to the provider and staff education initiative included a visit made three times by project staff. They were held by a physician or an immunisation specialist, at the beginning of the intervention period, during quarters three and four of the intervention period in 2015, and after the intervention period. These education initiatives provided information regarding the incidence and prevalence of HPV, the rate at which that department was conducting immunisation of HPV vaccines in adolescence, barriers to vaccination, and strategies to increase vaccinations in adolescents. The next area of the intervention was to report back to the providers. Providers received timely feedback that showed the number of vaccinations that they were recommended, their cost, and a comparison to other providers. The third area of intervention consisted of recall notes sent out to patients to remind them of their upcoming vaccination dates, and follow up vaccines if they have already initiated vaccination.

The results show that within the study period, HPV vaccine uses increased in a manner that was cost-effective. This increase encourages the need for health systems to improvise their vaccine communication with the public by implementing reminder and recall services targeting teenage children and their parents. The positive response to reminders and recalls for vaccinations may be attributed to the efforts put in to increase the scope of education on HPV infection. The use of technology seemed to further improve vaccination rates, with 40 percent of parents responding to text messages about getting their children vaccinated. The positive outcomes of the intervention support increased efforts aimed at achieving high HPV vaccination rates, in which strategies focus on provider and staff education, in addition to reminder and recall systems. These strategies could be sustainable long term and could increase effectiveness in controlling the spread of HPV thereby reducing the chance of acquiring cancer in sexually active age groups.


Written By: Dr. Apollina Sharma, MBBS, GradDip EXMD

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