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An Investigation of the Recommendation Styles and Same-Day Vaccination Rates for Pediatricians Discussing HPV Vaccine with Adolescent Patients & Their Caregivers Open Access

Background. HPV vaccination rates in the United States remain relatively low. Physicians report significant parental barriers to acceptance of their routine HPV vaccine recommendations. In contrast, parents of eligible adolescents report a very high likelihood of accepting their provider's recommendation for HPV vaccination. This study is to explore how pediatricians recommend HPV vaccination to parents and adolescents during well visits, and how likely these recommendations are to result in same-day HPV vaccination.

Methods. Between January and June of 2013, pediatricians on the panel of a dialogue research company were asked to record well visit encounters with girls aged 11-12 years and boys aged 11-18 years. These recordings were analyzed to review how the pediatrician introduced the recommendation for HPV vaccination during the well visit. These recommendation approaches were divided into 3 style categories: routine recommendation (HPV vaccine recommended the same as other adolescent vaccines); detailed discussion (HPV vaccine presented to parent with greater detail than other adolescent vaccines); and brief mention(HPV vaccine was mentioned without a recommendation or direction). We also assessed whether the patient received the vaccination at that visit.

Results. There were 204 well-visit recordings submitted by 20/23 pediatricians asked to participate. Of these, 167 visits (82%) mentioned an adolescent vaccine and 152 visits (75%) specifically mentioned HPV vaccination. The most commonly used recommendation strategy was the detailed discussion (72%). The same-day vaccination rate from this strategy was 38%. Brief mentions were used 17% of the time with a same-day vaccination rate of 27%. However, routine recommendationswere the least frequently chosen strategy (11%), but had a same-day vaccination rate of 94%.

Conclusion. The routine recommendation approach was least used by pediatricians in this study, but was the most effective in achieving same-day vaccination. Most pediatricians chose to employ a detailed discussion strategy, but were less successful in achieving same-day HPV vaccination. Brief mentions were least effective in achieving same-day vaccination. Pediatricians in this study would benefit from training to modify their HPV vaccination recommendation style.

Disclosures. L. Clark, Merck Vaccines: Employee, Salary B. Kuter, Merck Vaccines: Employee, Salary

Author notes