Training clinicians to improve HPV vaccination rates

The human papillomavirus (HPV) vaccine has been shown to be very effective and has led to striking changes in the incidence of cervical cancer, among others, in the United States. However, there is still room to improve HPV vaccination coverage in pediatrics. A study in JAMA Pediatrics explores whether training on communication strategies can improve vaccination coverage

The researchers use the network of the American Academy of Pediatrics Pediatric Research in Office Settings to find 48 primary care pediatric practices in 19 states. The practices were randomized to continue standard care or communication training. The communication training included 3 consecutive online educational modules to help clinicians communicate about the HPV vaccine, as well as weekly text messages to reinforce what they had learned in the modules. The researchers looked at all 11- to 17-year-old adolescents who had attended 24 intervention practices and 24 control practices.

In the 24 intervention practices, 122 of the 188 clinicians agreed to participate in the intervention and 120, 119 and 116 clinicians followed training modules 1, 2 and 3 respectively. In the intervention period, 29,206 teenagers had 28,123 acute or chronic visits and 15,888 visits to good childcare in intervention practices. There were 33,914 adolescents at control practices with 17,910 childcare visits and 35,281 acute or chronic visits. Practices using the intervention reduced the missed opportunity to discuss the HPV vaccine by 2.4 percentage points (-2.4%; 95% CI, -3.5% to -1.2%) more than control practices. The intervention also reduced the missed chance to initiate a vaccination during the visit to the good daycare center by 6.8 percentage points (-6.8%; 95% CI, -9.7% to -3.9%) more than control practices. The intervention did not appear to affect missed opportunities in acute or chronic visits, nor missed opportunities to administer subsequent doses.

The researchers concluded that the intervention led to an increase in HPV vaccination, especially during visits to good daycare centers. The intervention is scalable and they believe the results support widespread use of the intervention.


1. Szilagyi P, Humiston S, Stephens-Shields A, et al .; Effect of training pediatric clinicians in human papillomavirus communication strategies on human papillomavirus vaccination coverage. JAMA Pediatrician. May 24, 2021. Epub before going to print. doi: 10.1001 / jamapediatrics.2021.0766

This article was originally published on Contemporary Pediatrics®.

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