Lack of school requirements and clinician recommendations for human papillomavirus vaccination

Abstract

More than a decade after its introduction, human papillomavirus (HPV) vaccination coverage remains low in the United States despite a robust record of safety and effectiveness. A strong recommendation from a clinician is one of the most important determinants of uptake, yet clinicians often fail to provide effective recommendations. One potential barrier to effective recommendations by clinicians that has not been explicitly studied is the widespread lack of school entry requirements for HPV vaccination. In this qualitative study, we found the lack of requirements to be an important reason for clinicians’ framing HPV vaccination recommendations as optional and non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that is focused on disease prevention and uncoupled from requirements. Additionally, greater support for HPV vaccination requirements among clinicians may be needed to successfully enact requirements in the future.