Support for pharmacist-provided HPV vaccination: National surveys of U.S. Physicians and parents

Abstract

Background: State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. We characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. Methods: In 2014 to 2015, we conducted two national U.S. surveys of 776 primary care physicians (PCPs) and 1,504 parents of adolescents. Respondents indicated the extent to which they supported pharmacist-provided HPV vaccination for 13- to 17-year-olds who are past due. Respondents could endorse the provision unconditionally, or only if certain conditions were met, such as pharmacists receiving proper vaccination training. We used multivariable logistic regression to assess correlates of support. Results: Most physicians (79%) and parents (81%) endorsed pharmacist-provided HPV vaccination if pharmacists had received proper vaccination training, reported vaccine doses to adolescents' PCP, and referred adolescents to PCPs for other health services. Family medicine physicians were more likely than pediatricians to support trained pharmacists providing HPV vaccination [OR ¼ 1.62; 95% confidence interval (CI) 1.17–2.22]. Support was also higher among physicians who practiced in Western states (OR ¼ 2.11; 95% CI, 1.30–3.40). Parents' odds of endorsing trained pharmacists provision of HPV vaccine increased with higher overall satisfaction with their pharmacy's services (OR ¼ 1.10; 95% CI, 1.02–1.19), belief in pharmacists' competence in vaccination practices (OR ¼ 1.42; 95% CI, 1.18–1.70), and overall vaccine confidence (OR ¼ 1.30; 95% CI, 1.15–1.48). Conclusions: To increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care. Impact: Stakeholders' feedback and buy-in is important to help guide expansion of HPV vaccination in pharmacies.