U.S. health officials have been working to grow HPV vaccine uptake for years with some success. Now, a study shows that if doctors are persistent in encouraging the vaccine, parents will be more likely to opt for vaccination for their children even if they started out with hesitations.
Published in Pediatrics, the study documents 43 clinic visits in Dallas in which parents were undecided about vaccines. In 37 of the visits, parents expressed hesitancy about the vaccine in several ways, such as by asking questions, talking about their concerns or giving an assertive negative response.
When the doctors only acquiesced in response, no parents changed their minds, the researchers found. But when the doctors were persistent about recommending the vaccine at the clinic visits, 94% of children were vaccinated, or 17 out of 18 instances. Even when parents had strong reservations about the vaccine, doctor persistence led to vaccinations for children in 7 of 7 visits.
In a video summary of the work, researcher Laura Aubree Shay, an assistant professor at the University of Texas Health Science Center School of Public Health, said that when doctors respond only with acquiescence, it's "clearly a missed opportunity."
According to the CDC, the national HPV vaccine coverage rate is 60%, and coverage varies significantly from state to state. In California, for instance, at least 70% of children have received one dose or more, while in Texas the rate is under 50%. The agency recommends the vaccine for all children ages 11 to 12.
For years, uptake for HPV vaccines—namely Merck's Gardasil 9 now that GlaxoSmithKline's Cervarix is off the U.S. market—has been lower than desired by U.S. authorities and the medical community. After huge early sales projections, uptake has been hurt by a sex stigma, safety concerns and doctors’ reluctance to give the vaccines a strong recommendation. Still, Merck's Gardasil 9 is an important contributor for the drugmaker, generating sales of $2.3 billion last year.
In an effort to help uptake, the CDC in 2016 signed off on a two-dose regimen instead of recommending three doses. The U.S. Department of Health and Human Services has a goal of an 80% immunization rate for both boys and girls by 2020.