Human papillomavirus vaccination receipt and provider counseling rates among high-risk patients

• Published in: Vaccine 2023-05, Vol.41 (18), p.2961-2967
• Main Authors: Wang, Stephanie M., Keegan, Emma A., Bryan, Katherine M., Kazma, Jamil, Das, Kirsten J.H., Long, Beverly J., BuAbbud, Anna
• Format: Article
• Language: English
• Subjects: Adult; Age; Attitudes; Body mass index; Cellular biology; Cervical cancer; Cervical dysplasia; Chi-square test; Colposcopy; Counseling; Documentation; Dysplasia; Electronic health records; Electronic medical records; FDA approval; Female; Gynecology; Health care facilities; Health Knowledge, Attitudes, Practice; Human papillomavirus; Human papillomavirus 16; Human papillomavirus 18; Human papillomavirus vaccine; Human Papillomavirus Viruses; Humans; Hypertension; Immunization; Infections; Insurance coverage; Medical records; Middle Aged; Multivariate analysis; Obstetrics; Papillomavirus Infections; Papillomavirus Vaccines - therapeutic use; Patients; Polls & surveys; Risk groups; Sociodemographics; Uterine Cervical Dysplasia - prevention & control; Vaccination; Vaccines; Web portals; Women; Young Adult
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2023.03.073

•Adjuvant human papillomavirus vaccination among patients with history of dysplasia are low.•Physician counseling rates regarding vaccination among this population have not been studied.•Vaccination rates and physician counseling regarding vaccination in this cohort remain low. We describe provider documented counseling patterns and perception regarding HPV vaccination among patients with a history of cervical dysplasia. All patients ages 21–45 who underwent colposcopy at a single academic medical center from 2018 to 2020were sent a self-administered survey through the electronic medical record patient portal to assess their attitudes regarding human papillomavirus (HPV) vaccination. Demographic information, HPV vaccination history, and documented obstetrics and gynecology provider counseling at the time of colposcopy were examined. Of 1465patients, 434 (29.6 %) reported or had documented receipt of at least one dose of the human papillomavirus vaccine. The remainder reported they were not vaccinated or had no documentation of vaccination. Proportion of vaccinated patients was higher among White compared to Black and Asian patients (P = 0.02). On multivariate analysis, private insurance (aOR 2.2, 95 % CI 1.4–3.7) was associated with vaccinated status while Asian race (aOR 0.4, 95 % CI 0.2–0.7) and hypertension (aOR 0.2, 95 % CI 0.08–0.7) were less likely to be associated with vaccination status. Among patients with unvaccinated or unknown vaccination status, 112 (10.8 %) received documented counseling regardingcatch-up human papillomavirus vaccination at a gynecologic visit. Patients seen by a sub-specialist obstetrics and gynecologic provider were more likely to have documented provider counseling regarding vaccination compared to those seen by a generalist obstetric/gynecologist provider (26 % vs 9.8 %, p