It would be great to say HPV vaccination rates have hit their stride and are comparable with the rates of infant, toddler, and school-age scheduled vaccines—but they still are not. Perhaps the new two-dose schedule for children between 11 and 15 will help insure better compliance with full dosing—but it is too early to see that improvement.
On the other hand, how we communicate with our patients about the importance of this vaccine can make a difference—and that is shown this week in a randomized trial by Brewer et al. (10.1542/peds.2016-1764). The authors decided to study the effectiveness of two communication strategies –the use of an “announcement” to a family simply stating to a parent that their teen is ready to be vaccinated versus a participatory open-ended “conversation.”
The authors did a randomized clinical trial involving 30 pediatric and family medicine practices in North Carolina with some practices receiving no training of either strategy, and others getting one-hour of training to become facile with the announcement or conversation technique. The outcome was initiation of the vaccine series in pre-teens ages 11 and 12. Of the 17,000 teens seen in a 6 month period, one strategy was found to be statistically better than the other—that of announcements.
It is possible that some of us might be uncomfortable using this strategy since it seems like we are forcing a family to get the vaccine without allowing them to consider the option. On the other hand, it is also clear from prior studies such as Prevalence of HPV After Introduction of the Vaccination Program in the United States (10.1542/peds.2015-1968 )
that the benefits of getting this vaccine exceed any minor risks. How do you feel about simply announcing that you assume a patient is to get their vaccine at a given visit, rather than offer them an option? We’d love to hear your response either by responding to this blog, posting a comment on our website or sharing your thoughts on our Facebook or Twitter pages.