Combined support most effective in improving HPV vaccine delivery

Clinicians and families must work together to effectively promote HPV vaccine series receipt, according to recent study results published in Pediatrics.

“Focused on a highly effective vaccine that reduces cancer risk but is, as yet, poorly adopted, this trial demonstrated that clinician- and family-focused decision support complement each other in improving vaccine delivery to adolescent girls,” researchers wrote. The study included 22,486 girls aged 11 to 17 years due for HPV vaccine dose 1, 2 or 3. Participants were randomly assigned to family-focused decision support and educational phone calls. Four groups were established: family-focused intervention, clinician-focused intervention, combined intervention and no intervention.

Researchers found that final vaccination rates for HPV doses 1, 2 and 3 were 16%, 65% and 63%, respectively, among the controls. They also found that combined intervention increased the final vaccination rates by 9, 8 and 13 percentage points, respectively.

Researchers also found that the control group reached a 15% vaccination rate for the first dose and 50% for doses 2 and 3 after 318, 178 and 215 days, respectively. The combined intervention group reached 15% vaccination for the first dose a mean of 151 days faster and reached a 50% vaccination rate 68 and 93 days faster, respectively, for doses 2 and 3.  The clinician-focused intervention was more effective for promoting initiation of the series, while the family-focused intervention was more effective for promoting completion.

“Given the success of this intervention, future research should be directed at understanding how automated decision support based on [electronic health record] data and delivered to clinicians via [electronic health records] and to families via telephone, text message, email, or patient portals can support the provision of evidence-based care in varied clinical contexts,” researchers wrote. “Our results suggest that a focus on either one alone is likely to be inadequate to fully realize the benefits of [electronic health record] implementation for vaccine delivery.”

Disclosure: Two of the researchers report financial ties with Abbot Laboratories, Care Assistant, Merck and Pfizer.