Postpartum visits ‘missed opportunity’ to incorporate HPV vaccination into care

Key takeaways:

• Lack of awareness and knowledge are the biggest barriers to HPV vaccination among women.
• Incorporating HPV vaccination into routine postpartum care increased vaccine uptake and vaccine series completion rates.

The addition of HPV vaccination into routine postpartum care may increase vaccination rates, which can reduce patient costs, prevent HPV-related cancers and vaccinate vulnerable populations, researchers reported in Obstetrics & Gynecology.

“The postpartum period has been identified as a missed opportunity for HPV vaccination counseling and administration,” Sara E. Brenner, MD, MPH, third-year resident in the department of gynecology and obstetrics at Emory University School of Medicine, and colleagues wrote. “Many vaccinations are already given routinely in the postpartum period such as the Tdap and the measles-mumps-rubella vaccines. These are often incorporated into perinatal workflows so that patients are routinely educated on their options for vaccination during their prenatal visits and postpartum patients can receive them before leaving the hospital.”

In a systematic review, Brenner and colleagues analyzed data from nine studies conducted through July 2024 evaluating HPV vaccination during the postpartum period.

Researchers categorized studies based on their primary objective of defining the problem (n = 1), assessing patient perspectives (n = 2) or testing interventions to increase HPV vaccination (n = 7).

In one retrospective study of 51,913 postpartum women not vaccinated against HPV, only 1.8% received any HPV vaccine dose by 1-year postpartum. These findings highlight the missed opportunities for HPV vaccination, specifically during the postpartum period, according to the researchers.

Studies assessing patient perspectives suggested a lack of awareness and knowledge of the HPV vaccine as the largest barriers to successful vaccination. For one study, researchers interviewed 500 prenatal women and found 55% reported ever hearing of the HPV vaccine; Black women were more likely to cite concerns about vaccine costs and adverse events. Another study suggested postpartum women had an overall positive view of the HPV vaccine and appreciated the “convenience and patient-centric approach” of an inpatient postpartum vaccination program.

All studies evaluating interventions to increase HPV vaccination uptake demonstrated an increase in vaccination rates ranging from 22.3% to 75.4% for one inpatient HPV vaccine dose. Three postpartum vaccination programs assessed HPV vaccine series completion and observed an increased completion rate ranging from 13.6% to 84.4%.

Women who received their first HPV vaccine dose inpatient were more likely to receive a subsequent dose (60.3% vs. 30.2%) and were more likely to complete the vaccination series (35.8% vs. 9.3%) vs. women who received first HPV vaccine dose outpatient, according to one study.

“Effective interventions to increase rates of HPV vaccination include incorporating HPV vaccination into inpatient postpartum care, reducing patient cost burden and improving community awareness,” the researchers wrote. “The strategies outlined in this review should be considered by maternal health clinicians, hospital administrators and organization leaders to increase the uptake of the nonavalent HPV vaccine among the patients most at risk for HPV-related disease.”