In the Journals

Few physicians routinely recommend HPV vaccine to boys

Fewer than 15% of physicians routinely recommend HPV vaccination to male patients, according to study results.

Permissive guidelines, financial considerations and patient payer status may have influenced physicians’ decision-making, researchers wrote.

“HPV is responsible for almost all cases of cervical and anal cancers, as well as 64% of vaginal cancers, 36% of penile cancers and 51% of vulvar cancers,” researcher Susan T. Vadaparampil, PhD, senior faculty member in the Health Outcomes and Behavior Program at Moffitt Cancer Center, said in a press release. “Women tend to be afflicted by HPV-induced cancer more than men; however, more men have genital and oral HPV infections than women.”

In 2009, the CDC’s Advisory Committee on Immunization Practices (ACIP) issued a permissive recommendation indicating that physicians could vaccinate males aged 9 to 26 years against HPV. In 2011, the committee issued a stronger recommendation in support of routine vaccination of males ages 11 or 12 years.

Vadaparampil and colleagues conducted a mail-in survey of 746 family physicians and 473 pediatricians to examine factors associated with physician recommendations for HPV vaccination of patients ages 11 to 12 years, those aged 13 to 17 years, and those aged 18 to 26 years.

Physicians reported the frequency with which they recommended HPV vaccination to male patients, with a response of “always” equating to at least 75% of the time.

Results showed fewer than 15% of respondents reported always recommending the HPV vaccine for male patients. Researchers determined 10.8% of physicians always recommended HPV vaccination for boys aged 11 to 12 years; 12.9% always recommended vaccination for boys aged 13 to 17 years; and 13.2% always recommended vaccinations for those aged 18 to 26 years.

The researchers found that clinicians who self-reported as “early adopters” or innovators were more likely to routinely recommend the vaccine, despite only permissive guidelines from ACIP. Researchers noted that this may be due to a greater level of knowledge about clinical trial results of the HPV vaccine in males, or more positive attitudes toward change or risk.

Physician specialty also appeared to be a factor in recommendation practices, with more pediatricians than family physicians reporting that they recommended the vaccine to males. Physician race as well as payment method of the patient also were found to be associated with vaccine recommendation to patients aged 11 to 12 years. Patient race also was a factor in vaccine recommendations to those aged 13 to 17 years, as well as those aged 18 to 26 years.

“Public health interventions designed to increase HPV vaccine recommendation for males should focus on increasing recommendations by family practitioners, and also identifying and supporting innovators and early adopters who may help diffuse HPV vaccination guidelines and encourage later adopters to support the recommendations,” Terri L. Malo, PhD, of the Health Outcomes and Behavior Program at Moffitt Cancer Center, said in the release.

Disclosure: The researchers report research funding, consultant/lecture fees and grant funding from GlaxoSmithKline, Merck and Sanofi Pasteur.

Fewer than 15% of physicians routinely recommend HPV vaccination to male patients, according to study results.

Permissive guidelines, financial considerations and patient payer status may have influenced physicians’ decision-making, researchers wrote.

“HPV is responsible for almost all cases of cervical and anal cancers, as well as 64% of vaginal cancers, 36% of penile cancers and 51% of vulvar cancers,” researcher Susan T. Vadaparampil, PhD, senior faculty member in the Health Outcomes and Behavior Program at Moffitt Cancer Center, said in a press release. “Women tend to be afflicted by HPV-induced cancer more than men; however, more men have genital and oral HPV infections than women.”

In 2009, the CDC’s Advisory Committee on Immunization Practices (ACIP) issued a permissive recommendation indicating that physicians could vaccinate males aged 9 to 26 years against HPV. In 2011, the committee issued a stronger recommendation in support of routine vaccination of males ages 11 or 12 years.

Vadaparampil and colleagues conducted a mail-in survey of 746 family physicians and 473 pediatricians to examine factors associated with physician recommendations for HPV vaccination of patients ages 11 to 12 years, those aged 13 to 17 years, and those aged 18 to 26 years.

Physicians reported the frequency with which they recommended HPV vaccination to male patients, with a response of “always” equating to at least 75% of the time.

Results showed fewer than 15% of respondents reported always recommending the HPV vaccine for male patients. Researchers determined 10.8% of physicians always recommended HPV vaccination for boys aged 11 to 12 years; 12.9% always recommended vaccination for boys aged 13 to 17 years; and 13.2% always recommended vaccinations for those aged 18 to 26 years.

The researchers found that clinicians who self-reported as “early adopters” or innovators were more likely to routinely recommend the vaccine, despite only permissive guidelines from ACIP. Researchers noted that this may be due to a greater level of knowledge about clinical trial results of the HPV vaccine in males, or more positive attitudes toward change or risk.

Physician specialty also appeared to be a factor in recommendation practices, with more pediatricians than family physicians reporting that they recommended the vaccine to males. Physician race as well as payment method of the patient also were found to be associated with vaccine recommendation to patients aged 11 to 12 years. Patient race also was a factor in vaccine recommendations to those aged 13 to 17 years, as well as those aged 18 to 26 years.

“Public health interventions designed to increase HPV vaccine recommendation for males should focus on increasing recommendations by family practitioners, and also identifying and supporting innovators and early adopters who may help diffuse HPV vaccination guidelines and encourage later adopters to support the recommendations,” Terri L. Malo, PhD, of the Health Outcomes and Behavior Program at Moffitt Cancer Center, said in the release.

Disclosure: The researchers report research funding, consultant/lecture fees and grant funding from GlaxoSmithKline, Merck and Sanofi Pasteur.