HPV Vaccination Uptake

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The first vaccine for the treatment of the human papillomavirus (HPV4) was approved in 2006 (Walling et al., xx). In 2014, HPV4 was replaced by HPV9 (Gardasil®9), which protects against nine strains of HPV, as opposed to four, which were responsible for approximately 85% of cervical cancer cases (Barraza et al., 2016).  After its initial approval, the FDA extended the use of the vaccine for men and women aged 27-45. Still, vaccination rates remain well below the targeted rate. The literature looking at HPV vaccine hesitancy explicates the importance of a multifaceted approach informed by multiple stakeholders and data sources in order to gain a comprehensive understanding of HPV vaccine receipt. However, no review has yet been done of multi-level studies of vaccine hesitancy. 

Researchers at the Social Policy Institute received funding through the St. Jude WUSTL Implementation Science Research Collaborative to conduct a scoping review of the barriers and facilitators to HPV vaccine uptake within primary care settings. A scoping review allows for a much broader review than either systematic reviews or a meta-analysis. It aims to map out evidence on a complex topic that has not been extensively reviewed previously, delineating the main concepts and gaps in the literature (Pham et al., 2014). The purpose of this scoping review is to synthesize the literature respective to barriers and facilitators to HPV vaccine receipt in primary care settings from the perspective of the individual (families), providers and staff, clinic practice, and larger, external factors including reimbursement, medical guidelines, and the larger political landscape.  Findings from this review have the potential to help inform future research and primary care practice to increase HPV vaccination, particularly among un- and under-vaccinated populations.