What is already known on this topic? Parents are willing to use pharmacies as an alternative to clinics for their children's vaccination services, including the human papillomavirus (HPV) vaccine. However, the willingness of pharmacists to administer or promote this vaccine, especially in rural areas, is not well understood. What is added by this report? Rural pharmacists have the potential to be effective collaborators for HPV vaccine administration and promotion, but barriers, such as lack of education and capacity, exist. What are the implications for public health practice? Barriers to using pharmacists as providers of HPV vaccine could be overcome through partnerships with stakeholders who are already promoting the administration of HPV vaccine, and these barriers should be the focus of future research.

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Background Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is suboptimal in the United States (U.S.). Previous research has found a variety of intervention strategies (environmental and behavioral) to increase its uptake. The purpose of the study is to systematically review the literature on interventions that promote HPV vaccination from 2015 to 2020. Methods We updated a systematic review of interventions to promote HPV vaccine uptake globally. We ran keyword searches in six bibliographic databases. Target audience, design, level of intervention, components and outcomes were abstracted from the full-text articles in Excel databases. Results Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed at a single level (76.3%) of the socio-ecological model. Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twenty-seven (33.8%) reported using theory in intervention development. Of those reporting HPV vaccine outcomes, post-intervention vaccine initiation ranged from 5% to 99.2%, while series completion ranged from 6.8% to 93.0%. Facilitators to implementation were the use of patient navigators and user-friendly resources, while barriers included costs, time to implement and difficulties of integrating interventions into the organizational workflow. Conclusions There is a strong need to expand the implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults.

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What is already known on this topic?Research has shown that dental providers are willing to be involved in HPV vaccine promotion, but little is known about factors related to that willingness. What is added by this report?Our research identified important factors to address in future programs to help dental providers in HPV vaccine promotion. Our results aid design for an intervention to educate parents, to recommend the vaccine, and to refer parents to local providers.What are the implications for public health practice? Engaging dental providers in HPV vaccine promotion will give parents another source of information on the vaccine and ultimately help to increase vaccinations and reduce oropharyngeal cancers.