Purpose A review of the literature to identify modifiable influences on female human papillomavirus (HPV) vaccine uptake relevant to clinical practice in order to support nurse practitioners (NPs) in the prevention of cervical cancer. Data sources PubMed, CINAHL, reference lists of publications that surfaced in the electronic search. Conclusions Six influences are modifiable and potentially amenable to being addressed at the clinic encounter level: (a) cost and insurance coverage, (b) provider recommendation, (c) vaccination opportunity, (d) HPV and HPV vaccine knowledge, (e) vaccine safety concerns, and (f) HPV risk. Implications for practice NPs have an important role in improving HPV vaccine uptake and research suggests several areas they can address to increase vaccination during clinic visits.

Orf, a parapoxvirus, is a zoonosis causing a contagious pustular dermatitis, and has a high morbidity in sheep worldwide. Despite a vaccine being available, orf prevalence in England is estimated to be 2 per cent in ewes and 20 per cent in lambs​​. There is concern that farmers are not complying with the vaccination guidelines and therefore the objective of this study was to investigate if orf vaccine is used correctly on sheep farms in the UK and to identify barriers and motivators of sheep farmers to use the vaccine. The survey was completed by 570 respondents. The results show several areas of concern; only 27 per cent of respondents used the correct site (axilla), 37 per cent of respondents would use orf vaccine up to a week after opening a vial (shelf life is eight hours), 33 per cent of respondents would vaccinate their ewes too close to lambing and 73 per cent of respondents did not separate vaccinated and non-vaccinated animals (both leading to infection risk for non-vaccinated animals). When vaccinating, only 53 per cent of respondents were wearing gloves and 31 per cent washed their hands just before and immediately after vaccination. Results demonstrate that orf vaccination is not carried out correctly on all UK sheep farms, which is likely to affect vaccine efficacy. A concern around vaccine efficacy, the ‘hassle’ of the scratch administration, the ‘risk of making it worse’ and the zoonotic risk when vaccinating were the most common barriers for using orf vaccine, highlighting the importance of veterinary advice when prescribing orf vaccine.

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