Intent and subsequent initiation of human papillomavirus vaccine among young cancer survivors

Abstract

BACKGROUND:Despite an increased risk of subsequent human papillomavirus (HPV)-related malignancies, HPV vaccine initiation rates among cancer survivors remain critically low. The purpose of this study was to determine the relationship between HPV vaccine intent and subsequent vaccine initiation among cancer survivors by linking data from a cross-sectional survey with statebased immunization registry records. METHODS: Cancer survivors who were 9 to 26 years old were surveyed 1 to 5 years after their treatment to assess their HPV vaccine initiation status, HPV vaccine intent, sociodemographic factors, and vaccine-related health beliefs. HPV vaccine doses/dates were abstracted from the Georgia Registry for Immunization Transactions for 3.5 years after survey participation. Logistic regression models identified factors associated with vaccine intent and subsequent vaccine initiation. RESULTS: Among survivors who were HPV vaccine-naive at survey participation (n = 103), factors associated with vaccine intent included the following: 1) provider recommendation for the HPV vaccine (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.4-18.1; P = .014), 2) positive general attitude toward vaccines (OR, 4.8; 95% CI, 2.0-11.2; P < .001), and 3) perceived severity of HPV disease (OR, 3.5; 95% CI, 1.2-9.9; P = .02). Of the vaccine-naive patients, 28 initiated the HPV vaccine at a median of 1.1 years after the survey. Initiation was more likely among survivors who had reported vaccine intent (OR, 3.9; 95% CI, 1.2-12.5; P = .02) and was less likely among older survivors (OR per year, 0.7; 95% CI, 0.6-0.9; P < .001). CONCLUSIONS: These findings suggest that provider recommendation for the HPV vaccine plays a role in establishing intent, which then translates into subsequent initiation. Cancer 2019;125:3810-3817.

Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York

“…In addition, the vaccine is normally administered by a primary care provider (PCP) as opposed to an oncologist 28 . This can impact HPV vaccine delivery during a patient's transition from oncology to primary care, due to inconsistent linkages with PCPs, and uncertainty from oncologists regarding their role in HPV vaccination 17,26,28 . Opportunities for collaboration between healthcare providers and for a stronger role in HPV vaccination for cancer centers should be a priority in future implementation research.…”

“…Moreover, studies of HPV vaccination in childhood cancer survivors have involved short follow-up and relied on self-reported data. [14][15][16][17][18] Therefore, the purpose of this study was to assess HPV vaccination rates in a cohort of childhood cancer survivors since introduction of the vaccine using independent data from a statewide vaccine registry. In addition, we sought to identify clinical factors associated with HPV vaccine uptake (or hesitancy) that could be used to improve HPV vaccine uptake in this special population and in cancer care practice.…”

“…Little is known about the rates of HPV vaccination compared to other adolescent vaccines among young cancer survivors, and less is known about the clinical factors associated with vaccine uptake. Moreover, studies of HPV vaccination in childhood cancer survivors have involved short follow‐up and relied on self‐reported data 14–18 . Therefore, the purpose of this study was to assess HPV vaccination rates in a cohort of childhood cancer survivors since introduction of the vaccine using independent data from a statewide vaccine registry.…”

Human papillomavirus (HPV) vaccination is cancer prevention for childhood cancer survivors

“…Of the small proportion of childhood cancer survivors who did receive a health care provider recommendation, more than one‐half were vaccinated. Other barriers for HPV vaccination among childhood cancer survivors include uncertainty about insurance coverage or cost of the HPV vaccine and relevance or importance 8,11,15,16 . Perception of vaccine benefit has been shown to be highly correlated with completion of the HPV vaccination series, 16 and older age has been shown reported higher rates of uptake 10 .…”