Human papillomavirus vaccination receipt and provider counseling rates among high-risk patients

Authors

Stephanie M. Wang, George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States. Electronic address: swang16@gwu.edu.
Emma A. Keegan, George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States. Electronic address: emmakeegan@gwu.edu.
Katherine M. Bryan, George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States. Electronic address: kmbryan@gwu.edu.
Jamil Kazma, George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States. Electronic address: jkazma@gwu.edu.
Kirsten J. Das, George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States. Electronic address: kjh@gwu.edu.
Beverly J. Long, Sarasota Memorial Hospital, 1700 S Tamiami Trail, Sarasota, FL 34239, United States. Electronic address: beverly.long.11@gmail.com.
Anna BuAbbud, George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States. Electronic address: anna.buabbud@gmail.com.

Document Type

Journal Article

Publication Date

5-2-2023

Journal

Vaccine

Volume

41

Issue

18

DOI

10.1016/j.vaccine.2023.03.073

Keywords

Cervical dysplasia; Colposcopy; Human papillomavirus; Human papillomavirus 16; Human papillomavirus 18; Human papillomavirus vaccine

Abstract

OBJECTIVE: We describe provider documented counseling patterns and perception regarding HPV vaccination among patients with a history of cervical dysplasia. METHODS: All patients ages 21-45 who underwent colposcopy at a single academic medical center from 2018 to 2020were sent a self-administered survey through the electronic medical record patient portal to assess their attitudes regarding human papillomavirus (HPV) vaccination. Demographic information, HPV vaccination history, and documented obstetrics and gynecology provider counseling at the time of colposcopy were examined. RESULTS: Of 1465patients, 434 (29.6 %) reported or had documented receipt of at least one dose of the human papillomavirus vaccine. The remainder reported they were not vaccinated or had no documentation of vaccination. Proportion of vaccinated patients was higher among White compared to Black and Asian patients (P = 0.02). On multivariate analysis, private insurance (aOR 2.2, 95 % CI 1.4-3.7) was associated with vaccinated status while Asian race (aOR 0.4, 95 % CI 0.2-0.7) and hypertension (aOR 0.2, 95 % CI 0.08-0.7) were less likely to be associated with vaccination status. Among patients with unvaccinated or unknown vaccination status, 112 (10.8 %) received documented counseling regardingcatch-up human papillomavirus vaccination at a gynecologic visit. Patients seen by a sub-specialist obstetrics and gynecologic provider were more likely to have documented provider counseling regarding vaccination compared to those seen by a generalist obstetric/gynecologist provider (26 % vs 9.8 %, p < 0.001). Patients cited lack of physician discussion (53.7 %) and the belief that they were too old to receive the HPV vaccine (48.8 %) as the main reasons for remaining unvaccinated. CONCLUSION: HPV vaccination and the rate of obstetric and gynecologic provider counseling regarding HPV vaccination among patients undergoing colposcopy remains low. When surveyed, many patients with a history of colposcopy cited provider recommendation as afactor in their decision to undergo adjuvant HPV vaccination, demonstrating the importance of provider counseling in thisgroup.

APA Citation

Wang, Stephanie M.; Keegan, Emma A.; Bryan, Katherine M.; Kazma, Jamil; Das, Kirsten J.; Long, Beverly J.; and BuAbbud, Anna, "Human papillomavirus vaccination receipt and provider counseling rates among high-risk patients" (2023). GW Authored Works. Paper 2959.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2959

Department

Obstetrics and Gynecology