She’s due her HPV vaccination

Editorial Team

Editorial Team

January 3rd, 2017

Editorial Team

‘Uptake of the cervical cancer vaccine is highest when doctors tell parents that it’s time for their daughter’s jab. Beginning with an open question is less likely to work. ’

A study in Pediatrics, a medical journal, confirms that doctors can significantly influence whether adolescent girls have the HPV vaccine which can prevent several forms of cancer, including cancer of the cervix.

‘Presumptive announcement’ was found to be more effective than ‘participatory conversations’, according to the researchers. The study followed health professionals working at 30 clinics in North Carolina in the United States.

Communication training

At some centres, doctors were trained to announce that it was HPV vaccination day; others were trained to run conversations about HPV vaccination; while a control group were given no training. The researchers then looked at immunisation rates recorded in the state registry in the six months that followed.

In more than 17,000 girls aged 11 and 12 it was found that clinics where doctors had received ‘announcement training’ had 5% greater vaccine uptake than the other two groups of doctors.

Read: How should doctors communicate about immunisation

Training for the ‘announcement group’ was a little more sophisticated than simply advising doctors to declare it vaccination day – no questions asked. They were also trained to encourage vaccination on that day.

And, where parents had concerns about vaccination, clinicians sought to ease their concerns by providing information, before concluding with a clear recommendation at the end.

“We speculate that announcements normalise HPV vaccination for both providers and parents, making providers more likely to raise the topic and parents more likely to consent to vaccination,” say the authors.

Read: Training doctors to talk about vaccination

The findings echo earlier work looking at conversations between doctors and parents about childhood immunisations.

Dr Douglas Opel and colleagues at Seattle Children’s Hospital found that beginning a conversation with a clear recommendation rather than an open question increases the likelihood of vaccination.

The need to provide evidence-based communication training for health professionals is clear. In a separate new study published in the journal Cancer Epidemiology, Biomarkers & Preventionit was found that more than one quarter of doctors do not strongly recommend the HPV vaccine.

The survey of almost 800 doctors in the US found that 27% offered only a weak endorsement while 49% did not routinely recommend same-day vaccination.

“Many physicians in our national sample reported recommending HPV vaccine inconsistently, behind schedule, or without urgency,” said the authors. “These practices likely contribute to under-immunization among adolescents, and may convey ambivalence to parents.”

These might be discouraging findings but the authors of the paper said it highlights scope for improving uptake:

“By improving how physicians recommend HPV vaccine, we can raise national coverage, thereby ensuring that today’s youth enjoy the full benefit of a potent tool for cancer prevention.”

Experts are developing training programmes that will boost doctors’ communication skills.

“We know that the recommendation of doctors about vaccination is the most important thing in getting people to go ahead and get their children vaccinated,” says Professor John Parrish Sprowl, Professor of Communication Studies, Indian University-Purdue University.

“Most physicians are extremely well trained at being physicians,” he told Vaccines Today in a video interview. “[But] their communication skills do not always match their medical skills.”

Resources from the European Centre for Disease Prevention & Control (ECDC)

Tips for doctors on discussing vaccination: ‘Let’s talk about protection’
A guide to improving confidence in vaccines: ‘Let’s talk about hesitancy’