Improving HPV Vaccination Rates in a Pediatric Group: A Pilot Project

Background: Human Papilloma Virus (HPV) vaccines are safe and effective and provide long-lasting protection against the virus. The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination at 11-12 years old, although the series can be started at age 9 years. However, the American Academy of Pediatrics (AAP) and the American Cancer Society (ACS) recommend routinely starting the HPV vaccination series at age 9 years. Aims: The purpose of this quality improvement project was to improve HPV vaccination rates by 10% in patients ages 9-10 years at a large pediatric group in Salt Lake City, Utah. This purpose was accomplished through pediatric healthcare provider (HCP) education. Methods: A questionnaire was used to determine the HCPs’ clinical practice and confidence level regarding the HPV vaccine at baseline before the educational presentation. The vaccination education was based on HPV resources from the AAP and ACS and focused on the rationale for initiating the HPV vaccine series at ages 9-10 years. The goal was to increase HPV vaccinations in 9–10-year-olds by 10%. Results: Prior to HCP education, HCPs were somewhat confident initiating the HPV vaccine series at age 9-10 years old. HCPs reported that parents questioned the need for HPV vaccine at age 9-10 years because it is earlier than the age of typical sexual activity. Because the clinic had not yet adopted the AAP and ACS recommendation to routinely administer HPV vaccination at age 9-10 years, individual HCPs were more likely to follow the recommendations of the CDC. One year after presenting the HCP education, HPV vaccination rates increased by 149 (61%) doses among 9–10-year-old patients. Discussion: HCPs’ confidence levels in HPV vaccination increase as the child ages. However, there are multiple benefits to initiating HPV vaccination at the age of 9 years, including timely completion, prevention of more cancers, and improved immunogenicity. HCP education is an effective strategy to increase HPV vaccination in 9-10-year-old patients.