Catching up with the HPV vaccine: Challenges and opportunities in primary care

Andrew L. Sussman, Deborah Helitzer, Anzia Bennett, Angélica Solares, Marianna Lanoue, Christina M. Getrich

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


PURPOSE Data confirm that high rates of human papillomavirus (HPV) vaccination have not been achieved despite strong clinician endorsement of the vaccine. We conducted a study of primary care clinicians to assess the broad range of health care delivery, health policy, and attitudinal factors influencing vaccination uptake and opportunities for informed decision making. METHODS We implemented a mixed methods study in RIOS Net, a primary care practice–based research network in New Mexico. We first conducted qualitative, in-depth interviews with primary care clinicians, health policy makers, and immunization experts, and followed up with a confirmatory survey distributed to RIOS Net clinician members. RESULTS Health service delivery challenges emerged as the greatest barrier to HPV vaccination, specifically the lack of capacity to track and distribute reminders to eligible patients. Clinicians also reported variations in counseling approaches attributable to both age and emphasis on the cancer prevention benefits of the vaccine. There was no evidence of sociocultural influences on vaccine decision making, nor did concerns about perceived overprotection emerge. CONCLUSIONS Our findings, based on a long-term program of research, suggest that both patients’ attributes and health system delivery are most influential in HPV vaccination coverage challenges. Interventions targeting innovative communication techniques, as well as health system changes that build on efforts toward coordinated care and utilization of other venues to promote vaccination, will be necessary to address these challenges.

Original languageEnglish (US)
Pages (from-to)354-360
Number of pages7
JournalAnnals of Family Medicine
Issue number4
StatePublished - Jan 1 2015
Externally publishedYes


  • Adolescent health services
  • Cervical cancer
  • Health care delivery
  • Health services research
  • Mixed methods research
  • Vaccination

ASJC Scopus subject areas

  • Family Practice


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