Healthcare provider perspectives on HPV vaccinations at ages 9–10 in the United States

This study investigated health care providers' (HCPs') attitudes and experiences with initiating HPV vaccination at 9–10 y old instead of 11–12 y old. We conducted a cross-sectional online survey with 500 US HCPs who reported recommending and/or administering HPV vaccination to pediatric patients, recruited from a membership-based panel. The survey focused on providers' experiences with, and attitudes toward, routine HPV vaccination at age 9–10. Participants included pediatricians (n = 175), family medicine physicians (n = 175), nurse practitioners (n = 75), and physician assistants (n = 75). HCPs were mostly female (56%), white (79%), with a mean age of 43 y. HCPs reported mentioning the HPV vaccine to boys and girls before age 11 72% and 77% of the time, respectively, but recommending it prior to age 11 less frequently (38% and 51% of the time). Few HCPs (11%) reported introducing the vaccine at the same visit at which it was given; 36% reported multiple discussions before acceptance. A substantial proportion of HCPs (23%) would not administer HPV vaccine when children were <11 y old, even if asked by parents. HCPs reported that a majority of parents who were offered HPV vaccination for their children at 9–10 y of age accepted. HCPs identified benefits of earlier vaccination; the top three were improving on-time completion, completion prior to other adolescent vaccines and increased opportunities to vaccinate. Top concerns included parent misconception about the duration of protection and difficulty explaining HPV vaccination to a younger child. Findings suggest most HCPs would support earlier HPV vaccination and see potential for improved completion.