Acceptance of HPV Vaccination in Kidney Transplant Recipients

Background: Human Papilloma virus (HPV) infections are an increasingly concerning etiology for post-transplantation viral-related malignancies. The nonavalent HPV vaccine (Gardasil 9) affords transplant recipients the best opportunity for malignancy prevention, but vaccine uptake remains low. Not previously reported for solid organ transplant recipients, we studied influential factors for HPV vaccine non-initiation. Methods: This survey, conducted from May to December 2017, examined influential factors for HPV vaccine non-initiation. Post-survey we provided brief, informal education on the risks and benefits of HPV vaccination. Results: Of the 164 patients approached for the study, 157 participated and 154 completed the survey resulting in a 95% response rate. Thirty-two percent of patients within the United States Food and Drug Administration (FDA) approved age range had started or completed the HPV vaccine series at survey administration. The most significant reason for HPV vaccine non-initiation among these kidney transplant patients was a reduced physician recommendation. In addition, HPV vaccine series initiation improved from 32% pre-survey to 62% post-survey. Conclusions: HPV vaccination uptake remains low in kidney transplant patients. Emphasis on physician recommendation of HPV vaccination will reduce vaccine non-initiation rates.