Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2280-2289 (doi:10.1542/10.1542/peds.2006-1946)
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ARTICLE

A National Survey of Pediatrician Knowledge and Attitudes Regarding Human Papillomavirus Vaccination

Matthew F. Daley, MDa,b,c, Nicole Liddon, PhDd, Lori A. Crane, PhD, MPHc,e, Brenda L. Beaty, MSPHb,c, Jennifer Barrow, MSPHb,c, Christine Babbel, MSPHb,c, Lauri E. Markowitz, MDd, Eileen F. Dunne, MD, MPHd, Shannon Stokley, MPHf, L. Miriam Dickinson, PhDg, Stephen Berman, MDa,c and Allison Kempe, MD, MPHa,b,c

a Departments of Pediatrics
e Preventive Medicine and Biometrics
g Family Medicine
b Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado
c Children’s Outcomes Research Program, Children’s Hospital, Denver, Colorado
d Division of Sexually Transmitted Diseases Prevention
f National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVE. A human papillomavirus vaccine was licensed in June 2006. The vaccine is quadrivalent, protecting against 2 human papillomavirus strains that cause cervical cancer and 2 that cause genital warts. The objective of this study was to determine physician characteristics, knowledge, and attitudes associated with an intention to recommend human papillomavirus vaccination.

METHODS. Between August and October 2005, a cross-sectional survey was administered to a national network of 431 pediatricians. The network was developed from a random sample of American Academy of Pediatrics members and was designed to be representative of the organization’s membership with respect to urban/rural location, practice type, and region. The survey was conducted before human papillomavirus vaccine licensure and therefore focused on a candidate quadrivalent human papillomavirus vaccine and a range of potential vaccination recommendations. The main outcome measure was intention to recommend a quadrivalent human papillomavirus vaccine to young adolescent (10- to 12-year-old) females.

RESULTS. Survey response rate was 68%. If endorsed by national health organizations, 46% of respondents would recommend vaccination for 10- to 12-year-old females, 77% for 13- to 15-year-old females, and 89% for 16- to 18-year-old females. Corresponding rates for males were 37%, 67%, and 82%, respectively. Whereas 60% of respondents thought that parents would be concerned that human papillomavirus vaccination may encourage risky sexual behaviors, 11% reported that they themselves had this concern. Respondents who believed that other new adolescent immunization recommendations (eg, meningococcal, pertussis) would facilitate human papillomavirus vaccine implementation were more likely to intend to recommend vaccination.

CONCLUSIONS. Although a national sample of pediatricians expressed a high level of acceptance of human papillomavirus vaccination in older adolescent females, fewer than one half anticipated giving human papillomavirus vaccine to younger female patients. Provider concerns about parental vaccine acceptance will need to be addressed to optimize human papillomavirus vaccination implementation.

Key Words: immunization • human papillomavirus vaccine • physician attitudes

Abbreviations: HPV—human papillomavirus • FDA—Food and Drug Administration • ACIP—Advisory Committee on Immunization Practices • VFC—Vaccines for Children • AAP—American Academy of Pediatrics

Accepted Aug 24, 2006.


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