TABLE 5

Factors Associated With Not Strongly Recommending HPV Vaccine to 11- to 12-Year-Old Female Patients Among Pediatricians and Family Physicians Administering HPV Vaccine in Their Practices (N = 608)

nProportion Not Strongly Recommending, %Risk Ratio (95% Confidence Interval)
UnadjustedAdjusteda
Provider strongly or somewhat agrees with statementb
    It is necessary to discuss sexuality before recommending HPV vaccine28353.01.29 (1.09–1.53)1.27 (1.07–1.51)
    Other new adolescent vaccines have made it easier to introduce HPV vaccine41543.90.83 (0.70–0.99)
    Parents of 11–12 year-old patients have been upset that provider is offering a vaccine against a sexually transmitted infection to someone this age15251.31.14 (0.95–1.37)
    Parents of 11–12 year-old patients have been more likely to refuse HPV vaccine than parents of 16–18-year-old patients44054.82.23 (1.68–2.96)2.09 (1.66–2.81)
Provider perceives this issue as definitely or somewhat a barrier to HPV vaccinationc
    Time it takes to discuss HPV vaccination with parents7762.31.41 (1.16–1.72)1.30 (1.04–1.58)
    Provider concern about adding another vaccine to vaccine schedule4072.51.61 (1.31–1.99)
    Parent concern about HPV vaccine safety17154.41.25 (1.05–1.49)
    Parent concern about HPV vaccine efficacy9459.61.35 (1.11–1.63)
Estimated proportion of patients with public health insurance
    0%–9%22156.6ReferenceReference
    10%–24%15752.20.92 (0.76–1.12)0.85 (0.70–1.05)
    25%–49%11833.90.60 (0.45–0.79)0.63 (0.46–0.81)
    ≥50%8732.20.57 (0.41–0.79)0.59 (0.40–0.80)
Region
    South17447.7ReferenceReference
    Northeast14155.31.16 (0.94–1.44)1.17 (0.94–1.41)
    Midwest15842.40.89 (0.70–1.13)0.86 (0.67–1.05)
    West13540.70.85 (0.66–1.10)0.83 (0.64–1.06)
Specialty
    Pediatrics33743.6ReferenceReference
    Family medicine27150.21.15 (0.98–1.36)1.17 (0.99–1.36)
  • a All variables with adjusted risk ratios were included in final multivariate model.

  • b Reference group is provider somewhat or strongly disagreeing with the statement.

  • c Reference group is provider perceiving this issue as a minor barrier or not at all a barrier to HPV vaccination.