Association Between Patient Characteristics and HPV Vaccination Recommendation for postpartum Patients: A National Survey of Obstetrician/Gynecologists

Paige W. Lake, Moffitt Cancer Center
Katherine J. Head, Indiana University Purdue University Indianapolis
Shannon M. Christy, Moffitt Cancer Center
Andrea L. DeMaria, Purdue University
Erika L. Thompson, University of North Texas Health Science Center
Susan T. Vadaparampil, Moffitt Cancer Center
Gregory D. Zimet, Indiana University
Monica L. Kasting, Purdue University

This is the publisher's version of Lake PW, Head KJ, Christy SM, DeMaria AL, Thompson EL, Vadaparampil ST, Zimet GD, Kasting ML. Association between patient characteristics and HPV vaccination recommendation for postpartum patients: A national survey of Obstetrician/Gynecologists. Prev Med Rep. 2022 Apr 20;27:101801. doi: 10.1016/j.pmedr.2022.101801


Human papillomavirus (HPV) vaccination rates in the U.S. are relatively low. Provider recommendation rates for HPV vaccination often vary by patient age and relationship status. Obstetrician/gynecologists (OB/GYNs) represent a key provider group that can recommend the HPV vaccine. This study examined differences in OB/GYN recommendation of HPV vaccination for inpatient postpartum patients by age, parity, and marital status. Data were collected from OB/GYNs nationally via a cross-sectional survey. Participants were randomized to two vignette groups (23-year-old patient or 33-year-old patient). Within each group, participants received 4 vignettes that were identical except for patient marital status (married/not in a committed relationship) and number of children (first/third child), and were asked to indicate HPV vaccination recommendation likelihood on a scale of 0 (definitely would not) to 100 (definitely would). A 2 × 2 × 2 general linear model with repeated measures was used to examine main and interaction effects of patient age, relationship status, and parity. 207 OB/GYNs were included in the final analyses. Recommendation was high for 23-year-old patients (range: 64.5-84.6 out of 100). When marital status and parity were held constant, recommendation likelihood was higher for the younger vs. older patient and was also higher for patients not in a committed relationship, compared to married patients (all p-values < 0.001). Differences in recommendation exist when considering age and relationship status, which provides insight into OB/GYN clinical decision-making. Findings highlight the need to address barriers to HPV vaccination recommendation, including awareness of risk factors to consider when recommending the vaccine.