How Doctors Create Barriers to Getting the HPV Vaccine

HPV is the most common sexually transmitted disease there is. For most people, it doesn't cause serious problems. However, it can lead to a number of cancers. HPV has been associated with not just cervical cancer but penile, anal, oral, and even lung cancers!

The fact that HPV is so common is one of the reasons it was so exciting when the first vaccine against the most common high- and low- risk subtypes became available. Unfortunately, uptake of the vaccine has been slow in the United States. In countries where it's effectively mandated, the vaccine has greatly lowered HPV infections and the cancers they cause.

Why don't American parents vaccinate their kids against HPV? There are a number of reasons. Some of the biggest have to do with the behaviors of their doctors.

Doctors Don't Reliably Suggest the HPV Vaccine to Parents or Teens

HPV Vaccine
HPV Vaccine. Peter Dazeley / Photographer's Choice / Getty Images

A doctor recommendation is one of the single biggest factors in whether teens get vaccinated against HPV. However, for many doctors, this recommendation isn't yet a routine part of care. This has been shown time and time again.

Interestingly, there isn't a consensus on where doctors tend to focus their recommendations. It is clear that doctors vary their recommendations based on their perceptions of patient need. However, different studies have found different results in who is most likely to be offered the vaccine.

The lack of routine recommendations for the HPV vaccine needs to change. A doctor suggesting the vaccination is unquestionably the best way for the US to improve coverage rates. When doctors recommend the vaccine, teens are far more likely to get it.

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Appointments Aren't Automatically Scheduled for Shots 2 and 3

Vaccine Calendar
Vaccine Calendar. numbeos/Getty Images

Technology is a wonderful thing. However, sometimes we rely on it and it fails us. A study published in the winter of 2016 shows how mismatched expectations mean that young people often don't get the 2nd and third doses of the HPV vaccine. These doses are essential to effectiveness.

It was thought for a long time that parents were mostly worried about cost or inconvenience. Researchers assumed that was why young people didn't finish the vaccine series. This study suggested something different. People didn't get their 2nd and 3rd doses of the HPV vaccine because no one scheduled them.

Doctors thought parents would schedule. Parents thought doctors would schedule.... Unfortunately, they both were wrong. Fortunately, this is a problem that is easily fixed. Medical systems just need to make a point of scheduling appointments for follow up shots after the first vaccine is given. That sort of proactive response makes a difference.

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Doctors Think That Promoting the HPV Vaccine Is Too Much Work or Won't Work

Woman with Doctor in HOspital. Terry Vine/Blend Images/Getty Images

National studies of American doctors have investigated the reasons doctors don't talk about the HPV vaccine to parents. What did they find? Doctors found talking about the HPV vaccine much more difficult than talking about other vaccines. Doctors thought parents didn't care as much about the HPV vaccine. The doctors themselves found this vaccine to be less important. Therefore, they were much less likely to have these discussions.

Doctors also had to overcome their own reluctance to talk about HPV and sexual risk. It's not surprising. Doctors are people too. They often have to overcome the same difficulties talking about sexual matters as everyone else. It's not included nearly enough in their medical training. Fortunately, there is a growing recognition of the importance of both these conversations and HPV vaccination. That means that researchers and educators are finally starting to recognize the need to create communication support to help doctors have these sensitive and important discussions.


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Parents can make a change

Doctors play an enormous role in how individuals get medical care. That's natural. However, with teens, parents can take a big role too. That's particularly true for the HPV vaccine. If your teen's doctor doesn't recommend the HPV vaccine, ask for it. Encourage your son or daughter to discuss the risks and benefits with their physician. Discuss those risks directly with your kids. These discussions are a great way to improve your children's long term sexual health. That's not just because they increase vaccination rates. It's also because, by having these talks, you show your kids that you're safe to be open with about their sexual questions and concerns.

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