What affects human papillomavirus vaccination rates? A qualitative analysis of providers' perceptions.

PURPOSE To define factors that providers perceive as affecting their administration of human papillomavirus (HPV) vaccination in their clinical practices. METHODS We conducted in-depth, qualitative interviews with 34 pediatric and family medicine providers in four community health centers to explore providers' perceptions of factors that either enabled or impeded their ability to vaccinate their patients against HPV. RESULTS Providers' self-reported vaccination rates ranged from 25 to 95% (median, 75%) of the 11- to 26-year-old females in their practices. Factors that enabled vaccination included providers' beliefs that HPV vaccines were safe and would provide important health benefits, structured visits that promoted vaccination, and coadministration of HPV with other recommended vaccines. Factors that impeded vaccination included safety concerns, a low perceived severity of HPV disease, lack of school mandates, and policies against coadministration of HPV and meningococcal vaccines. Providers who described more enabling factors than impeding factors reported vaccinating more of their patients. CONCLUSIONS Provider perceptions around the ease or difficulty of providing HPV vaccination may influence their behavior when offering HPV vaccines to their patients.