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A National Survey of Pediatrician Knowledge and Attitudes Regarding
Human Papillomavirus Vaccination.
Pediatrics, 2006; 118(6):2280-2289.
Daley MF, Liddon N, Crane LA, Beaty BL, Barrow J, Babbel C, Markowitz
LE, Dunne EF, Stokley S, Dickinson M., Berman SM, Kempe A.
Abstract
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.