Potential barriers to HPV vaccine provision among medical practices in an area with high rates of cervical cancer

J Adolesc Health. 2008 Oct;43(4 Suppl):S61-7. doi: 10.1016/j.jadohealth.2008.06.015.


Purpose: Potential barriers to widespread vaccination of adolescent girls against human papillomavirus (HPV) infection are poorly understood. We provide an overview of potential barriers to provision of HPV vaccine and empirical data on the concerns of medical practices that may inhibit HPV vaccine provision.

Method: We conducted phone interviews with medical practices in rural areas in southeastern North Carolina with high rates of cervical cancer to assess 10 potential concerns about HPV vaccine provision.

Results: Concerns most commonly reported by medical practices (N = 71) were inadequate reimbursement (68%), high cost of the vaccine to patients (66%), and burden of determining insurance coverage (66%). Practices that were not providing the vaccine reported more concerns about HPV vaccine provision on average than practices providing the vaccine (6.0 vs. 4.5 concerns, p < .05).

Conclusions: Medical practices' concerns about the HPV vaccine may be barriers to stocking it and, thus, to providing it to adolescents. Even providers who stock the vaccine reported concerns. Research is needed to address ways to ameliorate these medical practices' concerns and also to understand other potential barriers to vaccine coverage.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Health Services
  • Attitude of Health Personnel
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Insurance, Health, Reimbursement
  • North Carolina / epidemiology
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / administration & dosage*
  • Papillomavirus Vaccines / economics
  • Papillomavirus Vaccines / supply & distribution
  • Parents
  • Patient Acceptance of Health Care*
  • Practice Patterns, Physicians'*
  • Rural Health Services
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology


  • Papillomavirus Vaccines