Collaborative patient-provider communication and uptake of adolescent vaccines

Soc Sci Med. 2016 Jun:159:100-7. doi: 10.1016/j.socscimed.2016.04.030. Epub 2016 Apr 25.


Rationale: Recommendations from healthcare providers are one of the most consistent correlates of adolescent vaccination, but few studies have investigated other elements of patient-provider communication and their relevance to uptake.

Objective: We examined competing hypotheses about the relationship of patient-driven versus provider-driven communication styles with vaccination.

Methods: We gathered information about vaccine uptake from healthcare provider-verified data in the 2010 National Immunization Survey-Teen for tetanus, diphtheria, and pertussis (Tdap) booster, meningococcal vaccine, and human papillomavirus (HPV) vaccine (initiation among females) for adolescents ages 13-17. We categorized communication style in parents' conversations with healthcare providers about vaccines, based on parents' reports (of whether a provider recommended a vaccine and, if so, if conversations were informed, shared, or efficient) (N = 9021).

Results: Most parents reported either no provider recommendation (Tdap booster: 35%; meningococcal vaccine: 46%; and HPV vaccine: 31%) or reported a provider recommendation and shared patient-provider communication (43%, 38%, and 49%, respectively). Provider recommendations were associated with increased odds of vaccination (all ps < 0.001). In addition, more provider-driven communication styles were associated with higher rates of uptake for meningococcal vaccine (efficient style: 82% vs. shared style: 77% vs. informed style: 68%; p < 0.001 for shared vs. informed) and HPV vaccine (efficient style: 90% vs. shared style: 70% vs. informed style: 33%; p < 0.05 for all comparisons).

Conclusion: Efficient communication styles were used rarely (≤2% across vaccines) but were highly effective for encouraging meningococcal and HPV vaccination. Intervention studies are needed to confirm that efficient communication approaches increase HPV vaccination among adolescents.

Keywords: Adolescents; Human papillomavirus (HPV) vaccine; Meningococcal vaccine; Patient-provider communication; Providers; Tetanus, diphtheria, and pertussis (Tdap) booster.

MeSH terms

  • Adolescent
  • Chi-Square Distribution
  • Communication*
  • Diphtheria-Tetanus-Pertussis Vaccine / therapeutic use
  • Female
  • Health Promotion / methods*
  • Health Promotion / standards
  • Health Promotion / statistics & numerical data
  • Humans
  • Male
  • Meningococcal Vaccines / therapeutic use
  • Papillomavirus Vaccines / therapeutic use
  • Parents / education
  • Parents / psychology*
  • Physician-Patient Relations*
  • Surveys and Questionnaires
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data


  • Diphtheria-Tetanus-Pertussis Vaccine
  • Meningococcal Vaccines
  • Papillomavirus Vaccines