Effective HPV Vaccination Strategies: What Does the Evidence Say? An Integrated Literature Review

Abstract

Problem: The updated Advisory Committee on Immunization Practices (ACIP) 2016 guidelines recommends vaccination for the human papillomavirus (HPV) for all adolescents starting at ages 11-12 years. The United States continues to fall short of the benchmarks set by Healthy People 2020. The national vaccination rates hover at 49.5%, creating much room for improvement in health care systems. The purpose of this literature review was to identify evidence-based interventions to implement for improved outcomes.

Eligibility criteria: An integrative literature review was conducted using the CINAHL, EBSCO, Academic Search Complete, ProQuest and Medline databases. The search was limited to studies published in peer reviewed journals in the last 10 years.

Sample: Of the available studies, 201 met inclusion criteria with 46 studies meriting further review.

Results: Barriers to vaccination included missed opportunities due to lack of provider recommendation and awareness of current guidelines, and parental vaccination hesitancy. Effective strategies included reminder systems and strong provider recommendations.

Conclusions: No one method has been effective in maintaining increases in vaccination rates. Multi-method strategies demonstrate the highest rates of maintaining increases in HPV vaccination. Strong provider recommendations are a cornerstone to any multi-method intervention.

Implications: Providers and nurses need to shift conversations to strong recommendations for the HPV vaccination and include additional reminder systems, including protocols to meet Healthy People 2020 goals for HPV vaccination.

Keywords: Human papillomavirus; Multi-method strategies; Provider recommendation; Vaccine; Vaccine hesitancy.