683 - Examining Parent, Child, and Provider Experiences with Early Childhood Immunization for an HPV Vaccine Trial Among Four to Eight-Year-Olds: A Mixed Methods Study

Publication Number: 683.5059

Antonio Pisani, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, United States; Natalie Joseph, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, United States

Background: Since the introduction of the first vaccine against human papillomavirus (HPV) in 2006, there has been a significant drop in HPV infection in the United States. Despite exemplary efficacy and safety data, less than 50% of US adolescents complete the HPV vaccine series by the recommended age of 13.

Objective: To explore and assess patient, parent, and provider experience with HPV vaccination at ages four to eight years old to adapt recruitment conversations, overcome perceived barriers, and improve future messaging and discussions conveying the importance of early childhood HPV vaccination.

Design/Methods: We conducted semi-structured interviews of a subset of participants currently enrolled in an investigational new drug (IND) trial at Boston Medical Center. Interviews were conducted via Zoom Telecommunications in English or Spanish, recorded, transcribed, translated verbatim, and analyzed for recurrent themes. Interviews were complemented by cross-sectional survey data comprising 100 children and their respective parent(s) taken at enrollment.

Results: The age range of the children enrolled in the IND trial spanned from 4 to 8 years, with a mean age of 6.01 years (SD = 1.49). Parents fell within the range of 30 to 42 years of age with a mean age of 36 years (SD=8.27). 83% of parents who completed the questionnaire identified as female. Parental ethnicity comprised: African American (57%), Hispanic (15%), White (4%), Asian (2%), and Other (22%).
Parents reported an understanding that their children are susceptible to severe diseases, including cancers that can be caused by HPV infection. Many parents concurred that long-term health benefits and responsibility to manage their children’s health outweighed any perceived risks of vaccinating. Parent trust in providers’ expertise and benevolence was a major facilitator to enrollment.
Providers reported primarily focusing on the cancer prevention benefits of the HPV vaccine when speaking with patients. Providers believe an adjustment period will be required for changing recommendations, however, offering the HPV vaccine at the four-year-old visit would further group vaccinations, which is preferable to them.

Conclusion(s): Routine HPV vaccination of children aged 4-8 is enthusiastically accepted by parents and feasible for providers. By adapting future recruitment conversations towards diverse patient populations, investigators may be able to increase HPV vaccination uptake. In doing so, researchers will help to diminish provider-identified barriers to vaccination and facilitate protection from HPV-associated cancers.

Poster: Examination of HPV Vaccine Study for Children Ages 4-8
Pisani Examination of HPV Vaccine Study for Children Ages 4-8.pdf