A systematic review of human papillomavirus vaccination among US adolescents.
Lisa N Mansfield, Ashlee Vance, Jacqueline A Nikpour and 1 others
PMID 33860541WHAT IT FOUND
Provider recommendation was the clearest facilitator of HPV vaccine initiation and completion among US adolescents.
Cancer prevention framing and schedule discussion were associated with higher completion.
Key findings
01Provider recommendation was the clearest facilitator of HPV vaccine initiation and completion, and expressing importance and urgency was associated with five to nine times higher odds of initiation.
02In one high-quality study, cancer prevention framing was associated with nearly two times higher odds of completion. In one longitudinal study, schedule discussion was associated with 2.26 times higher odds, and written HPV information with nearly three times higher odds.
03Findings were mixed for socioeconomic status, insurance status, community poverty, and school-entry policy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, so they show association rather than cause. Vaccination status was often self-reported by parents or taken from records, and many studies did not discuss confounding variables. All studies measured completion as three doses, although two doses are now recommended for adolescents ages 11 to 14. The review included only quantitative US English studies and mostly adolescent girls, so findings may not apply to boys, families in other countries, or unmeasured experiences. Some lower-quality studies were excluded, which may have removed additional factors.
Declared interests
The paper is tagged as NIH extramural research support. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not read the higher odds as evidence that provider recommendation or cancer framing causes vaccination. These associations came from observational studies, not tested interventions.