ASPO Abstracts
Disparities in HPV vaccine recommendation and on-site administration among a national sample of pediatric oncologists
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: Childhood cancer survivors (CCS) have a higher risk of human papilloma virus (HPV)-related cancers but low uptake of the HPV vaccine. We examined predictors of HPV vaccine recommendations and on-site administration in a national sample of pediatric oncologists.Methods: We recruited pediatric oncologists via email to complete an online survey of HPV vaccination practice, attitudes and beliefs about HPV vaccination, and barriers administering HPV vaccines. Oncologists' email addresses were identified from a medical marketing database (SK&A by IQVIA). We used logistic regression models to identify correlates of: 1) oncologist discussing or recommending HPV vaccination; and 2) practice offering on-site administration of HPV vaccines.Results: A total of 195 pediatric oncologists completed the survey (15% response). Just over half reported that they always or usually discuss or recommend the HPV vaccine (57%), but only 43% were in practices that offered on-site administration of the HPV vaccine. Correlates of HPV vaccine discussion or recommendation included female sex (OR=2.83, 95%CI:1.34-6.00) and ‚â•20 years in practice (OR=3.08, CI:1.28-7.41). Oncologists who believed primary care providers (PCPs) should handle HPV vaccine recommendation were less likely to discuss or recommend the vaccine themselves (OR=0.12, CI:0.05-0.29). On-site vaccine administration was less common in practices with majority non-White patients and among oncologists who believed PCPs should recommend the vaccine. (OR=0.30, CI:0.14-0.67). A higher proportion of oncologists who believed PCPs should recommend the vaccine were in practices with majority non-White patients (36% vs 23%, p<0.05) and with majority patients receiving Medicaid (37% vs 23%, p<0.05).Conclusions: Pediatric oncologists represent a critical target for increasing HPV vaccination in high-risk cancer survivors. A higher proportion of practices with majority non-White patients do not provide on-site vaccine administration, potentially exacerbating cancer disparities. Oncologists seeing majority non-White and Medicaid patients are also more likely to defer responsibility for HPV vaccination to PCPs. Future interventions should target these practices to decrease health disparities.
Keywords: HPV vaccine, childhood cancer survivor, health disparities