Children

The human papillomavirus (HPV) vaccine was introduced in the United States for preteens more than a dozen years ago, yet adherence rates are still below those for other childhood vaccines. Researchers at the University of Tennessee Health Science Center and Emory University have received a major grant totaling $2.7 million from the National Cancer Institute/National Institutes of Health to conduct a five-year study aimed at developing methods to improve adherence to the HPV vaccine. UTHSC will receive $1.25 million of the funding, with the remainder going to Emory and other universities collaborating on the project.

Arash Shaban-Nejad, Ph.D., MPH, an assistant professor in the Center for Biomedical Informatics and also in the Department of Pediatrics in the College of Medicine at UTHSC, will lead the TweenVax Project, a comprehensive practice, provider, and parent-patient intervention to improve adolescent HPV vaccination in Tennessee. Robert Bednarczyk, PhD, assistant professor, Hubert Department of Global Health in Rollins School of Public Health at Emory University, will lead the TweenVax Project in Georgia.

The two, along with collaborators at Yale School of Medicine and Johns Hopkins University, will investigate why the HPV vaccine, recommended for 11- to 12-year-old girls and boys, has approximately a 43% adherence rate, while other vaccines recommended for children and young adults have a 90% adherence rate, and how to improve those numbers for the HPV vaccine.

HPV is a common sexually transmitted infection. Human papillomavirus infection is responsible for more than 30,000 new cases of cancer annually in the United States, the researchers said. The infection can be prevented by immunization.

Established public health methods of education and recommendation employed with other vaccines have not proven as successful with the HPV vaccine, according to the researchers. “One key barrier to improving HPV vaccine uptake is that health care providers often do not recommend this vaccine with the same strength as they do for other adolescent vaccines,” they said. “Continued low uptake of HPV vaccine indicates that new systems-level approaches, beyond standard public health education campaigns, are needed.”

Cultural, political, and social barriers to the vaccine also exist.

Many parents actually associate getting HPV vaccines to somehow permitting their children to have sex.”

Dr. Arash Shaban-Nejad, Assistant Professor, Center for Biomedical Informatics and Department of Pediatrics, College of Medicine, UTHSC

The TweenVax Project will recruit health care practices, providers and patients/parents across Tennessee and Georgia, initially to assess via Zoom interviews the participants’ perceptions, opinions, beliefs, experiences, and sentiments toward the HPV vaccine. The research team will then use this contextual information to refine the intervention being developed to improve adolescent HPV provision in health care practices.

“This is going to be one of the largest HPV studies in the nation,’ Dr. Shaban-Nejad said. The project has the potential for two additional years of funding.

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