Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with over 90% of sexually active men and 80% of women infected at some point in their lives. While many infections clear on their own, high-risk HPV types—especially 16 and 18—can persist and lead to serious cancers, including cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers.
- From 2016 to 2020, an average of 1,958 HPV-associated cancer cases were diagnosed annually.
- Ohio’s incidence rate (13.9 per 100,000) was 11% higher than the national average.
- Rates were 24% higher among females and 30% higher among White Ohioans compared to Black Ohioans.
- Appalachian counties showed especially high rates, pointing to geographic disparities in healthcare access and outcomes.
- HPV-associated cancer rates rose 63% among males and 8% among females from 1996 to 2020.
Despite the existence of a safe and effective vaccine that prevents the majority of HPV-associated cancers, vaccination rates remain suboptimal. As of 2021, only 69% of Ohio females and 56% of males aged 13–17 were up to date on the HPV vaccine—far short of the Healthy People 2030 target of 80%.
The Role of Family Physicians in Addressing Vaccine Hesitancy
Family physicians are uniquely positioned to address vaccine hesitancy, a complex issue rooted in mistrust, misinformation, and competing priorities. Understanding the spectrum of vaccine confidence—ranging from high confidence to outright refusal—is essential for shaping tailored, empathetic interventions.
- Confidence: Concerns about vaccine safety, efficacy, and trust in the healthcare system
- Complacency: Low perceived risk of HPV or vaccine-preventable diseases
- Convenience: Barriers to access such as transportation, clinic hours, or cost.
Other influential factors include misinformation (e.g., false links between vaccines and autism), belief in natural immunity, and value placed on individual freedom.
- Deliver Strong Recommendations: A physician’s recommendation remains the single most effective influence on vaccine uptake. Use presumptive language (e.g., “Your child is due for three vaccines today”) to frame vaccination as routine.
- Employ the SHARE Method:
- Share reasons the vaccine is right for the patient
- Highlight positive experiences
- Address questions and concerns
- Remind patients about the vaccine’s protective benefits
- Explain the costs of infection vs. prevention.
- Use Motivational Interviewing: Meet patients with empathy, ask for permission to discuss vaccines, explore their readiness, and use reflective listening to understand and address their concerns.
- Combat Misinformation Directly:
- Lead with factual, clear, and relevant information
- Warn patients about common fallacies (e.g., vaccines contain harmful toxins)
- Explain why certain myths persist and offer evidence-based corrections.
- Create a Culture of Vaccination:
- Train all clinic staff to advocate for vaccines
- Standardize workflows to ensure vaccination opportunities aren’t missed
- Appoint a vaccine champion to lead efforts and track progress.
- Tailor Messages to Communities:
- Partner with local leaders in underserved or hesitant populations (e.g., Appalachian communities)
- Translate materials and use culturally relevant messaging
- Respect community concerns shaped by religion, historical injustices, or systemic inequities.
Call to Action for Family Physicians
As trusted sources of health information, family physicians must remain at the forefront of HPV vaccination efforts. Every encounter is an opportunity to protect patients from cancer through vaccination. Meeting patients with understanding, accurate information, and a strong, consistent recommendation can drive meaningful change.
By leveraging proven strategies to build vaccine confidence, clinicians in Ohio and across the country can help close the gap between current HPV vaccination rates and national goals—ultimately reducing the burden of preventable cancers and improving public health outcomes for future generations.
- EasyPI: HPV Vaccination track (Ohio Academy of Family Physicians)
Find resources, articles, team support, and instructions on submitting a performance improvement project on HPV vaccination to the American Board of Family Medicine for credit.
- HPV and the Burden of Cervical Conization webinar, June 12 at Noon
Hear scientific insights for HPV vaccination and the economic burden of cervical conization. Learning objectives and speaker information can be found on the flyer.
This spotlight is proudly supported by our Partner in Health, Merck; however, all content and data come from independent sources.