Human Papillomavirus Vaccination: Narrative Review of Studies on How Providers' Vaccine Communication Affects Attitudes and Uptake

The burden of human papillomavirus (HPV) infections is substantial, causing thousands of cancers and deaths in the United States yearly. Safe and effective vaccines exist, yet remains underutilized, particularly among younger adolescents for whom the vaccine is targeted. Provider communication techniques are known to affect parents' and adolescents' acceptance of this vaccine. In this review, we examine the influence that provider communication techniques have on parental attitudes regarding HPV vaccine, as well as how those techniques affect vaccination uptake. We explore the limited literature that has directly measured the influence of provider communication techniques on parental attitudes, which suggests that the strength of a provider recommendation strongly influences parents' perceptions regarding the safety of HPV vaccine, and that brief recommendations might be best for parents without significant concerns. We also review the literature regarding the use of so-called 'presumptive' recommendations, and how these types of recommendations are associated with increased HPV vaccine uptake. Finally, we present new information regarding the use of motivational interviewing as a provider communication technique to improve vaccination uptake, particularly among vaccine-hesitant parents. We close with suggestions for 'best practices' that include using brief, strong, unambiguous language to introduce the HPV vaccine, followed by more nuanced communication techniques, such as motivational interviewing, when encountering resistance.