Janio Emily A, Walker Cori, Steere Eliza, Seaman Aaron T, Askelson Natoshia, Pagedar Nitin A
Medical Scientist Training Program University of Iowa Carver College of Medicine Iowa City Iowa USA.
Department of Otolaryngology - Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa USA.
Laryngoscope Investig Otolaryngol. 2025 Jan 21;10(1):e70085. doi: 10.1002/lio2.70085. eCollection 2025 Feb.
The incidence of human papillomavirus (HPV)-related oropharyngeal cancers has increased such that they are now the most prevalent HPV-related cancer. In 2020, the Food and Drug Administration (FDA) expanded the indication for Gardasil-9 to include the prevention of oropharyngeal and other head and neck cancers caused by selected HPV types, but uptake remains low. Otolaryngology office interactions may provide opportunities to increase uptake, given the relevance of HPV to clinical practice. This study explored the feasibility of recommending HPV vaccination in otolaryngology clinics.
Participants were recruited between February to June of 2022 from the alumni of the residency and fellowship training programs at the University of Iowa Hospitals and Clinics. Participant interviews comprised open-ended questions pertaining to otolaryngologists' attitudes toward HPV vaccination recommendation. Interview recordings were transcribed, coded, and analyzed for themes.
Participants were willing to respond if patients asked about the HPV vaccine, although a common attitude toward vaccine discussions was that they were a pediatrician's responsibility. One barrier to recommending HPV vaccination was providers' concern that discussing the vaccine when not directly relevant to the patient's chief complaint could result in patient frustration. Nevertheless, participants endorsed the feasibility of discussing the vaccine during follow-up visits after the patient's needs had been addressed or via the distribution of educational materials to patients.
Otolaryngologists do not currently identify recommending HPV vaccine uptake as their clinical responsibility. While such recommendations may not be feasible in every patient encounter, there could be a role for this in the appropriate clinical scenario. These findings can be used to inform interventions aimed at recommending the vaccine in otolaryngology clinics.
人乳头瘤病毒（HPV）相关口咽癌的发病率有所上升，如今已成为最常见的HPV相关癌症。2020年，美国食品药品监督管理局（FDA）扩大了九价人乳头瘤病毒重组疫苗（Gardasil-9）的适应证，将预防特定HPV类型引起的口咽癌和其他头颈癌纳入其中，但该疫苗的接种率仍然很低。鉴于HPV与临床实践的相关性，耳鼻喉科门诊互动可能为提高接种率提供机会。本研究探讨了在耳鼻喉科诊所推荐HPV疫苗接种的可行性。
2022年2月至6月，从爱荷华大学医院及诊所的住院医师和专科培训项目校友中招募参与者。参与者访谈包括与耳鼻喉科医生对HPV疫苗接种推荐态度相关的开放式问题。访谈录音被转录、编码并分析主题。
如果患者询问HPV疫苗，参与者愿意做出回应，不过对疫苗讨论的普遍态度是这是儿科医生的职责。推荐HPV疫苗接种的一个障碍是，医护人员担心在与患者的主要诉求不直接相关时讨论疫苗可能会导致患者不满。尽管如此，参与者认可在解决患者需求后的随访期间或通过向患者分发教育材料来讨论疫苗的可行性。
目前，耳鼻喉科医生并不认为推荐HPV疫苗接种是他们的临床职责。虽然在每次患者就诊时进行此类推荐可能不可行，但在适当的临床场景中可能会有作用。这些发现可用于为旨在在耳鼻喉科诊所推荐该疫苗的干预措施提供信息。
