Keywords: HPV, Human papillomavirus, vaccination
Review:
Background
It is well established that Human papillomavirus (HPV) vaccination offers protection against the virus responsible for cervical cancer as well as oropharyngeal, anal, vulval and penile cancers. Internationally, numerous interventions aimed at increasing HPV vaccine exist, but considerable variations in uptake persist, with many countries’ rates remaining suboptimal. This umbrella review aimed to identify what interventions exist and to determine their effectiveness.
Methods
An umbrella review that appraised interventions used to enhance HPV vaccine uptake and/or intention among children aged 9 years and older, adolescents and young adults up to the age of 26, was undertaken using the JBI methodology. Comprehensive searches for English language systematic reviews were conducted across five databases from January 2011 to July 2021. Hand searches and forward citation tracking were also conducted.
Results
Ten systematic reviews met the inclusion criteria. A total of 79 studies were included across the reviews. Interventions promoted change at the individual level, the community level or the organisational level, while others used a multi-component approach. Face-to-face presentations, printed information and supplementing both strategies with additional components appeared to be effective at increasing HPV vaccination intention. Reminders and multi-component strategies, especially those that included interventions aimed at provider level (e.g. nurse standing-orders, health record alerts, pre-typed consents) appeared most effective at increasing vaccination uptake.
Conclusions
This is the first umbrella review to explore the evidence for interventions used to improve HPV vaccination intention and uptake in children, adolescents and young adults. The evidence suggests that there is no single solution to increasing vaccination uptake, and different approaches may be better suited to certain populations. However, generalisations are limited by poor reporting and a paucity of studies beyond the USA. Further high-quality research is, therefore, needed to understand how best to increase HPV vaccine uptake in different target populations.
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