Researchers Testing Video to Increase Teens' Acceptance of HPV Vaccine

About 79 million Americans are currently infected with human papillomavirus (HPV), and 14 million people become newly infected each year. Yet, despite these very real numbers, misconceptions about HPV seem to overshadow attempts to increase vaccination rates to prevent infection.

In 2014, coverage estimates for HPV continued to lag behind other routine immunizations recommended for adolescents’ ages 11 and 12, according to the Centers for Disease Control’s Morbidity and Mortality Weekly Report released July 25. Three vaccines that protect against HPV infection are currently available in the U.S. The quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70 percent of cervical cancers; HPV4 also protects against HPV types 6 and 11, which cause 90 percent of genital warts. The newly introduced nonavalent vaccine (HPV9) includes an additional 5 serotypes that increases overall coverage to more than 85% of cervical cancers.

HPV is a sexually transmitted infection that can be spread by having oral, vaginal, or anal sex with someone who has the virus. It is so common that nearly all sexually active men and women get or are exposed to it at some point in their lives.

These are some of the important facts that will be conveyed in an educational video being tested at The Children’s Hospital of Philadelphia. It is geared toward 11 to 17 year olds and aims to improve parents’ and teens’ acceptance of HPV vaccination. Kristen Feemster MD, MPH, MSHP, principal investigator for the study, helped to develop the content in collaboration with a medical education company that is producing the video.

“I think a video-based education tool could be helpful,” said Dr. Feemster, a faculty member at PolicyLab at CHOP and an assistant professor of Pediatrics in the division of infectious diseases at the Perelman School of Medicine at the University of Pennsylvania. “It’s interactive, and it’s coming from a different voice. The video includes images of teens, and cartoon images to illustrate the HPV virus. I think all of those methods help get the message across.”

The study will include about 300 participants who will be randomized to either receive routine care, which is receipt of the HPV Vaccine Information Statement (VIS), or to receive the VIS in addition to viewing the educational video. The study team expects to begin data analysis by the end of this year.

“We are hoping to see an impact,” Dr. Feemster said. “The video is shown before the provider comes in to make a recommendation, so this is not the only thing that will drive their decision making.”

If the study shows that the education video is effective, it eventually could be disseminated to clinicians as a helpful cancer prevention resource to addresses parents’ and teens’ questions regarding HPV vaccine safety and efficacy in a format that teens are comfortable using.

For example, boys may think that they do not need to be vaccinated against HPV because they cannot develop cervical cancer. Actually, the vaccine protects against HPV strains that also can help prevent penile, anal, and oropharyngeal cancers. Also, since sexual partners can be exposed to the disease, vaccinating males and females helps to increase the protection of others against cancers associated with HPV.

“You receive great individual protection from the vaccine, but to block transmission it helps to have as many people vaccinated as possible,” Dr. Feemster said. “This vaccine has a potential to make a significant public health impact globally and understanding ways to implement recommendations will be really important.”

According to the Center for Disease Control and Prevention, about 360,000 people in the U.S. get genital warts each year and more than 11,000 women in the U.S. get cervical cancer each year. These numbers seem unnecessarily high when a safe and effective vaccination to prevent HPV transmission has been available since 2006.

A compilation of common questions and answers about HPV and the vaccine is available on The Children’s Hospital of Philadelphia’s website.