Human papillomavirus (HPV) vaccine education
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Health factors shape the health of individuals and communities. Everything from our education to our environments impacts our health. Modifying these clinical, behavioral, social, economic, and environmental factors can influence how long and how well people live, now and in the future.
Educational efforts inform adolescents, young adults, and parents with eligible children about HPV and its consequences, as well as the benefits of vaccinating against the disease. Education may be provided through in person presentations, videos, printed materials, online content, or through other media such as radio1. Education may be provided by public health professionals, community health workers, other trusted medical professionals, and peers. HPV vaccines protect against HPV and HPV-associated diseases, including some cancers. Vaccines are recommended for individuals ages 11-26 and are most effective in those who receive all doses and have no previous exposure to HPV2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased vaccination
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased HIV and STI knowledge
Reduced incidence of HPV
What does the research say about effectiveness?
There is insufficient evidence to determine whether educational efforts increase HPV vaccination rates1, 3. Though greater vaccine-related knowledge is associated with higher uptake4 and available evidence indicates education can increase both HPV knowledge and vaccination intentions, overall the effect of education alone on vaccine behavior is minimal1, 5. Additional evidence is needed to confirm effects.
Educational interventions may increase HPV knowledge and vaccination intentions among both young women6, 7, 8 and men7 and across diverse populations3, including black men and women8, 9, Korean women10, and Latino and Korean parents11. Interventions may have a greater impact on adolescents and young adults than on parents1. Peer-based education may increase knowledge among high school students12, and in college students when led by pharmacy students13.
Most early studies did not attempt to reach marginalized populations1. Some small pilot studies suggest culturally tailored education may increase vaccine initiation in young gay and bisexual men14 and initiation and completion in the 9- to 12-year-old daughters of Hopi mothers15. A study among Kentucky Appalachian women indicated education after the first vaccine dose may increase compliance with the 3-dose series16. Effects of individually tailoring education for university women are mixed6, 17.
Provider recommendation of the vaccine increases acceptability18 and uptake4, 19. Multi-faceted strategies which include components such as education, improved access to the vaccine, and reminders are more likely to increase vaccination initiation and completion5.
There is no evidence that receipt of the HPV vaccine increases sexual risk behavior among adolescent girls and young women20, 21.
How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Resources
CDC-HPV professional resources - Centers for Disease Control and Prevention (CDC). HPV educational materials for clinicians.
Footnotes
* Journal subscription may be required for access.
1 Fu 2014 - Fu L, Bonhomme L-A, Cooper SC, Joseph J, Zimet G. Educational interventions to increase HPV vaccination acceptance: A systematic review. Vaccine. 2014;32(11):1901-1920.
2 CDC MMWR-Meites 2019 - Meites E, Szilagyi PG, Chesson HW, et al. Human papillomavirus vaccination for adults: Updated recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report (MMWR). 2019;68:698-702.
3 Niccolai 2015 - Niccolai LM, Hansen CE. Practice-and community-based interventions to increase human papillomavirus vaccine coverage: A systematic review. JAMA Pediatrics. 2015;169(7):686-692.
4 Kessels 2012 - Kessels SJ, Marshall HS, Watson M, et al. Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine. 2012;30(24):3546-3556.
5 Rodriguez 2019 - Rodriguez AM, Do TQN, Goodman M, et al. Human papillomavirus vaccine interventions in the U.S.: A systematic review and meta-analysis. American Journal of Preventive Medicine. 2019;56(4):591-602.
6 Gerend 2013 - Gerend MA, Shepherd MA, Lustria MLA. Increasing human papillomavirus vaccine acceptability by tailoring messages to young adult women’s perceived barriers. Sexually Transmitted Diseases. 2013;40(5):401-5.
7 Krawczyk 2012 - Krawczyk A, Lau E, Perez S, et al. How to inform: Comparing written and video education interventions to increase human papillomavirus knowledge and vaccination intentions in young adults. Journal of American College Health. 2012;60(4):316-22.
8 Kester 2014 - Kester LM, Shedd-Steele RB, Dotson-Roberts CA, Smith J, Zimet GD. The effects of a brief educational intervention on human papillomavirus knowledge and intention to initiate HPV vaccination in 18-26 year old young adults. Gynecologic Oncology. 2014;132(Suppl 1):S9-12.
9 Teteh 2019 - Teteh DK, Dawkins-Moultin L, Robinson C, et al. Use of community forums to increase knowledge of HPV and cervical cancer in African American communities. Journal of Community Health. 2019;44(3):492-499.
10 Lee 2016c - Lee HY, Koopmeiners JS, McHugh J, Raveis VH, Ahluwalia JS. MHealth pilot study: Text messaging intervention to promote HPV vaccination. American Journal of Health Behavior. 2016;40(1):67-76.
11 Valdez 2015 - Valdez A, Stewart SL, Tanjasari SP, Levy V, Garza A. Design and efficacy of a multilingual, multicultural HPV vaccine education intervention. Journal of Communication in Healthcare. 2015;8(2):106-118.
12 Castellanos 2018 - Castellanos M, Odaimi T, Demissie S, Lee A, Farberov M. A new peer-to-peer educational model to increase knowledge and acceptability of HPV vaccination. Journal of Adolescent Health. 2018;62(2):S105-S106.
13 Hayes 2019 - Hayes KN, Pan I, Kunkel A, McGivney MS, Thorpe CT. Evaluation of targeted human papillomavirus vaccination education among undergraduate college students. Journal of American College Health. 2019;67(8):781-789.
14 McRee 2018 - McRee A-L, Shoben AB, Reiter PL. Effects of a pilot randomized controlled trial of a web-based HPV vaccination intervention for young gay and bisexual men: The Outsmart HPV Project. Journal of Adolescent Health. 2018;62(2):S10.
15 Winer 2016 - Winer R, Gonzales A, Noonan C, Buchwald D. A cluster-randomized trial to evaluate a mother-daughter dyadic educational intervention for increasing HPV vaccination coverage in American Indian girls. Journal of Community Health. 2016;41(2):274-281.
16 Vanderpool 2013 - Vanderpool RC, Cohen EL, Crosby RA, et al. “1-2-3 Pap” intervention improves HPV vaccine series completion among Appalachian women. Journal of Communication. 2013;63(1):95-115.
17 Bennett 2015 - Bennett AT, Patel DA, Carlos RC, et al. Human papillomavirus vaccine uptake after a tailored, online educational intervention for female university students: A randomized controlled trial. Journal of Women’s Health. 2015;24(11):950-957.
18 Brewer 2007 - Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine. 2007;45(2-3):107-114.
19 Kester 2013 - Kester LM, Zimet GD, Fortenberry JD, Kahn JA, Shew ML. A national study of HPV vaccination of adolescent girls: Rates, predictors, and reasons for non-vaccination. Maternal and Child Health Journal. 2013;17(5):879-885.
20 Mayhew 2014 - Mayhew A, Mullins TLK, Ding L, et al. Risk perceptions and subsequent sexual behaviors after HPV vaccination in adolescents. Pediatrics. 2014;133(3):404-411.
21 Rysavy 2014 - Rysavy MB, Kresowik JD, Liu D, et al. Human papillomavirus vaccination and sexual behavior in young women. Journal of Pediatric and Adolescent Gynecology. 2014;27(2):67-71.
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