HPV immunisation in primary care

Optimising HPV vaccination in primary care is discussed by Dr Grace Lee, Deputy Director Goodfellow Unit and Associate Professor Nikki Turner, academic General Practitioner and the Director of the Immune Advisory Centre.

Topics covered include:

  • The 2017 HPV immunisation schedule - Overview and catch up advice for primary care practitioners.
  • The NZ experience of HPV immunisations – sector challenges and strategy going forward.
  • Tips for managing HPV immunisation in primary care.
  • Take home messages for HPV vaccines.

Resources

Peer group discussion points

Rates of HPV vaccine uptake in New Zealand have been disappointing with only two thirds of our eligible young people fully vaccinated. There is hope with the change in eligibility criteria that this will increase community acceptance of the HPV vaccine.

  • Have you noticed an increase in acceptability of the HPV vaccine now that it is given as a two dose vaccine schedule to younger adolescents? What about the impact of widening the vaccine access to boys and young men? 
  • Non-heterosexual young men (unlike their heterosexual counterparts) have not been benefiting from a reduction in genital warts presentations. There is capacity to reduce this inequity by vaccinating. How is your practice encouraging vaccine up take for this cohort?
  • For your sexually active patients (particularly over 27 years of age) wanting to discuss the gains of an HPV vaccine, what advice have you been giving them and has this changed upon reflecting on Nikki’s discussion?

The eligibility of HPV vaccination has widened with both males and females 26 years and under from January 2017 becoming eligible. Many of these will have fallen out of the range of school-based vaccination and need vaccination through their primary health care providers.

  • How does your practice identify eligible patients? Is there a system in place to capture those in need of a vaccination up to the age of 26 years?
  • A recall for patients at 14 years of age was recommended to identify catchup vaccinations and to have the capacity to offer 2 rather than 3 vaccines if needed. Is this something you could implement in your practice? 
  • Text and letter recall, opportunistic vaccination on presentation are some strategies that practices use to recall and encourage vaccination. What does your practice currently do to promote eligibility awareness and vaccine uptake?
  • Are your vaccinators confident in managing catch up vaccinations, interrupted schedules?

Reflecting on the MedTalk and the peer group discussions you have had, what could you do differently (if anything) in your practice to improve the uptake of HPV vaccination?

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Date Published: 
Tuesday, March 12, 2019