Offering HPV vaccines at dental visits improved uptake among children

Key takeaways:

• Physicians partnered with dentists to administer HPV vaccines during dental visits.
• Vaccine uptake improved from 5.3% to 13.9% during the intervention period.

Partnering with dental clinics to offer HPV vaccines to eligible children and adolescents improved vaccination rates by more than 8 percentage points in 1 year, according to a study published in Pediatrics.

The CDC recommends that children receive two doses 6 to 12 months apart between ages 11 and 12 years, although the vaccine can be administered starting at age 9 years. As Healio previously reported, HPV vaccine coverage has stalled since 2022 among adolescents. Experts have said there is a lack of knowledge about HPV and the vaccine and have recommended reframing it as a form of cancer prevention to ease parents’ concerns.

Initially, Jessica L. Jack, MD, a pediatrician and Denver Health and assistant professor of pediatrics at University of Colorado Anschutz Medical Campus, and colleagues partnered with dental clinics to offer multiple adolescent vaccines at dental visits, but she told Healio that they narrowed their scope to HPV vaccines because they are directly related to oral health.

From June 1, 2022, to May 31, 2023, six dental clinics within the Denver Health system offered HPV vaccines to all eligible patients aged 9 to 17 years during dental visits. The researchers compared vaccine uptake during the intervention period with their pilot study that took place at three clinics from June 1, 2021, to Nov. 15, 2021.

“It was quite feasible, thanks to the dentists’ motivation to prevent HPV-related oropharyngeal cancers — conditions they routinely screen for and diagnose,” Jack said.

Between June 1, 2021, and May 31, 2023, 5,896 children and adolescents (52.3% boys; 66.9% aged 9 to 11 years) visited a Denver Health dental clinic and were due for at least one dose of the HPV vaccine. The researchers noted that compared with those who were vaccinated, children who had not completed the vaccine series were more likely to be non-Hispanic Black or multiple races, to not speak English or Spanish, to be born outside the United States and to be uninsured.

In the year before the intervention began, 5.3% of eligible patients received the HPV vaccine at dental visits. Uptake rose to 13.9% during the intervention period, according to Jack and colleagues (P < .0001).

In an adjusted analysis, the researchers reported that patients were 4 times more likely to get their HPV vaccine at the dental clinic during the intervention period vs. before the intervention began (adjusted OR = 4.37; 95% CI, 3.22-5.92).

Compared with 9- to 11-year-olds, 15- to 17-year-olds were 40% less likely to get vaccinated at dental visits (aOR = 0.6; 95% CI, 0.36-0.99), and non-Hispanic Black and African American children were less likely to get vaccinated than non-Hispanic white children (aOR = 0.56; 95% CI, 0.31-0.98), according to the authors. They also noted that boys were more likely to get vaccinated than girls (aOR = 1.25; 95% CI, 1.04-1.75).

Jack said there were some barriers they experienced during the intervention period. She said adding immunization to appointments disrupted workflow at clinics with tight schedules, and some clinics experienced staffing shortages during the intervention period that affected providers’ ability to administer vaccines.

“In the current climate of vaccine hesitancy and misinformation, it is crucial that every health care professional reinforces the importance of vaccination,” Jack said. “By working together across disciplines — whether in medicine, dentistry or beyond — we can ensure that vaccinations are accessible in every setting where patients engage with the health care system.”

For more information:

Jessica L. Jack, MD, can be reached at jessica.jack@dhha.org.

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