A Scoping Review of Interventions Supporting Human Papillomavirus (HPV) Vaccination Rates, Knowledge, and Confidence in a Post-COVID-19 US Landscape

Abstract

Objective: The objective of this scoping review is to understand the extent and type of evidence available for interventions aiming to increase Human Papillomavirus (HPV) vaccination rates, knowledge, or confidence since the COVID-19 pandemic.Introduction: Since the COVID-19 pandemic, childhood vaccination rates have decreased in the United States (US) and exemptions have risen. HPV vaccination coverage varied widely even before the pandemic, with rates falling behind those of other childhood immunizations despite the HPV vaccine’s higher efficacy when administered at a younger age. It is unclear how vaccine hesitancy and misinformation during the COVID-19 pandemic has impacted acceptance and uptake for other immunizations like the HPV vaccine, making it imperative to re-evaluate what interventions are successful in this new context. Methods: A search of English records in the PubMed database was conducted in March 2024 guided by scoping review methodology from the Joanna Briggs Institute. Studies using experimental or quasi-experimental methods to evaluate interventions aimed at increasing HPV vaccination rates, knowledge or confidence were included. Only studies with intervention dates including or after January 1, 2021, were included due to the interest in those published during and after the COVID-19 pandemic. Studies with interventions aimed at individuals 9-26 or parents or clinical providers of these individuals were included. Results: A total of 1,110 publications were screened at the title and abstract level with 10 identified for inclusion. Four studies (five publications) included educational interventions to individuals or parents of individuals eligible for the HPV vaccine, and two included vaccination reminders to this population. Three studies evaluated interventions at the provider or clinic level, and one at the community level. Consistent with data prior to the COVID-19 pandemic, educational interventions at the individual level are successful at increasing HPV vaccination, knowledge, and confidence when tailored to a specific group whether by culture, race or ethnicity, or sexual orientation. The success of interventions at the community or provider level is mixed. Conclusions: There is a lack of experimental evidence describing interventions to increase HPV vaccination rates, knowledge, and confidence since the onset of the COVID-19 pandemic, especially at the interpersonal and policy levels. Individual level educational interventions have remained successful at increasing HPV vaccination rates, knowledge and confidence when tailored to a specific group, while the success of interventions at the organizational and community levels is mixed regardless of intervention components. Further evaluation is needed to better understand what efforts to increase HPV vaccination rates and determinants are still successful after the pandemic.