Human papillomavirus vaccine uptake in the United States: exploring alternative vaccination sites to increase uptake
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Human Papillomavirus is one of the most common sexually transmitted infections (STI) worldwide and is associated with more than 70% of invasive cervical cancer (ICC) cases. Vaccines against high-risk HPV infections have been developed: Gardasail, a quadrivalent vaccine protecting against HPV 16, 18, 6, and 11, and Cervarix for types 16 and 18 only. Although these vaccines have proven to be safe and effective in preventing HPV, vaccine coverage in the US remains much lower than other developed countries including Australia, the UK, and Canada. This thesis focuses on the implications of low HPV vaccine uptake and strategies to increase coverage in the US, specifically alternative venues for vaccine provision. Results from the literature search showed that common barriers to HPV vaccine uptake include lack of knowledge about HPV and the vaccines and lack of physician recommendation. With regards to alternative vaccination provision sites, the literature search showed the most evidence for mass vaccination in schools, particularly in Australia where government funded school-based vaccination programs have increased the national HPV vaccine coverage to 70%. Further, the literature search showed that pharmacies are another promising alternative venue for HPV vaccine administration because of their high accessibility and convenience.