Human Papillomavirus Vaccine Policies Among American Indian Tribes in Washington State

• Published in: Journal of pediatric & adolescent gynecology Vol. 25; no. 2; pp. 131 - 135
• Main Authors: Duvall, Jessie, BS, Buchwald, Dedra, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2012
• Subjects: Adolescent; Adult; American Indians; Child; Community Health Services - economics; Community Health Services - statistics & numerical data; Female; Health Care Surveys; Health Knowledge, Attitudes, Practice; Health Policy; Health Services Accessibility; HPV; Humans; Immunization Programs - economics; Immunization Programs - statistics & numerical data; Indians, North American; Obstetrics and Gynecology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - administration & dosage; Papillomavirus Vaccines - economics; Patient Education as Topic; Pediatrics; Vaccination; Vaccination - economics; Vaccination - utilization; Washington; Young Adult; Washington; American Indians; Vaccination; HPV
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2011.11.012

Abstract Study Objective American Indians experience high rates of cervical cancer, which is preventable by vaccination against human papillomavirus (HPV). We sought information on funding, barriers, education, and policies regarding HPV vaccination from clinics that serve tribal members in the Pacific Northwest. Design We surveyed staff either by telephone or by using a mailed survey at 31 tribal and Indian Health Service clinics serving the 29 federally recognized American Indian tribes in Washington State. The survey included 11 items on policies and use of the HPV vaccine. Main Outcome Measures Primary outcomes were funding options for HPV vaccine administration, barriers to vaccine delivery, potential gaps in education, and determination of tribal or clinic-specific policies. Results Thirty-one clinics provided information; 28 administered the vaccine. Vaccination was supported by federal, private, and tribal sources. Barriers were reported by 89% of clinics, most commonly patients' lack of knowledge, distrust of the medical system, and lack of funding. Patient and provider information was widely available. Thirteen clinics had either tribal or internal clinic vaccination policies, or both. Conclusion HPV vaccine is available, but complex policies on administration could result in tribal differences in vaccination rates.