Challenges related to human papillomavirus (HPV) vaccine uptake in Minnesota: clinician and stakeholder perspectives

Nicholas Yared, Molly Malone, Estee Welo, Inari Mohammed, Emily Groene, Matthew Flory, Nicole E Basta, Keith J Horvath, Shalini Kulasingam

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Human papillomavirus (HPV) vaccination rates among adolescents are increasing in Minnesota (MN) but remain below the Healthy People 2020 goal of 80% completion of the series. The goal of this study was to identify messaging and interventions impacting HPV vaccine uptake in MN through interviews with clinicians and key stakeholders. Methods: We conducted semi-structured key participant interviews with providers and stakeholders involved in HPV vaccination efforts in MN between 2018 and 2019. Provider interview questions focused on messaging around the HPV vaccine and clinic-based strategies to impact HPV vaccine uptake. Stakeholder interview questions focused on barriers and facilitators at the organizational or state level, as well as initiatives and collaborations to increase HPV vaccination. Responses to interviews were recorded and transcribed. Thematic content analysis was used to identify themes from interviews. Results: 14 clinicians and 13 stakeholders were interviewed. Identified themes were grouped into 2 major categories that dealt with messaging around the HPV vaccine, direct patient–clinician interactions and external messaging, and a third thematic category involving healthcare system-related factors and interventions. The messaging strategy identified as most useful was promoting the HPV vaccine for cancer prevention. The need for stakeholders to prioritize HPV vaccination uptake was identified as a key factor to increasing HPV vaccination rates. Multiple providers and stakeholders identified misinformation spread through social media as a barrier to HPV vaccine uptake. Conclusion: Emphasizing the HPV vaccine’s cancer prevention benefits and prioritizing it among healthcare stakeholders were the most consistently cited strategies for promoting HPV vaccine uptake. Methods to combat the negative influence of misinformation about HPV vaccines in social media are an urgent priority.

Original languageEnglish (US)
Pages (from-to)1107-1116
Number of pages10
JournalCancer Causes and Control
Issue number10
StatePublished - Oct 2021

Bibliographical note

Funding Information:
Supported by a Healthcare Delivery Research Program grant from the National Cancer Institute Division of Cancer Control & Population Sciences (NCI 5P30CA077598-19). Dr. Yared was supported by the National Institutes of Health Infectious Disease Training in Clinical Investigation Grant (T32 AI055433-11A1).

Funding Information:
The authors would like to acknowledge the assistance of collaborators from the Minnesota Department of Health in providing statewide data regarding HPV vaccine uptake in Minnesota and the Minnesota chapter of the American Cancer Society in assisting with identifying interview participants.

Publisher Copyright:
© 2021, The Author(s).


  • Cancer prevention
  • Human papillomavirus
  • Social media
  • Vaccines


Dive into the research topics of 'Challenges related to human papillomavirus (HPV) vaccine uptake in Minnesota: clinician and stakeholder perspectives'. Together they form a unique fingerprint.

Cite this