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HPV Vaccination Adults
5 Tips: HPV Vaccination in Adults

Released: September 26, 2024

Expiration: September 25, 2025

Tracy Zivin-Tutela
Tracy Zivin-Tutela, MD
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Key Takeaways
  • Adults 27-45 years of age can benefit from HPV vaccination and protection against serotypes to which they have not been exposed.

Shared decision-making is an important process in healthcare that involves patients and healthcare professionals (HCPs) working collaboratively to make informed choices about medical interventions, like vaccination. When it comes to human papillomavirus (HPV) vaccination for adults ages 27-45 years, this approach is particularly crucial. The decision to get vaccinated in this age group involves nuanced considerations, given the vaccine's benefits and limitations. Here are my five tips on how to approach this discussion effectively.

  1. Understand the Context

HPV vaccination is primarily recommended for younger people, 9-26 years of age, due to the vaccine’s maximum efficacy before the onset of sexual activity. However, for adults ages 27-45 years, the HPV vaccine can still offer substantial health benefits, such as reducing the risk of HPV-related cancers and genital warts. People in this age group may have already been exposed to some HPV serotypes but can still get protection against other serotypes.

  1. Engage in Open Dialogue

The cornerstone of shared decision-making is an open and honest dialogue between the HCP and the patient. HCPs should initiate conversations about HPV vaccination by discussing its potential benefits, risks, and limitations in the context of the patient’s specific health profile and lifestyle. This involves patient education, addressing patients’ concerns, and personalizing the discussion.

Patient Education
Clearly explain how the HPV vaccine works, including the serotypes it protects against and its role in preventing HPV-related cancers. Highlight that, while the vaccine is most effective before exposure to any HPV serotype, it can still reduce the risk of cancers and genital warts for serotypes that they have not yet been exposed to. The HPV vaccine does not prevent progression of HPV infection that already exists, and that counseling point is important to provide.

Addressing Patients’ Concerns
Adults may have concerns or misconceptions about the HPV vaccine. These could include worries about potential adverse effects and vaccine efficacy in people their age. HCPs should address these concerns with evidence-based information and empathetic communication.

Personalizing the Discussion
Tailor the conversation to the patient’s health history, sexual activity, and risk factors. For instance, if a patient has a new sexual partner, it could be a good time for them to get vaccinated. Discussing their specific situation and how the vaccine could help them can make the decision more relevant and actionable.

  1. Weigh Benefits and Risks

Patients should be guided through a balanced assessment of the benefits and risks associated with the HPV vaccine:

Benefits
Emphasize that the vaccine can protect against additional HPV strains not previously encountered and reduce the risk of developing HPV-related cancers and genital warts. Provide patient-friendly statistics and evidence on the effectiveness of the vaccine in reducing cancer incidence and other health issues.

Risks
Discuss potential adverse effects, which are generally mild, such as soreness at the injection site or mild fever. Be transparent about any less common but more serious risks and how they compare to the benefits of vaccination. Also discuss the scenarios that HPV vaccination will not protect against and the potential cost of vaccination (if known).

  1. Facilitate Informed Choices

Encourage patients to consider their own values and priorities when making the decision. Some questions they might reflect on include the following:

Health Goals
How do they prioritize cancer prevention in their life? Do they have specific health concerns that might make the vaccine more relevant?

Lifestyle Considerations
How does their current sexual activity impact their perceived risk of HPV?

Broader Perspective
Are they interested in long-term health and cancer prevention, even if they are already past the optimal HPV vaccination age? Are they aware of and interested in the public health benefit of reducing the incidence and spread of HPV-related cancers?

  1. Support the Decision

Once a decision is made, provide support for the next steps. If the patient chooses to proceed with vaccination, ensure they understand the dosing schedule and any follow-up requirements. For those who decide against it, respect their choice while providing them with resources and information should they reconsider it in the future.

Conclusion

Effective shared decision-making for HPV vaccination in adults ages 27-45 years involves a thorough, personalized discussion between healthcare providers and patients. By focusing on education, addressing concerns, and facilitating an informed choice, providers can help individuals make decisions that align with their health goals and values. This collaborative approach not only enhances patient autonomy but also promotes better health outcomes by ensuring that individuals are well-informed and empowered in their healthcare choices.

Your Thoughts?

How do you discuss HPV vaccination with your patients who are 27-45 years of age? Join the discussion by posting a comment.