Improving Human Papillomavirus Vaccination Rates in a Primary Care Clinic

Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Jean Dowling Dols


An estimated 85% of unvaccinated sexually active individuals will acquire Human Papillomavirus (HPV) in their lifetime (Chesson et al., 2014). HPV vaccination rates remain low in the United States. Provider-based interventions are associated with increased acceptance of vaccination. This project aims to promote initial HPV vaccinations for patients aged nine to 45 through education, eligibility, provider prompts, follow-up appointments, and provider recommendations in accordance with the Centers for Disease Control and Prevention (CDC) guidelines. This quality improvement project aims to increase the initial HPV vaccination rate in a primary care clinic for patients nine to 45. Before project implementation, clinic staff was educated about HPV vaccination and provider recommendations. Patient education incorporated the CDC HPV vaccination information sheet and discussion by the provider. Immunization cards were used as provider prompts to remind providers to discuss vaccination recommendations.

Data was gathered using the patient electronic medical record, which provided documentation of the administration of HPV vaccines, provider prompts, patient education, and provider recommendations. Results show an overall percentage increase in Gardasil® 9 doses administered, resulting in an increase of 318.2% for the first dose, 140% for the second dose, and 200% for the third dose. There were opportunities to increase the HPV vaccination rate at this clinic, as only 1% of the 675 vaccine-eligible patients seen during the three-month pre-implementation period had received an initial HPV vaccination.

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