Term of Award

Spring 2011

Degree Name

Doctor of Public Health (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Jiann-Ping Hsu College of Public Health

Committee Chair

John Luque

Committee Member 1

Robert Vogel

Committee Member 2

Stuart Tedders


The purpose of this study was to examine Georgia physicians' administration of the quadrivalent human papillomavirus (HPV) vaccine to 11-12 year old females according to the Advisory Council Immunization Practices (ACIP) guidelines, their intention to recommend HPV vaccine to 11-12 year old males, and their perceived knowledge and barriers associated with HPV vaccination. A distinction between urban and rural was examined to determine if there were differences in HPV vaccination recommendation. A stratified sample was created from the Georgia Vaccine For Children (VFC) provider list. The final sampling frame included 264 (n = 264) providers. Of these, 218 physicians were contacted yielding a response rate of 82.6%. Forty-two were located in rural counties and 176 were located in urban counties. Examination of perceived barriers, perceived knowledge and administration practices revealed no differences between urban and rural physicians. Approximately one in ten Georgia physicians (12%) who responded reported they always vaccinate 11-12 year old females. The number increased to one in five (22.9%) who always vaccinate females age 13-17 years, suggesting parents or physicians may be delaying vaccination until females are older than12 years. Approximately one quarter (23.7%) recommend the vaccine to their male patients. More than half (59.4%) reported insufficient insurance coverage for the vaccine as a barrier to vaccinating males and females. In multivariate logistic regression models, variables independently associated with not recommending to 11-12 year old females included: female gender of the physician (OR, 3.07; 95% CI, 1.02-9.29) and parental barriers (OR 1.15; CI, 1.04-1.29). There were no associated findings with not recommending male vaccination. Findings from this study may serve as a helpful resource for further assessment of HPV vaccination in Georgia and targeting educational and policy interventions.

Research Data and Supplementary Material