Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 19, 2025
Open Peer Review Period: Jun 3, 2025 - Jul 29, 2025
Date Accepted: Mar 26, 2026
(closed for review but you can still tweet)
Vaccination-Related Applications and Healthcare Professionals' Observed Changes in the Human Papillomavirus Virus Vaccine Hesitancy: Cross-sectional Survey
ABSTRACT
Background:
Digital tools have been shown to play a role in promoting public health interventions. The recommendation that healthcare providers (HCPs) use vaccination-related mobile or web-based applications has contributed to improving vaccine awareness and acceptance among vaccine-eligible individuals. In the United States, the state of Texas, which has one of the lowest HPV vaccination rates, has seen a significant increase in HPV vaccination hesitancy during the COVID-19 pandemic.
Objective:
This study examined the association between changes in the HPV vaccine hesitancy observed by HCPs among patients in Texas and the promotion of vaccination-related applications at their healthcare facilities during the COVID-19 pandemic.
Methods:
A population-based cross-sectional survey administered to HCPs working in Texas between January and April 2021 by The University of Texas MD Anderson Cancer Center was used for this study. We described the observed changes in the HPV vaccination hesitancy reported by the HCPs among patients using descriptive statistics. We conducted a logistic regression analysis to examine the association between the decrease in the HPV vaccine hesitancy observed by HCPs among patients and the promotion of vaccination-related applications at their facility.
Results:
A total of 1283 HCPs completed the survey. Among the 730 HCPs who reported changes in the HPV vaccination hesitancy, 7.0% observed a decrease in the HPV vaccine hesitancy among patients during the COVID-19 pandemic. Among the 576 HCPs who responded to the survey question regarding vaccination-related applications, 20.7% reported that vaccination-related applications were promoted at their facilities. The respondents were predominantly aged 35-54 years (62.6%), females (77.3%), non-Hispanic Whites (50.5%), and working in group practice (39.6%). Compared to HCPs who did not promote vaccination-related applications, those who promoted vaccination-related applications at their healthcare facility had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients during the COVID-19 pandemic (Adjusted Odds Ratio [aOR]: 2.53, 95% CI: 1.18-5.41). Compared to HCPs who worked at university/teaching hospitals, HCPs working at Federally Qualified Health Clinics (aOR: 8.96, 95% CI: 1.74-46.10), public facilities (aOR: 12.53, 95% CI: 2.01-78.26) and Employed Physician Practices (aOR: 8.63, 95% CI: 1.37-54.39) had significantly higher odds to observe a decrease in the HPV vaccine hesitancy among patients during the COVID-19 pandemic.
Conclusions:
Our findings demonstrate the benefits of promoting vaccination-related applications at healthcare facilities in areas with high HPV vaccine hesitancy, such as Texas. Digital health interventions could provide a platform for promoting and increasing HPV vaccination uptake in a context of pandemic preparedness. Clinical Trial: N/A
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.