Abstract
BACKGROUND: HPV vaccination coverage among U.S. adolescents remains below national targets. Community pharmacies are highly accessible vaccination venues, but staff need to enhance practical skills to identify vaccine-eligible adolescents and communicate effectively with parents. OBJECTIVES: To evaluate the acceptability and feasibility of a team-based HPV vaccine communication training for pharmacy staff. METHODS: We used a single-group pre/post-test design in three community pharmacies in Washington state between December 2022-May 2023. The prerecorded online vaccine communication training integrated vaccine eligibility forecasting with 5A's counseling and Announcement Approach recommendation language. Pharmacy staff involved in adolescent immunizations completed baseline (n=18) and follow-up (n=13) online surveys assessing behavioral outcomes related to adolescent HPV vaccination before and after completing the training. Adolescent vaccination counts were audited for pre- (February-May 2022) and post-implementation (February-May 2023) periods. RESULTS: The proportion of staff reporting strong HPV vaccine recommendations increased from 22% pre-implementation to 67% post-implementation (p=0.016). The proportion of staff recommending HPV vaccination starting at ages 9-12 increased from 33% to 50% for both female and male adolescents, though this was not statistically significant (p=0.324). Self-efficacy improved for personal interactions (mean 2.8 to 3.4; p=0.004), goal setting (2.7 to 3.5; p=0.004), and addressing hesitancy (2.6 to 3.3; p=0.010). Post-implementation, staff rated the acceptability (mean 4.1/5), appropriateness (4.0/5), and feasibility (4.1/5) of pharmacy-based HPV vaccination favorably. Vaccination audits showed increased HPV doses at one pharmacy (2 doses to 20 doses) and no change at the other pharmacy (1 dose to 1 dose). The third pharmacy did not administer any adolescent vaccinations during the post-implementation period. CONCLUSION: A team-based HPV vaccine communication training was acceptable and feasible and improved staff-reported HPV recommendation behaviors, with heterogeneous short-term changes in HPV vaccination delivery. Larger multisite studies with longer observation periods are needed to evaluate effects on vaccination uptake.