Perspectives from Community Members: HPV and COVID-19 Vaccines in the Dental Office

Background: Vaccinations have long been a widespread disease prevention strategy against various transmissible diseases including Human papillomavirus (HPV) infection and COVID-19. Multiple states include dentists and dental health professionals in the community of providers authorized to provide both COVID-19 and HPV vaccines. Previous research has examined patient and dental provider attitudes around provision of vaccines in the dental setting. Results indicated variable rates of patient, parent, and dentist acceptance for dental professionals as providers of the HPV vaccine. No studies to date have formally examined patient willingness to receive the COVID-19 vaccine from dental providers and very little formal evidence exists around patient attitudes and approaches to COVID-19 vaccination in any setting given the novelty of the disease. In addition, previous research on dental professionals as vaccinators has focused on individual vaccines as opposed to comparing attitudes across different vaccines that may be provided in the dental setting. Therefore, it is not known whether patient acceptance of dental providers as vaccinators varies based on the nature of the vaccine or disease target. This study is designed to increase understanding of the possible role of dental professionals in the provision of preventive health care.

Methods: Using a cross-sectional design, we collected data using a convenience sample (n=600) of young adults, ages 18-45 patients attending appointments at Penn Dental community clinics, or who were in parks and cafes in the Philadelphia area. Four research assistants completed a psychometrically validated 23-item Likert scale survey over the summer of 2022 designed to assess participants’ knowledge, trust, and willingness to be educated about and given the COVID-19 or HPV vaccine by a dentist. Using Wilcoxon signed-ranked and chi-square tests, the data were analyzed.

Results: Of the total sample (n=604), 42%were assigned female at birth. The mean age for all was 28 years (+/- 7) with 30% African American, 20% Asian and 9% Latin-x. While most (92%) knew that COVID-19 vaccination helped prevent illness, slightly more than half (54%) knew that HPV vaccination prevented some types of head and neck cancer. Participants overall were open to education, recommendation, and administration of both the HPV and COVID-19 vaccines across demographic groups. However, the belief in dentists to educate about COVID-19 vaccines was significantly higher (1.419 ± 0.736) compared to HPV vaccines (1.281± 0.780) (p<0.0001). Comfort with dentists administering COVID-19 vaccines was significantly higher (1.520 ± 0.783) than for HPV vaccines (1.320 ± 0.833) (p<0.0001) as well. Race was the most important factor related to perceptions. African Americans were more inclined to answer all questions negatively compared to Whites and Asians (p<.005).

Conclusions and Implications: COVID-19 in the media has led to much greater awareness and attention to safety concerns compared to HPV. The importance of maintaining sexual health privacy could hinder discussion of STI prevention and vaccination given the age range of participants. Further research warrants an understanding of African Americans’ less positive perceptions of vaccines in the dental office and whether it is access to dentists, distrust of the health care system, or distrust regarding vaccinations.