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Practice 10 Minute Consultation

Discussing human papilloma virus vaccination

BMJ 2017; 357 doi: (Published 22 June 2017) Cite this as: BMJ 2017;357:j2730

Rapid Response:

Re: Discussing human papilloma virus vaccination

My thanks to the authors for this excellent article.

It is important that vaccinators are able to discuss HPV vaccination in detail, as the authors propose. However, it's also important to note that in most cases patients (and, where relevant, their parents) are content to have the vaccine, and don't necessarily want to discuss it in any great detail. In such circumstances discussion beyond - "You've come for your HPV vaccine to prevent cervical cancer? Are you happy for me to go ahead?" - can cause unnecessary anxiety. Certainly, in some places, where there is considerable (albeit misplaced and undue) anxiety the vaccine, it seems that a tentative "are you sure?" approach by healthcare workers is associated with a poorer uptake than a more direct "announcement" style of communication.[1]

I'm not for a moment suggesting that patients not be given sufficient information to provide properly informed consent; but I think (and suspect that the authors would agree) that in many cases going into the level of detail in this article would be inappropriate.

1. Brewer NT, Hall ME, Malo TL, Gilkey MB, Quinn B, Lathren C. Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial. Pediatrics 2016 PMID: 27940512 [10.1542/peds.2016-1764]: 10.1542/peds.2016-1764. (

Competing interests: No competing interests

23 June 2017
Peter M English
Public Health Physician