Background: Human papilloma virus (HPV) vaccination prevents the development of HPV-associated malignancies. Adolescent and young adult (AYA) survivors of childhood cancers and patients with sickle cell disease (SCD) are two vulnerable patient populations who would significantly benefit from HPV vaccination. Objective: In this mixed method study we determine the HPV vaccination rate amongst the AYA SCD and childhood cancer survivor populations. We then sought to describe patient and caregiver beliefs regarding HPV vaccination. Design/Method: We performed a retrospective chart review looking at vaccination status for patients seen in our clinics in 2019. Qualitative data was then collected via audio recorded interviews. Interviews were analyzed with a thematic content approach to understand attitudes regarding the HPV vaccination. Results: We found a notable difference between the rate of HPV vaccinations and other age-appropriate vaccinations in our childhood cancers survivors and patients with SCD. Qualitative interviews found that caregivers and AYA’s relied heavily on physician, recommendations for HPV vaccination, with a preference for subspecialist recommendation. A strong recommendation from a trusted subspecialty provider would create reassurance about vaccination and reduce misconceptions and concerns for side effects in the context of a chronic illness. Conclusion: Counseling from subspecialists could have a strong impact on understanding of the HPV vaccine in the context of chronic illness. This would likely help overcome many of the barriers to vaccination that are encountered by patients with SCD or oncology survivors.

Vulnerable patient populations have seen decreased rates of vaccination against SARS-CoV2 (COVID-19) due to hesitancies and distrust, magnified by a paucity of data for certain populations. The rates of COVID-19 vaccination in children with Sickle Cell Disease (SCD) remains low despite the risk for severe complications, resulting in continued infections and hospitalizations from COVID-19. We sought to describe vaccine reactions including vaso-occlusive crises, emergency department visits, and hospitalizations in children with SCD. Our findings will start to provide the necessary vaccine side effect data to inform patients, caregivers, and clinicians considering the COVID-19 primary vaccination series.

Background/Objectives With dramatic improvements in life expectancy, adolescents and young adults (AYA) with sickle cell disease (SCD) increasingly face sexual and reproductive health (SRH) concerns. Despite the high risk of maternal-fetal morbidity and mortality, over half of women with SCD experience pregnancy by age 21, indicating a gap in SRH care. This study examined SCD providers’ practices and attitudes related to SRH, particularly with regards to contraception. Design/Methods We distributed an adapted web-based survey to a national sample of SCD providers to identify their attitudes and practices in addressing SRH with their female patients. We analyzed results using descriptive statistics, independent sample t-tests, Chi-squared and Fishers exact tests. Results Ninety-two SCD providers completed the survey (84% pediatric and 13% adult providers). All respondents rated SRH discussions as moderately important or higher, with the majority (85%) agreeing this care should be standardized. Most respondents (76%) reported discussion of SRH, such as menses, pregnancy, and contraception, with their female patients with SCD at least annually. Although most providers refer SCD patients for birth control (87%), 37% favored the use of hormonal intrauterine devices in this population and 37% the use of injectable contraception among respondents who endorsed a preferred method. Approximately half of respondents (52%) felt the use of combined hormonal contraceptives (CHC) was unacceptable. Conclusion SCD providers consider SRH important for their female patients and largely believe these conversations should be standardized in their clinics. However, the range of conversations and contraceptive recommendations from SCD providers is broad, suggesting that this care can be improved.