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Our research examines ways to increase vaccine uptake.

Drivers of vaccination. Dr. Brewer is working with the World Health Organization to apply his Increasing Vaccination Model to understanding the drivers of vaccination globally.

Providers communication. Providers expect HPV vaccine discussions to be lengthy and problematic. We developed the Announcement Approach, for making quick and effective vaccine recommendations. Providers in 17 states have now received training in using the Announcement Approach. In collaboration with Dr. Melissa Gilkey. Funded by CDC and NCI.

Quality improvement. A quarter of the nation;s vaccine providers get quality improvement visits every year. We developed materials to increase the impact of these visits. Led by Dr. Melissa Gilkey in collaboration with state health departments. Funded by CDC and RWJF.

Articles

  • Advancing HPV vaccine delivery: 12 priority research gaps. Academic Pediatrics, 2018. Reiter, Gilkey, Saslow, Brewer.  PDF
  • Announcements versus conversations to improve HPV vaccination coverage: A randomized trial. Pediatrics, 2017. Brewer, Hall, Malo, Gilkey. PDF
  • Longitudinal predictors of HPV vaccine initiation among adolescent girls in a high-risk geographic area. Sexually Transmitted Diseases, 2011. Brewer, Reiter, McRee, Smith. PDF
  • Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine, 2007. Brewer, Fazekas. PDF
  • Racial differences in HPV knowledge, HPV vaccine acceptability, and related beliefs among rural, Southern women. Journal of Rural Health, 2009. Cates, Brewer, Fazekas, Mitchell, Smith.  PDF

  • HPV vaccine acceptability in a rural Southern area. Journal of Women’s Health, 2008. Fazekas, Brewer, Smith.  PDF

  • Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, Southern women. Cancer Causes & Control, 2008. Sperber, Brewer, Smith.  PDF

  • Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine, 2007. Brewer, Fazekas.  PDF

  • Pharmacist insights into adolescent human papillomavirus vaccination provision in the United States. Human Vaccines and Immunotherapeutics, 2019. Islam, Gruber, Kepka, Kunwar, Smith, Rothholz, Brewer, Smith. PDF
  • Implementing pharmacy-located HPV vaccination: Findings from pilot projects in five states. Human Vaccines and Immunotherapeutics, 2019. Calo, Shah, Gilkey, Vanderpool, Barden, Doucette, Brewer. PDF
  • Pharmacies versus doctors’ offices for adolescent vaccinations. Vaccine, 2018.Shah, Marciniak, Golin, Brewer.  PDF
  • Service quality and parents’ willingness to get adolescents HPV vaccine from pharmacists. Preventative Medicine, 2018. Shah. Calo, Golin, Brewer.
  • Support for pharmacist-provided HPV vaccination: National surveys of US physicians and parents. Cancer Epidemiology, Biomarkers & Prevention, 2018. Shah, Calo, Gilkey, Brewer.  PDF
  • Parents’ willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy. Preventive Medicine, 2017. Calo, Gilkey, Shah, Brewer. PDF
  • Opportunities and challenges of adolescent and adult vaccination administration within pharmacies in the United States. Biomedical Informatics Insights, 2017. Islam, Smith, Brewer. PDF
  • Pharmacist authority to provide HPV vaccine: Novel partners in cervical cancer prevention. Gynecologic Oncology, 2014. Brewer, Chung, Smith. PDF
  • Evaluation of an intervention providing HPV vaccine in schools. American Journal of Health Behavior, 2014. Stubbs, Panozzo, Moss, Reiter, Brewer. PDF
  • Opportunities for increasing HPV vaccine provision in school health centers. Journal of School Health, 2014. Moss, Feld, O’Malley, Gilkey, Brewer. PDF
  • Promising alternative settings for HPV vaccination of U.S. adolescents. Expert Review of Vaccines, 2014. Shah, Gilkey, Pepper, Brewer. PDF
  • What parents and adolescent boys want in school vaccination programs in the United States. Journal of Adolescent Health, 2014. Shah, McRee, Reiter, Brewer. PDF
  • Correlates of comfort with alternative settings for HPV vaccine delivery. Human Vaccines & Immunotherapeutics, 2013. McRee, Reiter, Pepper, Brewer. PDF
  • Early lessons learned from extramural school programs that offer HPV vaccine. Journal of School Health, 2013. Hayes, Smith, Brewer. PDF
  • Default policies and parents’ consent for school-located HPV vaccination. Journal of Behavioral Medicine, 2012. Reiter, McRee, Pepper, Brewer. PDF
  • Mothers’ support for voluntary provision of HPV vaccine in schools. Vaccine, 2011. Kadis, McRee, Reiter, Brewer. PDF
  • Disparities and reverse disparities in HPV vaccination: A systematic review and meta-analysis. Preventive Medicine, 2019. Spencer, Calo, Brewer. PDF
  • Advancing HPV vaccine delivery: 12 priority research gaps. Academic Pediatrics, 2018. Reiter, Gilkey, Saslow, Brewer.  PDF
  • Creating a national coalition to increase human papillomavirus vaccination coverage. Academic Pediatrics, 2018. Saslow, Sienko, Nkonga, Brewer.
  • Predictors of HPV vaccine follow-through among privately insured US patients. American Journal of Public Health, 2018. Spencer, Brewer.  PDF
  • Concomitant adolescent vaccination in the United States, 2007-2012. American Journal of Preventive Medicine. 2016 (in press). Moss, Reiter, Brewer. PDF
  • Summer peaks in uptake of human papillomavirus (HPV) and other adolescent vaccines in the United States. Cancer Epidemiology, Biomarkers & Prevention, 2016. Moss, Rimer, Ribisl, Brewer. PDF
  • Validation of the Vaccination Confidence Scale: A brief measure to identify parents at risk for refusing adolescent vaccines. Academic Pediatrics, 2016. Gilkey, Reiter, Brewer. PDF
  • Vaccination confidence and parental refusal/delay of early childhood vaccines. PLoS One, 2016. Gilkey, McRee, Reiter, Brewer. PDF
  • Herd immunity and the herd severity effect.The Lancet Infectious Diseases, 2015. Brewer, Moss. PDF
  • Effects of a presidential candidate’s comments on HPV vaccine. Journal of Health Communication, 2015. Zucker, Reiter, Mayer, Brewer. PDF
  • Correlates of human papillomavirus vaccine coverage: A state-level analysis. Sexually Transmitted Diseases, 2015. Moss, Reiter, Brewer. PDF
  • The Vaccination Confidence Scale: A brief measure of parents’ vaccination beliefs. Vaccine, 2014. Gilkey, Magnus, Brewer. PDF
  • Application of the Carolina Framework for Cervical Cancer Prevention. Gynecologic Oncology, 2014. Moss, Gilkey, Brewer. PDF
  • Provider-verified HPV vaccine coverage among a national sample of Hispanic adolescent females. Cancer Epidemiology, Biomarkers, and Prevention, 2014. Reiter, Brewer, Gilkey, Smith. PDF
  • Awareness is not enough: The need to increase meningococcal vaccine uptake. Clinical Pediatrics, 2013. Coyne-Beasley, Reiter, Brewer. PDF
  • Engaging in health behaviors to lower risk for breast cancer recurrence. PLoS One, 2013. O’Neill, DeFrank, Richman, Brewer. PDF
  • Organizational correlates of adolescent immunization: Findings of a state-wide study of primary care clinics in North Carolina. Vaccine, 2013. Moss, Gilkey, Brewer. PDF
  • Do correlates of HPV vaccine initiation differ between adolescent boys and girls?  Vaccine, 2012. Gilkey, Moss, Brewer. PDF
  • Opportunities and challenges of web 2.0 for vaccination decisions. Vaccine, 2012. Betsch, Brewer, Stryk. PDF
  • Theory-based predictors of influenza vaccination among pregnant women. Vaccine, 2012. Gorman, Brewer, Chambers. PDF
  • Trends in HPV vaccine initiation among adolescent females in North Carolina, 2008-2010. Cancer Epidemiology Biomarkers & Prevention, 2012. Moss, Gilkey, Reiter, Brewer. PDF
  • Correlates of receiving recommended adolescent vaccines among adolescent females in North Carolina. Human Vaccines, 2011. Reiter, McRee, Brewer. PDF
  • Human papillomavirus vaccine and behavioral disinhibition. Sexually Transmitted Infections, 2011. Schuler, Reiter, Smith, Brewer. PDF
  • Longitudinal predictors of HPV vaccine initiation among adolescent girls in a high-risk geographic area. Sexually Transmitted Diseases, 2011. Brewer, Reiter, McRee, Smith. PDF
  • Uptake of 2009 H1N1 vaccine among adolescent females. Human Vaccines, 2011. Reiter, McRee, Brewer. PDF
  • Statewide HPV vaccine initiation among adolescent females in North Carolina.  Sexually Transmitted Diseases, 2010. Reiter, McRee, Shafer, Brewer. PDF
  • Vaccinating adolescent girls against human papillomavirus – who decides? Preventive Medicine, 2010. McRee, Reiter, Brewer. PDF
  • How much will it hurt? HPV vaccine side effects and influence on completion of the three-dose regimen. Vaccine, 2009. Reiter, Brewer, McRee, Smith. PDF
  • HPV vaccine initiation in an area with elevated rates of cervical cancer. Journal of Adolescent Health, 2009. Gottlieb, Brewer, Ziarnowski, Markowitz. PDF
  • Predictors of cervical cancer screening among infrequently screened women completing human papillomavirus self-collection: My Body My Test-1. Journal of Women’s Health, 2019. Lea, Perez-Heydrich, Marais, Richman, Barclay, Brewer, Smith. PDF
  • Home Self-Collection by Mail to Test for Human Papillomavirus and Sexually Transmitted Infections. Obstetrics and Gynecology, 2018. Des Marais, Zhao, Brewer, Smith.  PDF
  • Mailed human papillomavirus self-collection with Papanicolaou test referral for infrequently screened women in the United States. Sexually Transmitted Diseases, 2018. Smith, Des Marais, Brewer. PDF
  • Preference for human papillomavirus self-collection and papanicolaou: Survey of underscreened women in North Carolina. Journal of Lower Genital Tract Diseases, 2018, Kilfoyle, Des Marais, Brewer, Smith.  PDF
  • Reducing overuse of cervical cancer screening: A systematic review. Preventative Medicine, 2018. Alber, Brewer, Smith.  PDF
  • Using home self-collected samples with mailed return to detect human papillomavirus and sexually transmitted infections among infrequently screened US women. Obstetrics and Gynecology, 2018. Des Marais, Zhao, Brewer, Smith.
  • Acceptability and ease of use of mailed HPV self-collection among infrequently screened women in North Carolina. Sexually Transmitted Infections, 2017. Anderson, Richman, Brewer, Smith. PDF
  • Trends in genital warts in the era of HPV vaccination. Sexually Transmitted Diseases, 2015. Calo, Brewer. PDF
  • Perceptions of mailed HPV self-testing among women at higher risk for cervical cancer. Journal of Community Health, 2014. Galbraith, Gilkey, Richman, Brewer. PDF
  • Uptake and predictors of anal cancer screening in men who have sex with men. American Journal of Public Health, 2013. D’Souza, Rajan, Brewer. PDF
  • HPV genotypes in high grade cervical lesions and invasive cervical carcinoma as detected by two commercial DNA assays, North Carolina, 2001-2006. PLoS One, 2012. Hariri, Brewer, Smith. PDF
  • Optimising human papillomavirus self-testing for high risk women. Sexually Transmitted Infections, 2011. Richman, Brewer, Liebman, Smith. PDF
  • Meta-analysis of human papillomavirus infection concordance. Cancer Epidemiology, Biomarkers, and Prevention, 2010. Reiter, Pendergraft, Brewer. PDF
  • Re: Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on All HPV-associated genital diseases in young women. Journal of the National Cancer Institute, 2010. Brewer, Reiter. PDF
  • Evaluating the impact of the human papillomavirus vaccine. Vaccine, 2009. Chang, Brewer, Smith. PDF
  • Human papillomavirus awareness in Haiti: Preparing for a national HPV vaccination program. Journal of Pediatric and Adolescent Gynecology, 2017. Gichane, Calo, McCarthy, Brewer. PDF
  • Time preferences predict mortality among HIV-infected adults receiving antiretroviral therapy in Kenya. PLoS One, 2015. Thirumurthy, Brewer. PDF
  • Cervical cancer awareness and screening in Botswana. International Journal of Gynecological Cancer, 2012. Mingo, Panozzo, Brewer. PDF
  • A cross-sectional study of HPV vaccine acceptability in Gaborone, Botswana. PLoS One, 2011. DiAngi, Panozzo, Brewer. PDF
  • HPV vaccine acceptability among Kenyan women. Vaccine, 2010. Becker-Dreps, Brewer, Smith. PDF
  • Society of Behavioral Medicine supports increasing HPV vaccination uptake:  An urgent opportunity for cancer prevention. Translational Behavioral Medicine, 2016. Peterson, Brewer. PDF
  • Overcoming barriers to low HPV vaccine uptake in the United States: Recommendations from the National Vaccine Advisory Committee. Public Health Report, 2016. National Vaccine Advisory Committee. PDF
  • Process evaluation of an intervention to increase provision of adolescent vaccines at school health centers. Health Education & Behavior, 2014. Golden, Feld, Turner, DeFrank, Brewer. PDF
  • Increasing provision of adolescent vaccines in primary care: A randomized controlled trial. Pediatrics, 2014. Gilkey, Moss, Sparks, Brewer. PDF
  • Comparing in-person and webinar delivery of an immunization quality improvement program: A process evaluation of the Adolescent AFIX trial. Implementation Science, 2014. Gilkey, Moss, Brewer. PDF
  • Increasing adolescent immunization by webinar: A brief provider intervention at federally qualified health centers. Vaccine, 2012. Moss, Reiter, Brewer. PDF
  • HPV and HPV vaccine education intervention: Effects on parents, healthcare staff, and school staff. Cancer Epidemiology, Biomarkers, and Prevention, 2011. Reiter, Stubbs, Brewer. PDF
  • Socioeconomic and racial-ethnic disparities in prosocial health attitudes: The case of human papillomavirus (HPV) vaccination for adolescent males. Journal of Health and Social Behavior, 2016 (in press). Polonijo, Carpiano, Reiter, Brewer. PDF
  • HPV vaccine for teen boys: Dyadic analysis of parents’ and sons’ beliefs and willingness. Preventive Medicine, 2015. Moss, Reiter, Brewer. PDF
  • Gay and bisexual men’s willingness to use a self-collected anal cancer screening test. Journal of Lower Genital Tract Diseases, 2015. Thompson, Reiter, Moss, Brewer. PDF
  • HPV transmission in adolescent men who have sex with men. Lancet Infectious Diseases, 2015. Brewer, Calo. PDF
  • Early adoption of human papillomavirus vaccine among Hispanic adolescent males in the United States. Cancer, 2014. Reiter, Brewer, Gilkey, Smith. PDF
  • HPV vaccination among adolescent males: Results from the National Immunization Survey-Teen. Vaccine, 2013. Reiter, Gilkey, Brewer. PDF
  • Longitudinal predictors of HPV vaccination among a national sample of adolescent males. American Journal of Public Health, 2013 [Article abstracted in Perspectives on Sexual and Reproductive Health, 2013.] Reiter, McRee, Pepper, Gilkey, Brewer. PDF
  • Parents’ and sons’ beliefs in sexual disinhibition after human papillomavirus vaccination. Sexually Transmitted Diseases, 2013. Mayer, Reiter, Zucker, Brewer. PDF
  • Advertisements promoting HPV vaccine for adolescent males: Does source matter? Sexually Transmitted Infections, 2012. Pepper, Reiter, McRee, Brewer. PDF
  • Improving HPV vaccine delivery: A national study of parents and their adolescent sons. Journal of Adolescent Health, 2012. Reiter, McRee, Pepper, Brewer. PDF
  • Association of human papillomavirus-related knowledge, attitudes, and beliefs with HIV status: A national study of gay men. Journal of Lower Genital Tract Disease, 2011. Gilbert, Brewer, Reiter. PDF
  • Hepatitis B vaccination among a national sample of gay and bisexual men. Sexually Transmitted Diseases, 2011. Reiter, Brewer. PDF
  • HPV vaccine acceptability in heterosexual, gay, and bisexual men. American Journal of Men’s Health, 2011. Gilbert, Brewer, Reiter, Smith. PDF
  • HPV vaccine and adolescent males. Vaccine, 2011. Reiter, McRee, Kadis, Brewer. PDF
  • Acceptability of HPV vaccine among a national sample of gay and bisexual men. Sexually Transmitted Diseases, 2010. Reiter, Brewer, McRee, Gilbert, Smith. PDF
  • Does framing HPV vaccine as preventing cancer in men increase vaccine acceptability? Cancer Epidemiology, Biomarkers and Prevention, 2010. McRee, Reiter, Brewer. PDF
  • Human papillomavirus knowledge and vaccine acceptability among a national sample of heterosexual men. Sexually Transmitted Infections, 2010. Reiter, Brewer, Smith. PDF
  • Men’s beliefs about HPV-related disease. Journal of Behavioral Medicine, 2010. Brewer, Ng, McRee, Reiter. PDF
  • Gay and bisexual men’s willingness to receive anal Papanicolaou testing. American Journal of Public Health, 2010. Reed, Reiter, Brewer. PDF
  • Questions and concerns about HPV vaccine: A communication experiment. Pediatrics, 2019. Shah, Calo, Gilkey, Boynton, Dailey, Todd, Robichaud, Margolis, Brewer. PDF
  • Coaching primary care clinics for HPV vaccination quality improvement: Comparing in-person and webinar implementation. Translational Behavioral Medicine, 2018. Calo, Gilkey, Leeman, McKinnon, Brewer.  PDF
  • Engaging parents around vaccine confidence: Proceedings from the National HPV Vaccination Roundtable Meetings. Human Vaccines & Immunotherapeutics, 2018. Perkins, Fisher-Borne, Brewer.  PDF
  • Exploring factors that might influence primary care provider discussion of and recommendation for prostate and colon cancer screening. International Journal of General Medicine, 2018. Kistler, Brewer, Barclay.  PDF
  • HPV vaccination recommendation practices among adolescent health care providers in five countries. Journal of Pediatric & Adolescent Gynecology, 2018. Topazian, Peebles, Morgan, Brewer, Smith.  PDF
  • Why is announcement training more effective than conversation training for introducing HPV vaccination? A theory-based investigation. Implementation Science, 2018. Malo, Hall, Brewer, Gilkey.  PDF
  • Questions and concerns about HPV vaccine: A communication experiment. Pediatrics, 2018. Shah, Calo, Gilkey, Boynton, Alton Dailey, Todd, Brewer. PDF
  • Pediatrician-parent conversations about human papillomavirus vaccination: An analysis of audio recordings. Journal of Adolescent Health, 2017. Sturm, Brewer. PDF
  • Announcements versus conversations to improve HPV vaccination coverage: A randomized trial. Pediatrics, 2017. Brewer, Hall, Malo, Gilkey. PDF
  • Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences. Human Vaccines & Immunotherapeutics, 2017. Gilkey, Calo, Brewer. PDF
  • Collaborative patient-provider communication and uptake of adolescent vaccines. Social Science & Medicine, 2016. Moss, Reiter, Rimer, Brewer. PDF
  • Quality of physician communication about HPV vaccine – Response. Cancer Epidemiol Biomarkers Prev, 2016. Gilkey, Malo, Brewer. PDF
  • Provider communication and HPV vaccination: The impact of recommendation quality. Vaccine, 2016. Gilkey, Calo, Moss, Shah, Brewer. PDF
  • Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination. Human Vaccines & Immunotherapeutics, 2016 (in press). Moss, Gilkey, Rimer, Brewer. PDF
  • Messages to motivate human papillomavirus vaccination: National studies of parents and physicians. Cancer Epidemiology, Biomarkers & Prevention, 2016. Malo, Gilkey, Hall, Shah, Brewer. PDF
  • Physician communication about adolescent vaccination: How is HPV vaccine different? Preventive Medicine, 2015. Gilkey, Moss, Hall, Shah, Brewer. PDF
  • Quality of physician communication about human papillomavirus vaccine: Findings from a national survey. Cancer, Epidemiology, Biomarkers and Prevention, 2015. Gilkey, Malo, Shah, Hall, Brewer. PDF
  • HPV vaccine requirements, opt-outs and providers’ support: Key studies missing from a recent systematic review. Human Vaccines & Immunotherapeutics, 2019. Calo, Brewer. PDF
  • Physician support of HPV vaccination school-entry requirements. Human Vaccines & Immunotherapeutics, 2016 (in press). Califano, Calo, Gilkey, Brewer. PDF
  • Parents’ support for school-entry requirements for HPV vaccination: A national study. Cancer Epidemiology Biomarkers & Prevention, 2016 (in press). Calo, Gilkey, Shah, Moss, Brewer. PDF
  • School entry requirements and coverage of nontargeted adolescent vaccines. Pediatrics, 2016. Moss, Reiter, Truong, Rimer, Brewer. PDF
  • Mandatory HPV vaccination.  JAMA, 2012. Gilkey, Brewer. PDF
  • Acceptability of school requirements for human papillomavirus vaccine. Human Vaccines, 2011. Smith, Brewer, Gottlieb. PDF
  • Parent attitudes about school requirements for human papillomavirus vaccine in high-risk communities of Los Angeles, California. Cancer Epidemiology Biomarkers & Prevention, 2011. Robitz, Brewer, Markowitz. PDF
  • Stories about HPV vaccine in social media, traditional media, and conversations. Preventive Medicine, 2019. Margolis, Brewer, Shah, Calo, Gilkey. PDF
  • A content analysis of HPV vaccination messages available online. Vaccine, 2018. Calo, Gilkey, Malo, Brewer.  PDF
  • Recommendations for a national agenda to substantially reduce cervical cancer. Cancer Causes & Control, 2013. Smith, Brewer, Casey. PDF
  • Burden of invasive cervical cancer in North Carolina. Preventive Medicine, 2012. Denslow, Brewer, Smith. PDF
  • Cognitive testing of human papillomavirus vaccine survey items for parents of adolescent girls. Journal of Lower Genital Tract Disease, 2012. Richman, Coronado, Brewer. PDF
  • HPV vaccine discussions: An opportunity for mother-daughter communication about sexual health. Sexually Transmitted Diseases, 2012. McRee, Reiter, Brewer. PDF
  • Parents’ internet use for information about HPV vaccine. Vaccine, 2012. McRee, Reiter, Brewer. PDF
  • Mother-daughter communication about HPV vaccine. Journal of Adolescent Health, 2011. McRee, Reiter, Brewer. PDF
  • How parents hear about human papillomavirus vaccine: Implications for uptake. Journal of Adolescent Health, 2010. Cates, Shafer, Reiter, Brewer, McRee, Smith. PDF
  • The association between cervical abnormalities and attitudes toward cervical cancer prevention. Journal of Women’s Health, 2010. Salz, Brewer, Gottlieb. PDF
  • Availability of human papillomavirus vaccine at medical practices in an area with elevated rates of cervical cancer. Journal of Adolescent Health, 2009. Gottlieb, Brewer, Keating, Markowitz. PDF
  • Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiology, Biomarkers & Prevention, 2009. Hughes, Cates, Brewer. PDF
  • Present choices, future outcomes: Anticipated regret and HPV vaccination.  Preventive Medicine, 2009. Ziarnowski, Brewer, Weber. PDF
  • The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS): Scale development and associations with intentions to vaccinate. Sexually Transmitted Diseases, 2009. McRee, Brewer, Reiter, Smith. PDF
  • Potential barriers to HPV vaccine provision among medical practices in an area with high rates of cervical cancer. Journal of Adolescent Health, 2008. Keating, Brewer, Ludema, Smith. PDF

Funding Disclosure

Our HPV vaccine research has been funded by CDC, GSK, Merck, NCI, and Pfizer. Dr. Brewer has been a paid member of advisory boards for Merck and FDA.