Episode 251 | April 2026 | Part 1 American Family Physician

Summary

AFP Podcast Episode 251 | April 2026, Part 1: Summary

Episode Overview

This episode, hosted by Dr. Steve Brown and co-hosted with residents Alaina and Austin Cotter, covers high-yield clinical topics from the April 2026 issue of American Family Physician. The team discusses vaccine adverse effects, effective vaccine conversations, use of beta blockers post-MI, evaluation and management of thrombocytosis, guidelines on drowning resuscitation, and factors influencing HPV vaccine uptake. Their tone is candid, supportive, and practical, aiming to inform busy family physicians.

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Key Topics & Insights

1. Vaccine Adverse Effects: Overview

Source: Dr. Sarah Coles (Flagstaff, Arizona)
Main Points:

• Misinformation & Hesitancy: Highlighted the impact of social media on vaccine mistrust and rising hesitancy.
  • "Unfortunately, we are living in an era of misinformation which is amplified by social media. The result? Fear mongering, vaccine hesitancy and patient mistrust of physicians." — Alaina (01:44)
• Common Adverse Effects: Local and systemic reactogenicity (pain, swelling, fever, myalgias, rashes) is common, but usually mild.
• Acetaminophen Use: May relieve reactogenicity post-vaccine without significantly reducing immune response, especially for boosters.
• Anaphylaxis: Rare but important; always review inactive ingredients and, in the event of an anaphylactic reaction, arrange allergy testing.
  • "Anaphylactic reactions to vaccines are rare. However, expert opinion recommends that physicians review the excipients ..." — Alaina (02:51)
• Pediatric Updates:
  • No causal link between MMR vaccine and autism. Slight increase in febrile seizures (6–14 days post-vaccination), but no long-term effects.
  • AAFP recommends separate MMR and varicella vaccines for the first dose; co-administration is allowable if preferred (03:39).
• Adolescent Vaccines: HPV vaccine can cause syncope; observe for 15 minutes after administration (03:53).
• OB Recommendations: Influenza and RSV vaccines are safe during pregnancy; no increased risk for severe pregnancy outcomes (04:09).
• COVID-19 Update: Vaccination lowers severe outcomes vs. infection. Slight increase in myocarditis/pericarditis risk with mRNA vaccines compared to risk from COVID-19 infection (04:31).
  • "While COVID 19 vaccination reduces the risk of ED visits, hospitalization and death, but unfortunately vaccination rates remain low." — Austin Cotter (04:31)
• Message: Vaccines save lives; severe adverse reactions are rare.

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2. Curbside Consultation: Vaccine Conversations

Sources: Drs. Townes and Shaughnessy
Main Points:

• Approaching Hesitancy: Avoid overwhelming hesitant parents with evidence. Present vaccines as the medical standard and engage in shared decision making.
  • "The authors say it is not helpful to provide more evidence that contradicts a patient's beliefs ... This can trigger a paradoxical ... worldview backfire effect." — Steve Brown (06:27)
• Tactics:
  • Avoid lecturing; frame vaccines as routine.
  • Empathetically ask about concerns and directly address them.
  • Use statements like, "If this were my child, I'd definitely give vaccines.”
  • Offer compromise: administer the most crucial vaccine if there's resistance.
• Notable Quotes:
  • "We should think of ourselves as choice architects." — Alaina (06:52)
  • "Most patients are very open to discussion. Only about 1 in 8 parents has a negative attitude about vaccines." — Austin Cotter (07:00)
  • "Getting a vaccine is one way to make sure your child thrives as an adult." — Alaina (07:52)
• Conclusion: Meeting patients with understanding and aligning goals fosters trust and vaccine uptake.

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3. FPIN Clinical Inquiry: Beta Blockers After MI in Patients Without Heart Failure

Source: Drs. Roten, Muncie, Paulus (UNC)
Main Points:

• Conflicting Evidence: Recent RCTs show mixed results; beta blockers may not decrease risk of all-cause mortality, MI, or stroke but may reduce composite major cardiovascular events in some studies.
• Guideline Nuance: 2023 AHA/ACC guidelines suggest "it may be reasonable" to reassess long-term beta blocker use (>1 year) post-MI in patients without heart failure.
• Summary: No clear role for long-term beta blockers post-MI in patients without HFrEF; follow local recommendations. (09:55)
  • "So to summarize, several recent high quality studies have not demonstrated a clear role for beta blockers post MI in patients without heart failure." — Alaina (09:55)
• Tone: Acknowledges the ongoing "may be reasonable" ambiguity.

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4. Thrombocytosis: Rapid Evidence Review

Source: Drs. Williams & Williams (Bethesda, Maryland)
Main Points:

• Definition: Platelet count ≥450,000/μL, often discovered incidentally.
• Initial Workup: Repeat CBC with peripheral smear to exclude lab error (11:25).
• Secondary Causes: Address iron deficiency, infection, or asplenia first. Repeat CBC after addressing underlying issue.
• Primary Causes: If persistent, evaluate for myeloproliferative neoplasms (most commonly essential thrombocythemia, ET), involving Heme/Onc referral.
  • "The first step is the easiest. Always repeat the complete blood count with a peripheral smear to rule out spurious causes ..." — Steve Brown (11:25)
• Treatment: Aspirin (low dose) is standard. Use IPSET-thrombosis score for risk stratification. Some patients may need hydroxyurea; avoid in pregnancy (aspirin only); pediatric cases—treat only if symptomatic.
  • "We actually treat to prevent complications from high platelet related thrombosis or hemorrhage." — Alaina (12:51)

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5. Practice Guideline: Resuscitation After Drowning

Source: Dr. Arnold
Main Points:

• Guideline Score: 8/8 G-Trust score; actionable, evidence-based.
• Drowning Chain of Survival:
  1. Prevention: Fencing, supervision, swim lessons (15:01).
  2. Recognize distress.
  3. Provide flotation (preferably without entering water).
  4. Remove from water safely (horizontal position if unconscious).
  5. Provide basic/advanced life support (rescue breathing prioritized).
• CPR Recommendation: Ventilation after drowning is essential; compression-only CPR is not recommended (15:45).
• AED Use: Do not delay intervention waiting for an AED (15:52).

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6. Cochrane Review: HPV Vaccination of Adolescents

Source: Drs. Yancy & Bibel
Main Points:

• HPV Vaccination Rates: Only 57% of 13–15-year-olds receive the full series; contrast with >90% for others.
• Qualitative Review: Eight themes influence vaccine uptake:
  1. Biomedical knowledge, 2. Risk/benefit perception, 3. Views of other vaccines, 4. Family decision dynamics, 5. Social network influence, 6. Cultural beliefs/practices, 7. Institutional trust, 8. Logistical concerns (17:23).
  • "Teens and their caretakers often have limited biomedical knowledge about HPV in general and the vaccine." — Steve Brown (17:53)
• Barriers: Limited HPV knowledge, fears about sexual activity, fear of needles, perception as "female-only" vaccine.
• Interventions: Focused mainly on biomedical knowledge and logistics; less attention to cultural and family dynamics.
• Conclusion: Broader public trust interventions may improve HPV uptake.
  • "Improving the public's view on vaccines in general may increase acceptance of the HPV vaccine." — Steve Brown (18:51)

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Notable Quotes & Memorable Moments

• “Vaccines save lives, period. Severe vaccine reactions are rare and vaccine reactogenicity can be treated with acetaminophen after vaccination without significantly lowering the immune response.” — Alaina (04:50)
• “We should think of ourselves as choice architects. We're organizing information people use to make decisions.” — Alaina (06:52)
• “The authors say it is not helpful to provide more evidence that contradicts a patient's beliefs or information. This can trigger a paradoxical ... worldview backfire effect… patients reinforcing, not questioning their misinformation.” — Steve Brown (06:27)
• “[Beta blocker guidelines:] It may be reasonable for clinicians to reassess the indication for long-term ... beta blocker use for specific patients with chronic coronary disease. ... This guideline is based off the current evidence, which has not established a clear benefit.” — Austin Cotter (09:29)
• “90% of drownings are preventable. Fences, swim lessons, life jackets, lifeguards and close supervision.” — Alaina (15:01)
• “Teens and their caretakers often have limited biomedical knowledge about HPV in general and the vaccine.” — Steve Brown (17:53)
• “Improving the public's view on vaccines in general may increase acceptance of the HPV vaccine.” — Steve Brown (18:51)

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Timestamps for Important Segments

• Vaccine Adverse Effects: Overview: 01:30 – 05:05
• Vaccine Conversations (Curbside Consultation): 05:12 – 08:11
• Beta Blockers After MI: 08:11 – 10:17
• Thrombocytosis: 10:44 – 14:17
• Drowning Resuscitation Guideline: 14:17 – 16:04
• HPV Vaccine Uptake Factors (Cochrane Review): 16:04 – 19:02

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Summary

This episode provides family physicians with practical summaries and implementation insights on recent evidence and guidelines relevant to primary care. With a focus on hot-button vaccine topics (including adverse effects and discussions with hesitant patients), the hosts offer actionable counseling advice, reinforce the value of lifelong learning, and advocate for evidence-driven, patient-centered care—even in ambiguous and emotionally charged scenarios.

The tone is collegial, supportive, and relatable, making this episode a useful and encouraging listen for busy clinicians seeking high-quality, concise updates.

Transcript

[Podcast Sponsor/Announcer]

The AFP podcast is brought to you by the American Academy of Family Physicians and by Elation Health. Elation's AI billing connects the signed note to acute claim automating routine steps that often slow family medicine billing and giving clinical staff and physicians clear visibility into claims and progress. Information is [e-mail] AFP.

[Steve Brown]

Welcome welcome to the American Family Physician podcast for part one of the April 2026 issue. I'm Steve.

[Alaina]

I'm Alaina.

[Austin Cotter]

And I'm Austin.

[Steve Brown]

We are residents and faculty, mostly residents, from the University of Arizona College of Medicine, Phoenix Family Medicine Residency. Today on the podcast we're going to talk about vaccine adverse effects. Vaccine conversations Beta blockers after myocardial infarction, thrombocytosis, drowning and HPV vaccine The opinions

[Alaina]

expressed in the podcast are our own and do not represent the opinions of the American Academy of Family Physicians. The editor of American Family Physician or Banner Health do not use this podcast for medical advice. Instead, see your own family doctor for medical care.

[Steve Brown]

We're on a mission to living the best from American Family Physician on a

[Austin Cotter]

mission delivering the best strong American family

[Steve Brown]

okay, let's start with Vaccine Adverse effects An overview. This is from Dr. Sarah Coles, our friend, podcast founder and Program Director from North country in Flagstaff, Arizona.

[Alaina]

Unfortunately, we are living in an era of misinformation which is amplified by social media. The result? Fear mongering, vaccine hesitancy and patient mistrust of physicians.

[Austin Cotter]

Yeah, this has led to some devastating outcomes, including the ongoing measles outbreak, which has been the largest outbreak of measles since it was declared eliminated in 2000.

[Steve Brown]

Do not fret. As family medicine doctors, we can help restore trust in vaccine safety by being knowledgeable about adverse effects and providing appropriate counseling to our patients.

[Alaina]

So what is considered a vaccine adverse effect?

[Austin Cotter]

Yeah, well, these are unintended reactions that that occur after vaccine administration. Reactogenicity refers to the physical symptoms of an immune response to a vaccine, which commonly manifests as pain, swelling, fevers, myalgias and rashes. Acetaminophen administration following vaccination may lessen reactogenicity with minimal or no reduction in the immune response, particularly in booster doses.

[Steve Brown]

What about anaphylaxis? Patients are often very concerned about anaphylaxis and it seems to contribute to vaccine hesitancy.

[Alaina]

Anaphylactic reactions to vaccines are rare. However, expert opinion recommends that physicians review the excipients or inactive ingredients and recommended vaccines to ensure that patients with a history of anaphylaxis and severe allergies to these ingredients are not inadvertently exposed. Any patient who has an anaphylactic reaction to a vaccine should undergo immediate allergy skin testing to determine which vaccine component will was responsible.

[Austin Cotter]

Moving on to common pediatric vaccine recommendations and adverse reactions, A recent meta analysis found no causal link between MMR vaccination and autism spectrum disorder. They did however find that the MMR vaccine has been linked to a small increase in febrile seizures. This typically occurs 6 to 14 days after vaccination and is not associated with long term sequela.

[Steve Brown]

The AAFP recommends administering the MMR and varicella vaccine separately for the first dose in children ages 12 to 47 months, but co admin is acceptable if parents or caregivers prefer.

[Alaina]

For our adolescents, syncope is reported as an adverse reaction of the HPV vaccine and physicians should consider observing patients for 15 minutes after vaccination.

[Austin Cotter]

What about recommendations for OB patients? This is another challenging population to discuss vaccines with.

[Steve Brown]

A key update is that the influenza vaccine has not been associated with adverse outcomes during pregnancy and RSV vaccination during pregnancy does not increase the risk of stillbirth, birth defects, growth restriction or infant death.

[Alaina]

And last and probably most controversial amongst patients, the COVID 19 vaccine.

[Austin Cotter]

While COVID 19 vaccination reduces the risk of ED visits, hospitalization and death, but unfortunately vaccination rates remain low. The COVID 19 MRNA vaccine is associated with a small increase in the risk of myocarditis and pericarditis, although compared with COVID 19 infection the risk is significantly lower and clinical outcomes are much better.

[Alaina]

A good take home message is that vaccines save lives, period. Severe vaccine reactions are rare and vaccine reactogenicity can be treated with acetaminophen after vaccination without significantly lowering the immune response.

[Austin Cotter]

Thanks Dr. Coles, we appreciate your advocacy and leadership so so much. Yes,

[Steve Brown]

speaking of vaccines, here's a curbside consultation Vaccine Conversations Meeting patients where they are this is from Dr. Townes and Shaughnessy from Cambridge Health Alliance.

[Alaina]

This curbside consultation starts with a situation we are all familiar with. We are wrapping up a well child visit and let the parent know the nurse will be giving vaccines next and

[Austin Cotter]

then the parent declines citing a story about a family member who they think has been harmed by vaccines.

[Alaina]

How do we gain insight into the parents attitude about vaccinations and how do we begin a constructive conversation that leads to a shared understanding and shared decision making?

[Steve Brown]

Let's start with a little background here. In 2019 the World Health Organization named vaccine hesitancy one of its top 10

[Austin Cotter]

global health threats and since 2020, the discourse has only intensified, but moving out of the physician office and into the public realm.

[Alaina]

Now there is some perception among some that doctors might not have their best

[Steve Brown]

interest in mind, and politicians and influencers exploit this doubt to promote themselves or their ideas.

[Austin Cotter]

A patient may come in with outrage Factors that influence perception of risk so

[Alaina]

how do we respond to vaccine refusal?

[Steve Brown]

The authors say it is not helpful to provide more evidence that contradicts a patient's beliefs or information. This can trigger a paradoxical what's so called worldview backfire effect. Seen that that results in patients reinforcing, not questioning their misinformation.

[Austin Cotter]

We really want to avoid an us versus them power struggle instead of a constructive alignment with the patient.

[Alaina]

We should think of ourselves as choice architects. We're organizing information people use to make decisions.

[Steve Brown]

We should avoid lecturing.

[Austin Cotter]

Most patients are very open to discussion. Only about 1 in 8 parents has a negative attitude about vaccines.

[Alaina]

It's more effective to present vaccines as standard medical treatment. You can say we're scheduled to give some shots today.

[Steve Brown]

If someone seems hesitant, ask about apprehension and address questions and concerns directly using straightforward statements.

[Austin Cotter]

For instance, you can say if this were my child, I'd definitely give vaccines. Or the side effects are usually mild, such as low grade fever or pain at the injection site.

[Alaina]

Stay curious. If they continue to refuse, ask permission to share information.

[Steve Brown]

Sometimes you might offer the option of just one vaccine, the one that is most important for that child at that visit.

[Austin Cotter]

Avoid providing facts or figures or citing authorities.

[Steve Brown]

Looking at the link from Table 1 from the American Medical association, here's some other statements that you might try Getting

[Alaina]

a vaccine is one way to make sure your child thrives as an adult.

[Austin Cotter]

We have a shared goal. We want what's best for your child.

[Alaina]

In conclusion, this conversation is really hard. Yeah, thank you all out there doing this important work.

[Steve Brown]

Next, FPIN's clinical inquiries FPIN is the Family Physicians Inquiries Network. Beta blockers to improve post myocardial infarction outcomes in patients without heart failure. This is from doctors Roten Muncie and Paulus from the University of North Carolina.

[Alaina]

This article addresses the clinical question, do beta blockers improve post MI outcomes in patients without heart failure?

[Austin Cotter]

What did they find?

[Alaina]

Well, the results were mixed. Some recent high quality randomized controlled trials have shown that beta blockers do not decrease the risk of a composite outcome of death, non fatal mi, non fatal stroke or hospitalization for another cardiovascular reason. However, other recent studies have shown that beta blockers do reduce the risk of a composite outcome of death and major adverse cardiovascular events.

[Steve Brown]

Sounds like we need more evidence to have a clear recommendation, and so it sounds like this is kind of more of an expert opinion.

[Alaina]

Definitely, given the mixed evidence. Without a clear benefit of beta blockers after mi, physicians should continue to follow local practice recommendations. This is a strength of recommendation. B Heterogeneous results of randomized controlled trials and meta analysis of cohort studies.

[Austin Cotter]

That's also consistent with the 2023 AHA ACC guideline for Chronic coronary Disease management, which states that it may be reasonable for clinicians to reassess the indication for long term longer than one year beta blocker use for specific patients with chronic coronary disease. These include patients without a history of HFREF who were started on beta blocker therapy for a previous mi. This guideline is based off the current evidence, which has not established a clear benefit.

[Alaina]

So to summarize, several recent high quality studies have not demonstrated a clear role for beta blockers post MI in patients without heart failure.

[Steve Brown]

I love the statement maybe reasonable.

[Alaina]

They love it. I said that today. So helpful. They said it may be reasonable to get a lipid panel. I'm like, what does that mean?

[Austin Cotter]

Oh my gosh.

[Steve Brown]

We'll be right back.

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[Steve Brown]

the moment you've all been waiting for. Thrombocytosis Rapid Evidence Review this is from Drs. Williams and Williams from Uniformed Services in Bethesda, Maryland.

[Alaina]

Thrombocytosis, defined as a platelet count of 450,000 per microliter or greater, is an incidental finding fairly familiar to most family physicians.

[Austin Cotter]

Definitely. I just had two hit my inbox last week. Most of the time it seems secondary to another process like in infection, asplenia, medications, or even anemia. But I know there are some pretty serious neoplastic primary causes too. So what should I do when this lab comes back? Can I just call the finding reactive and go about my day?

[Steve Brown]

Well, that would be nice, but like you said, there are some pretty serious primary causes, so not quite. The first step is the easiest. Always repeat the complete blood count with a peripheral smear to rule out spurious causes stemming from automatic cell count errors.

[Alaina]

Hmm. Okay, easy enough. I usually order that along with other labs to identify triggers for secondary thrombocytosis like iron studies and C reactive protein. Then it's easy enough to treat anemia or infection and repeat the CBC a few weeks later to identify resolution.

[Austin Cotter]

That's great, but what if no secondary cause is apparent? Or if the thrombocytosis doesn't improve after anemia or infection is treated?

[Steve Brown]

Then it's time to think about primary causes, which in adults is most commonly due to myeloproliferative neoplasm, including essential thrombocythemia. So, Alayna, how would we start this workup?

[Alaina]

Well, if we're thinking neoplasm, then a heme ONC consult would be an excellent next step.

[Austin Cotter]

I concur.

[Steve Brown]

All right. These patients will likely need HEMONC for bone marrow biopsy, JAK2 testing and ruling out other myeloproliferative neoplasms required as part of the major diagnostic criteria for essential thrombocythemia.

[Austin Cotter]

I remember that one from med school. Aren't patients with essential thrombocythemia at risk of progression to leukemia or myelofibrosis?

[Alaina]

Exactly. But interestingly, that's not why we treat. Since drug therapy doesn't really show increased survival or decreased leukemia progression, we actually treat to prevent complications from high platelet related thrombosis or hemorrhage.

[Austin Cotter]

So do we treat everyone? Is this going to be another case for aspirin?

[Steve Brown]

Yes, aspirin is right. Specifically low dose, but. But not everyone with ET should get treated the same. We can use the revised international Prognostic score of Thrombosis for essential thrombocythemia or IPSET thrombosis score to risk stratify with the goal of guiding treatment.

[Austin Cotter]

What a mouthful.

[Steve Brown]

Yeah.

[Alaina]

Now, most patients are fine to receive once daily low dose aspirin, with some very low risk patients being fine to observe and some other higher risk refractory patients requiring twice daily dosing. Another medication commonly seen for ET is hydroxyurea, which is cytoreductive, helping to prevent clots and hemorrhage by actually decreasing the number of platelets.

[Austin Cotter]

There are some caveats for treatment though. If our patient is pregnant or going to be pregnant, then we should avoid teratogens like hydroxyurea and be sure to initiate low dose aspirin. And if our patient is a child, then we should only treat them if symptomatic. And if we need to start therapy, then we need to monitor for bleeding, complications and REY syndrome while they are on aspirin.

[Steve Brown]

We have a practice guideline now, resuscitation after drowning in updated guidelines from the American Heart association and American Academy of Pediatrics. And this is from Our fearless editor, Dr. Arnold from Naval Undersea Medicine Institute in Connecticut. Kudos to the American Heart association and the AAP for an 8 out of 8 score on the G Trust Scorecard.

[Alaina]

This guideline has clear and actionable recommendations, is based on a systematic review, and focuses on patient oriented outcomes.

[Austin Cotter]

Nice. Let's go over some recommendations from this guideline.

[Steve Brown]

There are five steps in the drowning chain of survival first, prevention.

[Alaina]

90% of drownings are preventable. Fences, swim lessons, life jackets, lifeguards and close supervision.

[Austin Cotter]

Second, recognizing distress. This might not always be yelling.

[Steve Brown]

Third, provide flotation. If a rescuer can stay out of the water, that can be safer.

[Alaina]

4. Remove drowning person from water when safe. Unconscious people should be removed in a near horizontal position with head above body level and an open airway.

[Austin Cotter]

And five provide basic and advanced life support in water.

[Steve Brown]

Rescue breathing should be considered if the distance to shore will cause a delay.

[Alaina]

Rescue breathing using the first means available is a priority. Ventilation is essential after drowning.

[Austin Cotter]

Compression only. CPR is not recommended.

[Steve Brown]

Supplemental oxygen is recommended when available.

[Alaina]

And drowning CPR is more important than an automated external defibrillator, so don't delay to wait for an aed.

[Austin Cotter]

These are all great tips from this guideline that hopefully none of us will ever have to use.

[Steve Brown]

Yeah, yeah, we're going to bring it home today with a Cochrane for Clinicians HPV Vaccination of adolescents Factors that influence caregiver and adolescent views and practices. This is from Drs. Yancy and Bibel from Army Medical center in Fort Hood, Texas.

[Austin Cotter]

The HPV vaccine as a two or three dose series is recommended by the CDC for all 11 to 12 through 26 year olds in the United States, as well as select not yet vaccinated individuals up through age 45.

[Alaina]

But only about 57% of 13 to 15 year olds currently receive the full course, despite the vaccination rates for other childhood vaccines being above 90%. Yikes.

[Austin Cotter]

Yeah, definitely yikes. Counseling teens and their caregivers in the HPV vaccine is definitely one of the most nuanced conversations I have in, well, child visits.

[Steve Brown]

We're tackling a Cochrane review here. That's a review of qualitative research that helps to categorize the factors that play into this decision for teens and their caregivers. I don't remember that Cochrane did reviews of qualitative studies.

[Alaina]

Oh, way to go Cochrane.

[Steve Brown]

The factors outlined by the qualitative Cochrane review fall into one of eight broad categorical themes.

[Alaina]

These themes are 1 biomedical knowledge 2 perceptions of risk and benefit, 3 views of other vaccines, 4 familial decision making dynamics, 5 influence of social networks, 6 effect of cultural beliefs and practices, 7 level of trust in vaccine institutions or experts and 8 logistical concerns.

[Austin Cotter]

I also noticed they used grade to rate the evidence. The authors declare high confidence in several of their findings.

[Steve Brown]

Yeah, so new frontiers here. Grade for qualitative research. Teens and their caretakers often have limited biomedical knowledge about HPV in general and the vaccine. Additional skepticism arises from the perception that this is new. This vaccine as well concerns that it can somehow promote inappropriate sexual practices, adolescent

[Alaina]

fear of needles, and male teens perceiving the vaccine as feminine. Both additionally decrease uptake.

[Steve Brown]

Yeah, so this is great, these eight themes and all. But what are we supposed to do with these findings?

[Austin Cotter]

Well, the authors then compared these categories and findings to a systematic review of interventions designed to increase adolescent uptake for any vaccine. More than 50% of the interventions in that review targeted biomedical knowledge, perceptions of risk, institutional trust, and logistical concerns. No interventions targeted views of vaccine programs nor cultural beliefs or practices.

[Steve Brown]

This leads to the author's overall conclusion. Improving the public's view on vaccines in general may increase acceptance of the HPV vaccine.

[Alaina]

Well, that sounds easy. Let's just do that.

[Steve Brown]

Oh my.

[Austin Cotter]

We can be advocates too. But don't miss our recent bonus episode on an update for 2026. Send us your thoughts by emailing [e-mail]

[Steve Brown]

follow on Instagram fpjournal. Please subscribe and rate us wherever you get your podcasts.

[Alaina]

Escuchenos en Espanol Arrevista Medica A fap. Our podcast team is Jake Anderson, Puneet

[Austin Cotter]

Bharot, Steve Brown, Justin Chettiak, Sarah Coles,

[Alaina]

Austin Cotter, Rachel Dunn, Emily Eisenberg, Elena Kelly, Chisholm Okuwagu, and Kari Stauss.

[Austin Cotter]

Our sound and technical guru is Tyler Coles.

[Alaina]

Our theme song is written and recorded by family physicians Bill Dabs, Ryan Evans, and Justin Jenkins.

[Steve Brown]

This podcast is brought to you, by the way, residents and faculty of the University of Arizona College of Medicine, Phoenix Family Medicine Residency Programs.

[Austin Cotter]

We'll talk to you soon for the next edition of the American Family Physician Podcast.