Well-child Visits and HPV Vaccination Rates in Privately Insured Females Aged 9-21 Years in the United States, 2007-2012
Methods: This was a retrospective database (MarketScan®) cohort study. Eligible subjects were 9-21 year old females who had continuous enrollment since June 1, 2006 or January 1 of the year when a child turned 9 years old, had well-child visits, and didn’t initiate HPV vaccine series previously. Vaccination rates for HPV during well-child visits were estimated and compared with Tdap and MCV4 for 11-12 year old females. Females who got the 1st dose of HPV vaccine during well-child visits were followed for two years to estimate HPV vaccine series completion rates. Descriptive and multivariate analyses were used in assessing the study’s objectives.
Results: Well-child visits among 11-12 year old females were the highest (55.7% in 2012) and among ages 18-21 were the lowest (24.5%) (p<0.0001). As compared to 11-12 year olds, ages 13-15 were 24% less likely to come in for a well-child visit (p<0.0001). HPV vaccination rates during a well-child visit were similar in the 11-12 and 13-15 year age groups (19.0% and 21.1% in 2012). In 2012, HPV vaccination rates (19.0%) in 11-12 year old females during well-child visits were significantly lower than Tdap (33.7%) and MCV4 (32.0%) (p<0.0001). HPV vaccine three-dose series completion rates during a 2-year follow-up were 59.0% in 11-12 year old females and 49.1% in ages 13-15 for those who initiated the 1st dose during a well-child visit in 2010.
Conclusion: As determined from this claims analysis, 11-12 year old females are more likely to come in for a well-child visit and more likely to complete the HPV vaccine series compared to other age groups. Our analyses suggest that well-child visits at 11-12 years of age provide the best opportunity to maximize the potential of the HPV vaccination program in the US.
Merck: Employee, Salary
A. S. Kulkarni, Merck: Employee, Salary
L. Niccolai, Merck: Collaborator, Research Contractor and Scientific Advisor, Consulting fee