1863. Human Papillomavirus Vaccine Uptake and Missed Opportunities in the Vaccine Safety Datalink
Session: Poster Abstract Session: Vaccines: Improving Immunization Uptake
Saturday, October 10, 2015
Room: Poster Hall



    Human papillomavirus (HPV) vaccination has been recommended by the Advisory Committee on Immunization Practices for routine vaccination of adolescent girls and boys since 2006 and 2011, respectively. HPV is administered in a 3-dose series and co-administration of other routine adolescent vaccines is recommended. Nationally, HPV vaccine coverage rates remain low and correlate with missed vaccination opportunities.


    HPV vaccine uptake was examined within the Vaccine Safety Datalink (VSD) population aged 11 through 18 from January 2007 through December 2013. Total doses, as well as total individual- and co-administered vaccine visits, were captured. Vaccination coverage rates were calculated by gender at the 13th and 18th birthdays of individuals in each study year. Missed opportunities for vaccination, defined as outpatient visits where a patient eligible for HPV vaccine remained unvaccinated, were examined by visit type (preventive  and non-preventive) and overall, by study year. Vaccine eligibility for boys was restricted to 2012-2013.


    The average number of adolescents in the study population each year was 1,028,050; 1.7 million doses of HPV vaccine were administered over the study period (75% to girls). Among girls and boys, respectively, 59% and 53% of visits with HPV administration included co-administration of ≥1 other vaccine. HPV vaccine series initiation (≥1 dose) rates in 2013 at ages 13 and 18 were 55% and 72% for girls, and 34% and 46% for boys, respectively. From 2007 to 2013 series completion rates (≥3 doses) increased to 26% and 57% for girls at ages 13 and 18, respectively. Series completion rates for boys in 2013 were 9% and 16% at ages 13 and 18, respectively (Figure). Over the study period, 55% of girls and 68% of boys had a missed opportunity for HPV vaccine series initiation at a preventive care visit.  Rates of missed opportunities were higher at non-preventive visits (92% of girls and 95% of boys).



     HPV vaccine series initiation and completion rates in this predominantly insured population are similar to national estimates, and remain below national targets. Missed opportunities for HPV vaccination vary in frequency by visit type, but are common even at preventive care visits.


    Stephanie Irving, MHS1, Holly Groom, MPH1, Padmavati Dandamudi, MPH1, Matthew Daley, MD2, Shannon Stokley, MPH3, Julianne Gee, MPH4, James Donahue, DVM, PhD5, Marlene Lugg, DrPH6 and Allison Naleway, PhD7, (1)The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, (2)Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, (3)National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (4)Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, (5)Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Marshfield, WI, (6)Department of Research & Evaluation, Southern California Kaiser Permanente, Pasadena, CA, (7)Kaiser Permanente Center for Health Research, Portland, OR


    S. Irving, None

    H. Groom, None

    P. Dandamudi, None

    M. Daley, None

    S. Stokley, None

    J. Gee, None

    J. Donahue, None

    M. Lugg, None

    A. Naleway, GlaxoSmithKline: Investigator , Research support

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.