Low Uptake of Human Papillomavirus Vaccine Among Postpartum Women, 2006-2012.

Abstract

Young adult women find it acceptable to be offered the human papillomavirus (HPV) vaccine postpartum. Little is known about the practice of administering the HPV vaccine during the postpartum period. The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to develop a cohort of privately insured 18 to 26-year-old women with uncomplicated live-born pregnancies. Eligibility required no previous doses of HPV vaccine before delivery and continuous insurance enrollment from June 2006 through 1 year postpartum. Descriptive statistics were performed. A total of 51,913 women meet age and enrollment criteria, with 3912 (7.5%) having received any doses of vaccine before their delivery, leaving 48,001 women in this cohort. In the year postpartum, 861 women (1.8%) received any HPV vaccine. Of the women initiating the vaccine, only 337 (39%) completed the three-vaccine series. Women who received the vaccine, compared with women who did not, were younger (21 vs. 23 years old), more often the dependent to the insurance beneficiary (56% vs. 30%), and were more likely to have had an abnormal pap smear in the year prior (19.6% vs. 9.1%) or postdelivery (16.4% vs. 4.9). More women completed the HPV vaccine series when initiated within 2 months postpartum compared with women initiating the vaccine series >2 months postpartum (44% vs. 38%). Postpartum women are eligible for the HPV vaccine, yet very few are receiving it. The postpartum period is a missed opportunity for administration of this cancer-preventing vaccine.