Statewide Vaccine Registry Data Indicate High Number of Missed Opportunities for the HPV Vaccine Among Eligible Girls

Abstract

Abstract This study investigates the rate of missed opportunities for the HPV vaccine among eligible girls using statewide vaccine registry data. Methods: Using data from the Utah Statewide Immunization Information System (USIIS) from 2008–2012 for approximately 55,000 girls ages 11–18, we assessed the frequency of missed opportunities (receipt of other recommended vaccinations such as TDap, MCV4, and/or flu and not the HPV vaccine) among eligible female patients for the HPV vaccine. USIIS is a free, confidential, web-based information system that contains immunization histories for Utah residents of all ages. Records of all persons born in Utah since 1998 are in USIIS. USIIS is designed to help enrolled healthcare providers track immunization records for patient care by consolidating immunizations from enrolled providers into one centralized record. Vaccine administration from 86% of healthcare providers in Utah is reported to USIIS. USIIS data used for the study include date of birth, age, gender, ethnicity and race, zip code, and date and type of vaccine received. Descriptive statistics and chi- square tests were used to assess rate of missed opportunities for the HPV vaccine and associated demographic factors. Results: Approximately 65% of preteens (ages 11–12; N = 2,593) and 32% of female teens (ages 13–18; N = 4,937) had a missed opportunity for the HPV vaccine between years 2008–2012 in Utah (P < 0.001). Race and ethnicity related to rates of missed opportunities for the HPV vaccine among all girls ages 11–18 (Whites = 36%, N = 2,454; Hispanics = 21%, N = 254) (P < 0.001). Rural and urban locations were also associated with rates of missed opportunities for the HPV vaccine (urban = 31%, N = 4,448; large rural town = 42%, N = 202) (P < 0.001). Conclusions: For more than eight years, a vaccine to prevent cervical and other HPV-related cancers has been available, yet receipt of the 3-dose HPV vaccine in the United States is far below national goals for girls (33% vs. 80%; actual vs. target). Using statewide vaccine registry data, our study demonstrates that administering the HPV vaccine when providing other recommended adolescent vaccinations may dramatically improve rates of HPV vaccination among girls in a state with low HPV vaccine uptake. In addition, targeting rural communities and non-Hispanic White patients may further reduce missed opportunities.