From the Journals

Missed opportunities abound to give HPV vaccine to adolescent girls



Opportunities to give the human papillomavirus (HPV) vaccine were missed, especially during well-adolescent and vaccine-related visits, in a study of more than 14,000 fully insured teen girls, reported Claudia M. Espinosa, MD, of the division of pediatric infectious diseases, University of Louisville (Ky.), and her associates.

In a study of 14,588 girls in a fully insured commercial or Medicaid plan who turned 11 years old between Jan. 1, 2010, and Sept. 31, 2015, it was documented whether or not the girls received an HPV vaccine when they were given another adolescent vaccine – one or more doses of the Tdap vaccine and/or one or more doses of the 4-valent meningococcal conjugate vaccine (MenACWY vaccine).

Vaccine syringe luiscar/Thinkstock
Only 42% of eligible girls started the HPV vaccine series; 68% of girls who started the HPV vaccine series in their 11th year completed three doses during the 2-year measurement period, compared with 52% of those who started in their 12th year.

Girls who started HPV vaccination were more likely than those who didn’t to receive the MenACWY (86% vs. 64%, respectively; P less than .0001) and Tdap (86% vs. 73%, respectively; P less than .0001) vaccines.

“A missed opportunity was defined as the absence of an HPV vaccine dose administered during any visit with a Tdap or MenACWY vaccine claim, any well-adolescent visit, or any encounter with a primary care provider, regardless of visit type,” the investigators said.

Of 10,987 visits when a Tdap or MenACWY vaccine dose was given, HPV vaccine was given at the same visit in only 37% of cases. An HPV vaccine was administered at only 26% of 12,621 of well-adolescent visits, and 42% of 14,195 other visits with primary care providers.

“The data also suggest that pediatricians and nonpediatricians alike are missing opportunities to administer the HPV vaccine when other adolescent vaccines are given,” Dr. Espinosa and her associates noted. “Future research should focus on communication strategies that might facilitate the conceptual ‘bundling’ of HPV vaccine with other adolescent vaccines in the provider’s office.”

Read more in the Journal of the Pediatric Infectious Diseases Society (2017 Sep 23. doi: 10.1093/jpids/pix067).

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