Achieving High Adolescent HPV Vaccination Coverage.

Area of Science:

• Public Health
• Vaccinology
• Adolescent Medicine

Background:

• National human papillomavirus (HPV) vaccination rates for adolescents remain suboptimal.
• Safety net health systems face challenges in achieving high adolescent vaccination coverage.
• Interventions are needed to improve HPV vaccine uptake in urban adolescent populations.

Purpose of the Study:

• To evaluate the effectiveness of implemented interventions in increasing adolescent vaccination coverage.
• To determine if specific tactics achieved high rates of human papillomavirus (HPV) vaccination in a large, urban safety net health care system.
• To compare vaccination rates with state and national data.

Main Methods:

• Utilized vaccine registry and utilization statistics from Denver Health, an urban safety net system.
• Analyzed vaccination rates for adolescents aged 13–17 years from 2004–2014.
• Employed regression analysis to identify factors associated with vaccination status.

Main Results:

• In 2013, HPV vaccination coverage (≥1 dose) was 89.8% for females and 89.3% for males, significantly exceeding national rates (57.3% and 34.6%).
• Three-dose HPV coverage reached 66.0% for females and 52.5% for males, compared to national rates of 37.6% and 13.9%.
• Other adolescent vaccine coverages, including tetanus and meningococcal vaccines, also surpassed national averages.

Conclusions:

• System-wide, low-cost standard procedures successfully elevated adolescent vaccination rates above national benchmarks.
• Key strategies included "bundling" vaccines, offering them at every visit, and utilizing standard orders.
• Minimizing missed vaccination opportunities and normalizing the HPV vaccine were crucial for high coverage.