Improving HPV Vaccination Rates in a Racially and Ethnically Diverse Pediatric Population.

Area of Science:

• Public Health
• Pediatrics
• Vaccinology

Background:

• Nationally, only 54.2% of youth complete the human papilloma virus (HPV) vaccine series, with notable gender and racial/ethnic disparities.
• Persistent gaps in HPV vaccination coverage highlight the need for effective interventions.

Purpose of the Study:

• To implement and evaluate a multilevel quality improvement intervention to increase HPV vaccine series completion by age 13.
• To examine racial/ethnic and gender disparities in HPV vaccine uptake.

Main Methods:

• A quality improvement approach was used in 2 pediatric academic primary care practices.
• A multilevel intervention targeted patient, provider, and systems levels, including addressing parental hesitancy and improving provider communication.
• HPV vaccine series completion rates by age 13 were monitored using control p charts, with bivariate and multivariate analyses assessing disparities.

Main Results:

• HPV vaccine initiation by age 9 increased from 1% to 52%, and completion by age 13 rose from 37% to 77% during the study period (July 2014–September 2021).
• Hispanic children were more likely to initiate the HPV vaccine by age 9 (aOR 1.4-2.6) and complete the series by age 13 (aOR 2.3 [1.7-3.0]) compared to White and Black children.

Conclusions:

• A multilevel intervention effectively achieved sustained HPV vaccine series completion by age 13.
• Early vaccine initiation at age 9 and clinicwide protocols were crucial for sustained improvement.
• Qualitative family input and provider communication training were vital components of the intervention's success.