Predictors of Human Papillomavirus Vaccination in the Postpartum Period for Individuals Aged 18-26

Background: Human papillomavirus (HPV) vaccination during the postpartum period is an opportunity for vaccine eligible individuals to be vaccinated. Objective: Identify predictors of vaccine acceptance in the postpartum period among patients aged 18-26. Study Design: A retrospective chart review was conducted to evaluate the rate of HPV vaccination to eligible postpartum patients aged 18-26 who delivered between January 2021 and May 2023 at our institution. Clinical and demographic data were extracted. Comparisons were made between fully vaccinated individuals and those who were unvaccinated or incompletely vaccinated. Variables significantly associated with vaccination status or acceptance were included in a multivariable logistic regression model. Results: Of the 1,130 patients who met the study inclusion criteria, 42.1% were eligible for postpartum HPV vaccination. The average age was 23 years, the majority White (74.5%), and English speaking (93.1%). Nineteen percent of eligible patients accepted HPV vaccination, with differences between those who accepted or declined the vaccine identified in: preferred language, tobacco use, delivering provider's specialty, and receiving any vaccination during pregnancy. Spanish-speaking patients had >5× the odds of accepting the vaccine compared with English-speaking patients. Smokers, patients delivered by a family medicine provider, and those who accepted any vaccine during pregnancy had more than twice the odds of receiving the vaccine postpartum. Conclusion(s): The postpartum period remains an opportunity to provide HPV vaccination. Our study identified patients less likely to be vaccinated prior to delivery, as well as patients who are more likely to accept vaccinations postpartum.