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Electronic Health Record Clinical Decision Support to Close the Human Papillomavirus Vaccination Gender Disparity in

Carole H Stipelman1, Erica Ulibarri2, Natalie Wilson3

  • 1University Pediatric Clinic and Sugar House Pediatric Clinic, Division of General Pediatrics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.

Clinical Pediatrics
|March 13, 2025
PubMed

Insights

A quality improvement project successfully boosted human papillomavirus (HPV) vaccination rates in 9- and 10-year-olds. The intervention reduced gender disparities, making vaccination initiation more equitable for all children.

Area of Science:

  • Pediatric Health
  • Public Health Interventions
  • Vaccinology

Background:

  • Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers.
  • Initiation rates for HPV vaccination in children aged 9-10 years require improvement.
  • Existing gender disparities in HPV vaccination initiation need to be addressed.

Purpose of the Study:

  • To enhance HPV vaccination initiation frequency in 9- and 10-year-old children.
  • To decrease gender-based disparities in HPV vaccination initiation.
  • To evaluate the impact of a multifaceted quality improvement intervention.

Main Methods:

  • A quality improvement project was conducted across 31 clinics from July 2021 to October 2023.
  • Eleven process changes were implemented, including electronic health record clinical decision support (CDS) tools and medical assistant involvement.
  • The intervention involved phased implementation: preparation, CDS alerts with lowered initiation age (9 years), and patient portal outreach.

Main Results:

  • Initial HPV vaccination initiation was lower in boys (15%) than girls (19%).
  • Following CDS alerts and lowering the initiation age to 9, initiation increased significantly to 49% in boys and 50% in girls.
  • Patient portal outreach further increased initiation rates, demonstrating sustained improvement and reduced gender disparity.

Conclusions:

  • A multifaceted intervention incorporating CDS tools and early initiation age significantly increases HPV vaccination uptake.
  • The intervention effectively reduced gender disparities in HPV vaccination initiation among young children.
  • Quality improvement strategies are vital for optimizing childhood vaccination schedules and promoting health equity.

Keywords:
boyscancerpreventionquality improvementvaccine

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