An Integrated Health System's Approach to Improving Human Papillomavirus Vaccination Rates Through a Systemwide...

Human papillomavirus (HPV) vaccination rates lag behind other recommended adolescent vaccines. Practice- and clinician-based interventions to improve HPV vaccination rates are known to be effective in improving completion rates.

The aim is to determine whether implementing bundled interventions across an integrated health system would result in systemwide improvements in HPV vaccination rates.

We assessed the impact of multilevel interventions across an integrated health system to increase HPV vaccination rates between 2019 and 2024 in a large and predominantly rural state. We analyzed the effects of implementing sequential bundles of interventions over multiple years, including efforts focused on quality improvement, physician leadership, electronic medical record enhancements, clinical decision support tools, and communications.

Human papillomavirus vaccination completion rates improved from 46.2% in December 2019 to 55.4% in December 2024 (+9.2 percentage points), comparing favorably with changes in national rates during the same interval. These findings demonstrate that the interventions had a statistically significant impact on HPV vaccination rates in 13 year olds.

By applying multilevel interventions, a system-wide implementation strategy can be successful in increasing HPV vaccination rates across an integrated health system.