Adherence to the HPV Vaccine Dosing Intervals and Factors Associated With Completion of 3 Doses

Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 4000, Cincinnati, OH 45229-3039, USA.
PEDIATRICS (Impact Factor: 5.47). 01/2011; 127(1):77-84. DOI: 10.1542/peds.2010-0812
Source: PubMed


The objectives of this study were to determine (1) adherence to the immunization schedule for the human papillomavirus quadrivalent vaccine and (2) factors associated with completion of the 3-dose series.
This was a retrospective review of health information records from an academic medical center. The sample included all 9- to 26-year-old female patients who initiated vaccination within 2 years after quadrivalent vaccine availability. Multivariable logistic regression models were estimated to determine associations with completion of the 3-dose series within 7 and 12 months.
Among the 3297 female patients who initiated vaccination with human papillomavirus quadrivalent vaccine, 67% self-identified as black and 29% self-identified as white. Fewer than 3% of vaccine doses were received earlier than recommended, but >50% of doses were received late. Completion rates were 14% by 7 months and 28% by 12 months. Independent predictors of completion by 7 months included white versus black race (odds ratio [OR]: 2.04 [95% confidence interval (CI): 1.64-2.56]; P < .001), use of contraception that required intramuscular injections every 3 months (OR: 1.53 [95% CI: 1.12-1.95]; P < .001), and private versus public insurance (OR: 1.31 [95% CI: 1.06-1.63]; P < .05). Age and clinic type were not independent predictors of completion.
Adherence to recommended intervals and completion of the vaccine series were low. Lower rates of completion in black patients compared with white patients raises concern that disparities in vaccine completion could exacerbate existing disparities in cervical cancer.

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Available from: Anthony Leonard, Apr 18, 2014
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    • "Other studies in young adult women have also found an association between vaccination status and being single, unmarried or never married (with the exact measure being study dependent) [12] [14] [15] [22]. The relationship identified in the current study between HPV vaccine uptake and use of hormonal contraception, has not been previously documented in the Australian National HPV Vaccination Program and has only been investigated in a few other international studies of young adult women [10] [11] [21] [23]. Hormonal contraception use may act as a proxy for accessing health services on a regular basis, thus possibly increasing the likelihood of vaccination in the catch-up phase, and/or it may indicate increased awareness of women's health issues [24]. "
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    • "Only one of these studies showed that publicly insured adolescents were significantly more likely to complete the HPV4 series than those with private or no insurance (Schluterman et al., 2011). Most adolescent studies showed that those with private insurance were significantly more likely to complete the on-time HPV4 series than those with public or no insurance (Dempsey et al., 2011; Dorell et al., 2011; Neubrand et al., 2009; Tan et al., 2011; Widdice et al., 2011). Our data show that among those adolescents receiving three doses, public and private insurance of HPV4 led to equivalent on-time completion rates. "
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