Patient and clinician factors associated with uptake of the human papillomavirus (HPV) vaccine among adolescent patients of a primary care network

Julie H T Dang¹, Susan L Stewart², Dean A Blumberg³, Hector P Rodriguez⁴, Moon S Chen Jr⁵

Affiliations

¹ University of California, Davis School of Medicine, Division of Health Policy and Management, Department of Public Health Sciences, 4501 X Street, Suite 3003, Sacramento, CA 95817, USA. Electronic address: jtdang@ucdavis.edu.
² University of California, Davis School of Medicine, Division of Biostatistics, Department of Public Health Sciences, 2450 48th Street, Suite 1600, Sacramento, CA 95817, USA.
³ University of California, Davis Health, Department of Pediatrics, 2561 Stockton Blvd, Sacramento, CA 95817, USA.
⁴ University of California, Berkeley, School of Public Health, Division of Health Policy and Management, 2121 Berkeley Way #5427, Berkeley, CA 94704, USA.
⁵ University of California, Davis School of Medicine, Division of Hematology and Oncology, 2540 48th Street, Suite 1600, Sacramento, CA 95817, USA.

PMID: 34023133
PMCID: PMC12124373
DOI: 10.1016/j.vaccine.2021.04.055

Patient and clinician factors associated with uptake of the human papillomavirus (HPV) vaccine among adolescent patients of a primary care network

Julie H T Dang et al. Vaccine. 2021.

. 2021 Jun 11;39(26):3528-3535.

doi: 10.1016/j.vaccine.2021.04.055. Epub 2021 May 19.

Authors

Julie H T Dang¹, Susan L Stewart², Dean A Blumberg³, Hector P Rodriguez⁴, Moon S Chen Jr⁵

Affiliations

¹ University of California, Davis School of Medicine, Division of Health Policy and Management, Department of Public Health Sciences, 4501 X Street, Suite 3003, Sacramento, CA 95817, USA. Electronic address: jtdang@ucdavis.edu.
² University of California, Davis School of Medicine, Division of Biostatistics, Department of Public Health Sciences, 2450 48th Street, Suite 1600, Sacramento, CA 95817, USA.
³ University of California, Davis Health, Department of Pediatrics, 2561 Stockton Blvd, Sacramento, CA 95817, USA.
⁴ University of California, Berkeley, School of Public Health, Division of Health Policy and Management, 2121 Berkeley Way #5427, Berkeley, CA 94704, USA.
⁵ University of California, Davis School of Medicine, Division of Hematology and Oncology, 2540 48th Street, Suite 1600, Sacramento, CA 95817, USA.

PMID: 34023133
PMCID: PMC12124373
DOI: 10.1016/j.vaccine.2021.04.055

Abstract

Background: Human papillomavirus (HPV) vaccination rates for adolescents remain relatively low. The purpose of this study is to examine patient and clinician factors associated with HPV vaccination among patients, ages 11-17, of a large community-based primary care network.

Methods: Electronic health records and administrative data from a large primary care network from January 2017 - June 2018 for patients ages 11-17 (n = 10,682) and the 198 primary care clinicians that saw them were analyzed. Mixed effects logistic regression models examined the association of patient and clinician factors with HPV vaccine uptake.

Results: Most patients (63.0%) had at least one dose of the HPV vaccine, and 37.7% were up to date. In adjusted analyses, patients who received the tetanus, diphtheria, and pertussis (Tdap) vaccine (OR = 2.8, 95% CI: 2.1-3.9) compared to those who did not receive the vaccine and patients with five or more medical visits (OR = 1.9, 95% CI: 1.6-2.2) had the greatest odds of being up to date with the HPV vaccine series. Compared to White patients, African American/Black (OR = 0.8, 95% CI: 0.6 - 1.0) and Alaskan Native/American Indian (OR = 0.5, 95% CI: 0.3-0.9) patients were less likely to be up to date. Boys were also less likely to be up to date with the HPV vaccine series compared to girls (OR = 0.7, 95% CI: 0.7-0.8). Additionally, patients with family/general practice primary care clinicians were less likely to have their patients up to date than those with pediatricians (OR = 0.8, 95% CI: 0.6 - 1.0).

Conclusion: HPV vaccine uptake varied by patient characteristics, heath care utilization and primary care clinician specialty. These findings may inform future evidence-based interventions aimed at increasing HPV vaccine uptake among adolescents by targeting patient sub-groups and reducing missed opportunities for vaccination.

Keywords: Adolescent; Clinician; Human Papillomavirus; Primary Care; Vaccine Uptake.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

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Patient and clinician factors associated with uptake of the human papillomavirus (HPV) vaccine among adolescent patients of a primary care network

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Patient and clinician factors associated with uptake of the human papillomavirus (HPV) vaccine among adolescent patients of a primary care network

Authors

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Conflict of interest statement

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