Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 9:11:100192.
doi: 10.1016/j.jvacx.2022.100192. eCollection 2022 Aug.

Factors contributing to missed opportunities for human papillomavirus vaccination among adolescents, ages 11 to 13, in Iowa

Affiliations

Factors contributing to missed opportunities for human papillomavirus vaccination among adolescents, ages 11 to 13, in Iowa

Grace W Ryan et al. Vaccine X. .

Abstract

Introduction: Rates of human papillomavirus (HPV) vaccination remain low and missed opportunities for HPV vaccination are widespread. Researchers have identified factors related to HPV vaccination, but less is known about missed opportunities.

Methods: We used medical claims data from a large Midwestern insurance provider to explore relationships between adolescent and provider characteristics and missed opportunities for HPV vaccination. We stratified models by initiation status with adolescents who had received one or more HPV vaccinations in one group (n = 6,123) and adolescents with no record of an HPV vaccination in the other (n = 8,107).

Results: There were significant differences in comparisons of all variables between initiators and non-initiators. Notably, non-initiators had lower rates of vaccination for HPV and other adolescent vaccinations, and fewer well-child visits. For all adolescents, birth year, having other recommended vaccines, and number of well-child visits were significantly associated with missed opportunities. Additionally, among initiators, pediatrician as a primary care provider and being in a rural area were significantly associated.

Discussion: Overall, adolescents with greater healthcare utilization had more missed opportunities, indicating that, despite increased numbers of visits, providers are not taking advantage of these opportunities to vaccinate. Future research should prioritize developing a deeper understanding of why these missed opportunities are occurring and implementing new and existing strategies to prevent them. Reducing missed opportunities will help to prevent future HPV-related cancers and the significant morbidity and mortality that they can cause.

Keywords: ACIP, Advisory Committee on Immunization Pratices; Adolescent health; EHR, Electronic Health Record; HPV vaccination; HPV, Human Papillomavirus; MO, Missed Opportunity; MSA, Metropolitan Statistical Area; Medical claims data; PCP, Primary Care Provider.

PubMed Disclaimer

Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
Inclusion and exclusion criteria to create sample.

References

    1. Arbyn M., Xu L. Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials. Expert Rev Vaccines. 2018;17(12):1085–1091. - PubMed
    1. Giuliano A.R., Palefsky J.M., Goldstone S., Moreira E.D., Penny M.E., Aranda C., et al. Efficacy of quadrivalent HPV vaccine against HPV infection and disease in males. N Engl J Med. 2011;364(5):401–411. - PMC - PubMed
    1. Villa A., Patton L.L., Giuliano A.R., Estrich C.G., Pahlke S.C., O’Brien K.K., et al. Summary of the evidence on the safety, efficacy, and effectiveness of human papillomavirus vaccines. J Am Dent Assoc. 2020;151(4):245–254.e24. - PubMed
    1. Pingali C., Yankey D., Elam-Evans L.D., Markowitz L.E., Williams C.L., Fredua B., et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years — United States, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(35):1183–1190. - PMC - PubMed
    1. Loskutova N., Smail C., Webster B., Ajayi K., Wood J., Carroll J. Missed opportunities for improving practice performance in adult immunizations: A meta-narrative review of the literature. BMC Fam Pract. 2017;18(1):108. - PMC - PubMed

LinkOut - more resources