Predictors of three dose on-time compliance with HPV4 vaccination in a disadvantaged, underserved, safety net population in the US Midwest.
BACKGROUND
HPV4 is approved as a series of three timed doses expected to result in efficacy against specific HPV infections. Completion rates in the US are quite low at the same time the structure of health care delivery is changing. The aim of this study was to determine how the patient-, clinic- and systems-level characteristics facilitate or hinder the timely completion of three HPV4 doses in both adolescent and adult female populations in a high-risk safety net population.


METHODS
This is a retrospective study in which patient-, clinic- and systems-level data are abstracted from the electronic medical record (EMR) for all females 10-26 years of age receiving at least one dose of HPV4 between July 1, 2006 and October 1, 2009.


RESULTS
Adults were more likely to complete the three dose series if they had at least one health care visit in addition to their HPV4 visit, (aOR = 1.54 (95% CI:1.10, 2.15). Adults were less likely to complete the three dose series if they received their second HPV4 dose at an acute health care, preventive care or postpartum visits compared to an HPV4-only visit (aOR = 0.31 (95% CI: 0.13, 0.72), 0.12 (0.04, 0.35), 0.30 (0.14, 0.62), respectively). Hispanic adults were less likely than whites to complete the series (aOR = 0.24 (95% CI:0.10, 0.59). 39% of adolescents who completed two doses completed the series.


CONCLUSIONS
HPV4 is more likely to be effectively administered to adults in a safety net population if multiple health care needs can be met within the health care system.
Radboud University, Nijmegen, The Netherlands.
Inge
I
Verdenius
Diane M
DM
Harper
George D
GD
Harris
R Stephen
RS
Griffith
Jeffrey
J
Wall
Laura K
LK
Hempstead
Gerard J
GJ
Malnar
Ruud L M
RL
Bekkers
D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification; D002648:Child; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000627:therapeutic use; D010349:Patient Compliance; D012189:Retrospective Studies; D014481:United States; D035862:Vulnerable Populations; D055815:Young Adult
D053918:Papillomavirus Vaccines