title: HPV vaccine completion and dose adherence among commercially insured females aged 9 through 26 years in the US.
abstract: Although HPV vaccination has been recommended for use in girls and young women since 2007, HPV vaccine uptake is low in the US.
  
  
  
  We conducted a retrospective cohort study using the 2008-2011 MarketScan data to examine HPV vaccine completion and dose adherence among commercially insured females aged 9-26 years. We performed multivariable logistic regression models to examine factors related to HPV vaccine completion and HPV vaccine dose adherence.
  
  
  
  Among 378,484 females aged 9-26 years who initiated HPV vaccination, only 29.4% completed HPV vaccination. Compared with females receiving vaccines from primary care providers, those receiving vaccines from OB/GYN providers were more likely to complete the vaccine series. Age at HPV vaccine initiation, health insurance plan, seasonal pattern, and flu vaccination were also significantly associated with vaccine completion. Among 111,286 females who completed HPV vaccination, 62.4% received all doses within 30 days of the recommended schedules. Similar factors relating to HPV vaccine completion were consistently associated with HPV vaccine dose adherence. However, younger age (<22 years) and receipt of flu vaccine were negatively related to HPV vaccine dose adherence.
  
  
  
  Intervention programs to improve HPV vaccine reminding system and reduce logistic barriers for both physicians and patients are warranted.
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Guodong
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Lan
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania ; Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Ping
authors.initials: P
authors.lastname: Du
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D019458:Insurance Coverage; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012044:Regression Analysis; D012189:Retrospective Studies; D014611:Vaccination; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Commercially insured females; HPV vaccine completion; HPV vaccine dose adherence