title: Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?
abstract: We explored whether state laws allowing pharmacists to administer human papillomavirus (HPV) vaccinations to adolescents are associated with a higher likelihood of HPV vaccine uptake.
  
  
  
  We examined provider-reported HPV vaccination among 13-17year olds in the National Immunization Survey-Teen: 2008-2014 for girls (N=48,754) and 2010-2014 for boys (N=31,802). Outcome variables were HPV vaccine initiation (⩾1 dose) and completion (⩾3 doses). The explanatory variable of interest was a categorical variable for the type of pharmacist authority regarding HPV vaccination for adolescents (<18years) in the state: not permitted (reference), by prescription, by collaborative practice protocol, or independent authority. We ran separate difference-in-difference regression models by sex.
  
  
  
  During 2008-2014, 15 states passed laws allowing pharmacists to administer HPV vaccine to adolescents. Pharmacist authority laws were not statistically significantly associated with increased HPV vaccine initiation or completion.
  
  
  
  As currently implemented, state laws allowing pharmacists to administer HPV vaccine to adolescents were not associated with uptake. Possible explanations that need further research include restrictions on pharmacists' third-party billing ability and the lack of promotion of pharmacy vaccination services to age-eligible adolescents.
authors: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall, Campus Box 7411, Chapel Hill, NC 27599-7411, United States. Electronic address: justintrogdon@unc.edu.
authors: Justin G
authors: JG
authors: Trogdon
authors: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall, Campus Box 7411, Chapel Hill, NC 27599-7411, United States. Electronic address: shaferp@live.unc.edu.
authors: Paul R
authors: PR
authors: Shafer
authors: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, Campus Box 7440, Chapel Hill, NC 27599-7440, United States. Electronic address: pdshah@email.unc.edu.
authors: Parth D
authors: PD
authors: Shah
authors: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall, Campus Box 7411, Chapel Hill, NC 27599-7411, United States. Electronic address: wacalo@live.unc.edu.
authors: William A
authors: WA
authors: Calo
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010595:Pharmacists; D014481:United States; D014611:Vaccination / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Difference-in-difference; HPV vaccine; Human papillomavirus; Pharmacist; Pharmacy practice; Vaccination laws