ASPO Abstracts
Predictors of HPV Vaccine Follow-Through among Privately Insured Patients
Category: Behavioral Science & Health Communication, Pre-Malignant Conditions
Conference Year: 2018
Abstract Body:
Objective: We sought to assess predictors of timely HPV vaccine follow-through among privately insured individuals initiating the 3-dose vaccine series. Methods: We examined claims data for 1,332,217 privately insured US individuals ages 9-26 who initiated the HPV vaccine series from 2006-2015. The main study outcome was receipt of the third HPV dose within twelve months of the first dose, compared by year of initiation. We also examined alternative definitions of follow-through, including receipt of two doses within twelve months and receipt of three doses within eighteen months. Using multivariate analysis, we assessed the relationship between HPV vaccine follow-through and age at initiation, region of residence, insurance plan type, initiating provider type, and receipt of flu vaccine. Results: HPV vaccine follow-through showed a dramatic drop over time among females (from 67% in 2006 to 38% in 2015, p<.001) and a small drop for males (from 36% in 2011 to 33% in 2014, p<.001). Similar patterns emerged in analyses that controlled for patient characteristics or used alternative definitions of follow-through. Females receiving their first dose from an OB/GYN were more likely to complete the vaccine series than those receiving a first dose from a pediatrician (55% vs. 44%, p<.001). For both males and females, receipt of a flu vaccine in the prior year predicted timely vaccine follow-through (males: 46% vs. 32%; females: 53% vs 44%, p<.001). Conclusions: Low rates of HPV vaccine initiation and follow-through have left a generation of young people unnecessarily at risk for cancer, precancer and other HPV-related sequelae. While HPV vaccine initiation is increasing, follow-through rates are low and are declining. Vaccine programs should emphasize the importance of timely vaccine follow- through and should target a wide range of providers.
Keywords: hpv vaccine, private insurance, claims