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Interventions improve HPV vaccination coverage at Denver health system

Offering vaccines with every patient visit, standard orders, as well as “bundling” several adolescent vaccines — methods that are commonplace and inexpensive — led to higher vaccination rates at a Colorado-based safety net system, according to research published in Pediatrics. 

“Through low-cost, system-wide standard procedures, Denver Health achieved adolescent vaccination rates well above national coverage rates,” Anna-Lisa M. Farmar, MD, in ambulatory care services at Denver Health, and colleagues wrote. “HPV coverage rates at Denver Health are significantly higher than national rates, especially for boys.”

Denver Health serves more than 17,000 adolescents each year, the researchers wrote. To achieve higher vaccination rates, researchers implemented strategies including vaccine bundling – HPV, Tdap and MCV4 –, offering vaccines at every visit and standard orders. They used data from registry and vaccine utilization statistics to determine vaccination rates of adolescents aged 13 to 17 years between 2004 and 2014, comparing these rates with national and state rates in 2013. To identify vaccination characteristics, researchers used regression analysis.

In 2013 (n = 11,463), HPV coverage of at least one dose was 89.8% in girls 89.3% in boys, compared with national rates of 57.3% and 34.6%, respectively. Coverage of at least three doses was 66% in girls and 52.5% in boys, compared with national rates of 37.6% and 13.9%, respectively. In addition, being a girl, Hispanic, non-English speaker or teenager less than 200% below the federal poverty level increased the likelihood of receiving all three doses of the HPV vaccine. Overall, tetanus, diphtheria and pertussis vaccination coverage was 95.9% compared with 86% nationally, and meningococcal vaccine coverage was 93.5% compared with 77.8% nationally.

“Avoiding missed opportunities for vaccination and providing a strong recommendation for the HPV vaccine were key procedures that likely contributed to high coverage rates,” the researchers wrote. “Providers caring for adolescents may use these approaches to improve vaccination coverage rates in their populations.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.