Teens Aren’t Completing HPV Vaccine Series — Research Tells Us Why

It’s the most common sexually transmitted infection. It’s diagnosed in about 14 million people annually in the United States. It can lead to cancers of the cervix, mouth, and throat. To most providers, reasons to vaccinate for the Human Papilloma Virus (HPV) might appear evident. However, according to a story in the April issue of Contraceptive Technology Update” only 40% of females and 22% of males received the complete series of three doses over six months. Now we know why.

Sixty-five percent of the parents whose daughters didn’t finish the series thought the doctor’s office would schedule the follow-up vaccinations, according to research from Boston Medical Center. The no. two reason cited by parents was inconvenience, such as a long commute to the clinic. Providers blamed the failure on the fact that they didn’t have reminder systems. The study was published online in Human Vaccines and Immunotherapeutics.

"What we've learned is that there is a great opportunity to close the non-completion gap by improving education and dialogue between providers and parents about scheduling future visits to finish the three-dose vaccination series," said Rebecca Perkins, MD, MSc, an obstetrician at Boston Medical Center and lead author of the study.

The HPV vaccine is supposed to be given routinely to females and males at age 11 or 12. Vaccination is recommended up to age 26 for men who have sex with men, as well as for immunocompromised males. When patients haven’t completed the three-dose series, vaccination is recommended for females ages 13-26 and males ages 13-21. The vaccination rates for HPV lag behind the other vaccines given routinely to adolescents, “Contraceptive Technology Update” reported. In 2014, only 60% of females and 42% of males received one dose of an HPV vaccine series. When you look at the numbers for those who completed the three-dose series, they are worse: Only 40% of females and 22% of males.

The researchers suggest ways to increase completion of the vaccination series:

• Schedule follow-up appointments as the child receives the first dose.
• Implement reminder and recall systems in clinics, such as phone calls, educational brochures, and text messages.
• Have patients receive reminders directly from state immunization registries, which are independent from individual medical practices.
• Offer vaccines at alternative sites that are more convenient for parents, such as schools and pharmacies.

Another suggestion, mentioned in our Contraceptive Technology Update article, is to obtain CDC resources. The resources include how to answer questions from parents and how to link information from the CDC to your practice’s web site. (Look for coverage of the Boston research in the upcoming issue of STI Quarterly, the free supplement in Contraceptive Technology Update.)