Association of Provider Recommendation and Human Papillomavirus Vaccination Initiation among Male Adolescents Aged 13-17 Years—United States

Published:November 15, 2018DOI:https://doi.org/10.1016/j.jpeds.2018.10.034

      Objective

      To assess human papillomavirus (HPV) vaccination coverage among adolescents by provider recommendation status.

      Study design

      The 2011-2016 National Immunization Survey-Teen data were used to assess HPV vaccination coverage among male adolescents by provider recommendation status. Multivariable logistic analyses were conducted to evaluate associations between HPV vaccination and provider recommendation status.

      Results

      HPV vaccination coverage among male adolescents increased from 8.3% in 2011 to 57.3% in 2016. Likewise, the prevalence of provider recommendation increased from 14.2% in 2011 to 65.5% in 2016. In 2016, HPV coverage was higher in male adolescents with a provider recommendation than in those without a provider recommendation (68.8% vs 35.4%). In multivariable logistic regression, characteristics independently associated with a higher likelihood of HPV vaccination included receipt of a provider recommendation, age 16-17 years, black or Hispanic race/ethnicity, any Medicaid insurance, ≥2 physician contacts in the previous 12 months, and urban or suburban residence. Participants with a mother with some college or a college degree, those with a mother aged 35-44 years, and those who did not have a well-child visit at age 11-12 years had a lower likelihood of HPV vaccination.

      Conclusions

      Receiving a provider recommendation for vaccination was significantly associated with receipt of HPV vaccine among male adolescents, indicating that a provider recommendation for vaccination is an important approach to increase vaccination coverage. Evidence-based strategies, such as standing orders and provider reminders, alone or in combination with health system interventions, are useful for increasing provider recommendations and HPV vaccination coverage among male adolescents.

      Keywords

      Abbreviations:

      4vHPV ( Quadrivalent human papillomavirus vaccine), ACIP ( Advisory Committee on Immunization Practices), HPV ( Human papillomavirus), MSA ( Metropolitan statistical area), NIS-Teen ( National Immunization Survey-Teen)
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