Charts were reviewed until November 26, 2008, for a minimum 17 months of follow-up. Completion was defined as receipt of 3 HPV vaccinations. Charts were reviewed for age, race/ethnicity, type of insurance (private vs Medicaid/Child Health Insurance Program [CHIP]), and distance from home to the clinic. Sexual history variables included sexual activity status prior to initiation of the series and history within 3 years of vaccine initiation of a gynecological exam and/or Papanicolaou (Pap) test, HPV DNA test, or sexually transmitted infection. The reason for each visit was classified as nonsick visit (well child, well woman, contraception), sick visit, or vaccine only. If the patient did not complete the series, the chart was reviewed to determine if the patient had any clinic visits after she was due for her next shot.Statistical analyses were performed using SPSS, version 12.0, with an α level of <.05 determining statistical significance. Missing data did not exceed 2% for any of the predictor variables with the exception of sexual activity status for which 27% were missing. Only Caucasian, African American, or Hispanic patients were included in analyses assessing race/ ethnicity, as these 3 groups comprised >98% of the sample. Bivariate relationships between patient characteristics and vaccine series completion were conducted. Variables that were significant were entered into a logistic regression analysis using backward stepwise elimination.
ResultsA total of 352 charts met criteria for inclusion. A total of 193 (54.8%) patients received their vaccinations at an on-campus university-based pediatric T he Advisory Committee for Immunization Practices has recommended routine human papillomavirus (HPV) vaccination of 11 to 12-year-old girls and catch-up for females 13 to 26 years of age. 1 The 3 doses are administered at 0, 2 months (minimum 4 weeks), and 6 months (minimum 12 weeks after the second dose). 1 Low socioeconomic status, a primary language other than English, being an ethnic minority, not having health insurance, and not having consistent transportation were associated with poor hepatitis B virus vaccine completion in adolescents. [2][3][4] In contrast, completion rates increase when providers take advantage of opportunities for vaccination (eg, sick visits) and have reminder systems. 5 The purpose of this study was to describe the completion rates and timeliness of HPV vaccine receipt in university-associated practices. We also evaluated whether patient demographics and reasons for the clinic visit were associated with completion and if the reason for the visit was associated with timeliness.
MethodsFollowing institutional review board approval, eligible medical charts were identified by using CPT code 90649. Criteria for inclusion in the study were female patient, age 21 years old or younger,