Receipt of human papillomavirus vaccine among privately insured adult women in a US Midwestern Health Maintenance Organization
PREVENTIVE MEDICINE
Authors: Kharbanda, Elyse Olshen; Parker, Emily; Nordin, James D.; Hedblom, Brita; Rolnick, Sharon J.
Abstract
Objectives. To describe human papillomavirus (HPV) vaccine coverage among adult privately insured women including variation in coverage by race/ethnicity. Methods. This cross-sectional, observational study included women 18-26 years of age with continuous enrollment in a U.S. Midwestern health insurance plan and at least one visit to a plan affiliated practice. Vaccination data came from insurance claims and the electronic medical record. Primary outcomes were: receipt of at least 1 HPV vaccine (HPV1) and completion of the 3-dose HPV vaccine series (HPV3). Coverage was described for the entire cohort and stratified by race/ethnicity. For a subset of women, automated data was compared to personal recall. Results. As of June 2010, among 2546 privately insured women 18-26 years, 72.7% had received their first HPV vaccine and 57.9% completed the 3-dose series. Compared to white women, African American and Asian women had significantly lower coverage for HPV1 and HPV3. There was 94.5% (95% CI: 88.5-100%) agreement between personal recall and claims/EMR for receiving HPV1. Conclusions. In this cohort of privately insured women, a majority received HPV1 and more than half completed the 3-dose vaccine series. Marked disparities in receipt of HPV vaccine by race/ethnicity were observed. (C) 2013 Elsevier Inc. All rights reserved.
Text message reminders to promote human papillomavirus vaccination
VACCINE
Authors: Kharbanda, Elyse Olshen; Stockwell, Melissa S.; Fox, Harrison W.; Andres, Raquel; Lara, Marcos; Rickert, Vaughn I.
Abstract
Objective: To implement and evaluate text message reminders for the second (HPV2) and third (HPV3) vaccine doses. Design: Site-based intervention. Setting: Nine pediatric sites (5 academic and 4 private) located in New York City. Participants: Parents of adolescents 9-20 years who received HPV1 or HPV2 during the intervention period. January-June 2009. Intervention: Parents who enrolled received up to three weekly text message reminders that their daughter was due for her next vaccine dose. Outcome measure: On-time receipt of the next vaccine dose, within one month of its due date. Results: During the intervention period, of 765 eligible HPV vaccine events, 434 enrollment instructions were distributed to parents (56.7% of doses). Parents of 124 adolescent girls (28.6% of those handed instructions) activated text message reminders. Comparing children of parents who enrolled versus those who did not, on-time receipt of next HPV vaccine dose occurred among 51.6% (95% CI 42.8-60.4%) versus 35.0% (95% CI 29.6-40.2%) of adolescents (p = .001). Similarly, among a historical cohort of adolescents, receiving HPV1 or HPV2 in the six months prior to the intervention period, on-time receipt of next vaccine dose was noted for 38.1% (95% CI 35.2-41.0%) (p = .003). Increases in receipt of next vaccine dose among intervention subjects were sustained at 4 months following the vaccine due date. Using a logistic regression model, after controlling for insurance and site of care, intervention subjects were significantly more likely than either control population to receive their next HPV vaccine dose on-time. Conclusion: Among those choosing to enroll, text message reminders were an effective intervention to increase on-time receipt of HPV2 or HPV3. (C) 2011 Elsevier Ltd. All rights reserved.