Background: Human papillomavirus (HPV) vaccine is recommended routinely for adolescents (females since 2006; males since 2011). As of 12/31/13 in New York City (NYC), 64% of female and 40% of male 13-18 year olds had received >1 HPV vaccine dose. Most women aged <26 attending STD clinics are naïve to >1 HPV vaccine types, suggesting adolescent STD clinic populations could benefit from vaccination. There are no published HPV vaccination coverage estimates for these populations.
Methods: We matched medical records of NYC public STD clinic visitors aged 13-18 during 2010-2013 against the Citywide Immunization Registry (CIR), which contains immunization records for New Yorkers through age 18. We assessed HPV vaccine initiation (>1 dose) and series completion (3 doses among those who initiated) as of STD clinic visit date, by: sex, visit year, race/ethnicity, and census-tract poverty. We compared receipt of >1 HPV dose among clinic attendees in 2013 with receipt of tetanus-diphtheria-acellular pertussis (Tdap) and meningococcal vaccines.
Results: Of 16,364 clinic attendees, 13,505 (82%) matched in CIR; 69% (9,328/13,505) were female. HPV vaccine initiation rates increased during 2010-2013; females: 57.6% to 69.7%, males: 1.5% to 36.3%, (p<.0001). Among females, initiation was lowest among Whites (53.4%) and highest among Hispanics (73.3%); among males, lowest among Whites (6.9%) and highest among Asians (20.9%). Initiation rates increased with increasing poverty. Series completion during 2010-2013 increased (females: 48.6% to 65.4%; males: 8.0% to 32.2%), with no significant variation by race/ethnicity or poverty level. Receipt of >1 HPV dose (59.7%) was low compared with Tdap (82%) and meningococcal (76%) vaccines.
Conclusions: HPV >1 dose coverage was similar to citywide estimates, but low for several demographic groups. Given low series completion and coverage compared with other recommended adolescent vaccines, STD clinics may provide opportunities for vaccine initiation and completion, thereby enhancing citywide efforts to improve HPV vaccination.