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5A2 Adolescents Attending New York City Sexually Transmitted Disease Clinics Have Missed Opportunities for Receiving HPV Vaccine with Primary Care, and Other Providers

Friday, September 23, 2016: 8:15 AM
Salon C
Kelly Jamison, MPH, Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, NY, Preeti Pathela, DrPH, MPH, Bureau of Sexually Transmitted Disease Control, New York City Department of Health & Mental Hygiene, Long Island City, NY, Vikki Papadouka, PhD, MPH, Bureau of Immunization, NYC Department of Health and Mental Hygiene, Long Island City, NY, Lauri Markowitz, MD, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA and Julie Schillinger, MD, MSc, Bureau of Sexually Transmitted Disease Control, NYC Department of Health & Mental Hygiene, Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Long Island City, NY

     

Background: Human papillomavirus (HPV) vaccine is recommended routinely for all adolescents (females since 2006; males since 2011). STD clinic populations are at higher risk of HPV infection and could benefit from HPV vaccination. We calculated missed opportunities for vaccination throughout New York City (NYC) among STD clinic attendees.

Methods: We matched medical record data for adolescents attending NYC STD clinics during 2010-2013 against the Citywide Immunization Registry (CIR), which contains all immunization records for NYC residents aged ≤18 years. Analysis was limited to patients who had ≥1 immunization event in CIR between 1/1/2008-12/31/2013 (females) and 1/1/2012-12/31/2013 (males) at which time patients were 11-18 years old and eligible for HPV vaccine. We used logistic models to examine associations between a missed opportunity, defined as occasions when patients received another vaccine in any healthcare setting and were eligible for, but did not receive HPV vaccine, and race/ethnicity, census-tract poverty, number of sex partners, and history of STD.

Results: Overall, 57.0% (4,321/7,586) of females and 48.6% (461/948) of males had ≥1 missed opportunity. Missed opportunities did not differ by race or poverty-level among males, but non-Hispanic (NH) females were significantly more likely to have a missed opportunity compared with Hispanics (NH-Black: OR=1.5, 95% CI: 1.4-1.7; NH-White: OR=1.6, 95% CI: 1.3-1.9; NH-Other: OR=1.9, 95% CI: 1.4-2.6), and females living in lower-poverty census tracts were more likely to have missed opportunities (versus very-high-poverty, high-poverty: OR=1.3, 95% CI: 1.2-1.5; medium-poverty: OR=1.4, 95% CI: 1.2-1.5; low-poverty: OR=1.6, 95% CI: 1.4-1.9). Numbers of sex partners and STD history were not associated with ≥1 missed opportunity.

Conclusions: Adolescents attending STD clinics had evidence of missed opportunities for HPV vaccination. Providing HPV vaccine in STD clinics, along with other efforts to increase the recommendation/administration of HPV vaccine in primary care, could improve citywide HPV vaccination coverage.

See more of: Teenage Wasteland: Helping Providers Get It Right
See more of: Oral and Poster
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