HPV vaccine timeliness and completion rates, Florida 2007-2011

Background: Yearly 7 million in United States estimated to be infected with human- papillomavirus (HPV). Vaccines have been licensed and recommended for routine vaccination for girls 11-12 years, with catch-up for 13-26. Recent reports indicate decreased incidence of high-grade cervical abnormalities and genital warts in countries that initiated comprehensive HPV vaccination programs. In 2011, CDC reported 70.7% of females completed the series after initiated. Objectives: Determine the percentage of females who initiated and completed on time the series of HPV vaccine and identify factors associated with implications for program and policy change. Methods: Analyzed data from the statewide immunization registry between 01/07/2001 - 12/31/2011 to examine factors associated with timely series completion. Descriptive analysis, multivariate logistic regression and generalized linear models used to adjust for covariates. Results: Overall 52% of girls <18 completed series. Only 23% completed the series with on-time-dosing. The older the age at initiation, the less likely to complete series. Among those who initiated the series between ages 18 – 21 years, 19.7% completed with on-time dosing. Those receiving vaccine as VCFeligible Medicaid were significantly less likely to complete series with ontime dosing, as were African Americans. Girls who received vaccine through private physicians were 1/3 more likely to complete on time than girls who received vaccine from public health departments. Conclusions: On-time completion rates fell below national rates. This has implication for targeted interventions among college age women, and restructuring health system attributes to improve both completion and ontime dosing, especially important before sexual-exposure and college-entry.