Objective: Despite its effectiveness in preventing several cancers, there are marked disparities in HPV vaccination initiation and series completion. The present study sought to understand disparities in HPV vaccinations among patients in northern Virginia (ages 9-26) and the impact of patient and provider gender concordance, in lieu of CDC’s vaccine recommendation changes in 2016, which reduced the recommended doses from three to two, in this population. Design: Analyses of electronic medical records collected from 2012 to 2017. Setting: A large health care system in Northern Virginia. Participants: A total of 37,427 patients, ages 9 to 26, were included in analyses. Main outcome measures: We examined odds of initiating vaccination, completing vaccination at 6 months, completing vaccination at 12 months and clinical completion. We examined if patient and provider characteristics were associated with initiating vaccination and vaccination completion at different durations. Results: Racial minorities had higher odds of getting vaccinated, relative to non-Latino whites. Each additional year between the patient’s first and last visit was associated with higher odds of initiating vaccination, completing vaccination at both 6 and 12 months, and clinical completion. Compared to female patients who were 19 years and older, female patients aged 9-18 years had higher odds of initiating vaccination and clinical completion. Compared to male patients who were 19 years and older, female patients aged 9-18 years had higher odds of clinical completion Female and male patients had better outcomes when seen by female primary care providers than male primary care providers.
Conclusions and Relevance: Further research should investigate the observed benefit of female providers and to understand the long-term impact of changes in CDC recommendations.
Patel, Isha; Benitez, Norma M.; Maxwell, George L.; Camacho, Fabian T.; and Balkrishnan, Rajesh
"HPV Vaccination in the Virginia Context: Demographic Disparities, Patient-Provider Gender Concordance and the Impact of Changing Recommendations,"
Virginia Journal of Public Health: Vol. 5:
2, Article 4.
Available at: https://commons.lib.jmu.edu/vjph/vol5/iss2/4