HPV vaccination in community health organizations: what is going right and how can it be replicated?
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PURPOSE: Human papillomavirus (HPV) vaccination is recommended for individuals between 9 and 12 years of age to prevent six different cancers. Lower rates of vaccination exist among underserved populations. We evaluate rates of up-to-date (UTD) HPV vaccination within a nationwide network representing many medically underserved communities. METHODS: This study was conducted using OCHIN, a diverse national database of over 6 million publicly or underinsured patients seen at an OCHIN clinic from January 2015 to December 2023. HPV vaccination initiation and completion rates were the primary outcomes. RESULTS: 1,848,813 patients were included. HPV vaccination rates for all races and ethnic groups were below the Healthy People 2030 goal of 80.0%. Vaccination varied by race/ethnicity, with Hispanic individuals having the highest rates of UTD vaccination. There was no statistically significant difference between male and female genders for HPV vaccination. Odds of successful completion of the vaccine series were highest when series initiation occurred at ages 9-10 and among those with at least two clinical visits per year. CONCLUSIONS: HPV vaccination completion rates remain below the national goal among all ages and racial/ethnic groups in this large, nationwide cohort though all rates increased throughout the study period for most groups. Hispanic race, younger age at initiation, and higher number of clinical visits had increased odds of HPV vaccination. Notably, the gap between males and females closed. Exploration in how these clinics is appealing to the Hispanic population; caregivers of younger children and the male population should be investigated.