Abstract PR-11: HPV vaccine adherence in urban youth

Abstract

Background: Human papillomavirus (HPV) is the most common sexually transmitted disease among adolescent females in the United States, with 29.5% of sexually active 14-19 year olds infected at any given time. Persistent infection with cancer causing types of HPV is also a necessary step in the cervical cancer carcinogenesis process. HPV vaccines have been licensed in the United States since 2006; however, relatively modest proportions of the vaccine-eligible population have elected to receive the HPV vaccine. Further, among those who initiate HPV vaccination, a majority fail to complete the three-dose regimen needed for maximum protection.

Methods: Data from the clinical data repository at the University of Maryland Medical Center was queried to identify women that initiated HPV vaccination between August 2006 (when UMMC began offering the HPV vaccine) and August 2010. Statistical analyses were conducted to assess vaccine adherence in the study population. The association of age and race with vaccination adherence was also assessed.

Results: During the time period of interest, 9,658 women potentially eligible women between 9-26 years were seen at the UMMC outpatient practices. Of those, 2,641 women (27.3% of the target group) initiated HPV vaccination. African-American women comprised 2/3 of those who initiated vaccination. Among those women that initiated vaccination, 39.1% completed a single dose, 30.1% completed 2 doses, and 30.78 completed the recommended 3-dose regimen. Age was related to vaccine adherence, with women 18 and older being least likely to complete more than a single dose (p=0.001). African-American women were less likely than Caucasian women to complete the three-dose regimen (p<0.001).

Conclusions: Despite strong efficacy data for the HPV vaccines, relatively small proportions of eligible women have elected to uptake the vaccine as primary prevention for cervical cancer. Further, of those who initiate vaccination, significant proportions fail to complete the recommended three-dose regimen. Young adult women are the least likely to complete the three-dose regimen as are women in minority groups. The public health consequence of this is that significant numbers of women remain unprotected or underprotected. Evidence-based interventions are needed to foster both vaccine uptake and adherence for optimal prevention cervical cancer. Interventions that address barriers for minority women and young adult women are needed. Technological innovations such as text messaging may offer an effective method to address these issues.

This talk is also presented as Poster B103.

Citation Information: Cancer Prev Res 2010;3(12 Suppl):PR-11.