How to Achieve High HPV Vaccination Rates: Study

October 6, 2016

By bundling vaccines, offering them at every visit, and making them standard, an urban health system was able to achieve human papillomavirus (HPV) vaccination rates well above the national average for adolescents. Researchers reported their findings in Pediatrics.

In 2013, approximately 90% of adolescent girls and boys treated at Denver Health received one or more dose of the HPV vaccine, compared with national rates of approximately 57% and 35%, respectively. Denver Health, an integrated urban safety net health system, provides care to more than 17,000 adolescents each year.

Additionally, 66% of girls and 52.5% of boys received 3 or more doses of the HPV vaccine, while nationally only 37.6% of girls and 13.9% of boys received 3 or more doses.

To achieve these rates, Denver Health used a vaccine registry, standing orders for vaccines, bundling of vaccines, and programs at school-based health centers. Offers of vaccines were extended at each visit, including to patients who had previously declined vaccination.

The success of the program also extended to other vaccines. Rates of vaccination for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis were 95.9% in the program versus 86% nationally. Coverage of the meningococcal conjugate vaccine was 93.5% in the program versus 77.8% nationally.

In particular, the program was able to increase the vaccination rates among certain groups. Girls, Hispanic participants, non-English speakers, and adolescents less than 200% below the federal poverty level were more likely to have received 3 doses of HPV.

The study is limited by its focus on an urban population with a mostly low-income population, but the authors believe that certain aspects of the program, such as strongly recommending the HPV vaccine and avoiding missed opportunities for vaccination, are generalizable to other care environments.

—Lauren LeBano


Farmar ALM, Love-Osborne, K, Chichester K, Breslin K, Bronkan K, Hambidge SJ. Achieving high adolescent HPV vaccination coverage. Pediatrics. 2016 October;[Epub ahead of print].