The impact of provider recommendation on human papillomavirus vaccine and other adolescent vaccines

ABSTRACT

This study explored the association between provider recommendation and adolescent vaccine coverage. We analyzed data from the 2008 to 2018 National Immunization Survey-Teen including coverage with one dose of quadrivalent meningococcal conjugate vaccine (MenACWY), Tetanus-diphtheria-acellular pertussis vaccine (Tdap), and one and three doses of Human papillomavirus (HPV) vaccine. We compared vaccine coverage between those who recalled a provider recommendation and those who did not. Among those who received a provider recommendation for MenACWY, coverage trended from 67.8% (2008) to 88.1% (2013), contrasted to those who did not, trending from 30.9% to 73.1%. Among those with a provider recommendation for Tdap, coverage trended from 47.6% to 89.7%, contrasted to those who did not, trending from 35.6% to 82.2%. Among females with a provider recommendation for HPV vaccine, receipt of initial dose of HPV vaccine trended from 57.5% (2008) to 74.3% (2018), contrasted to those who did not, trending from 18.1% to 49.8%, and among males, trended from 17.2% (2010) to 75.1% (2018) for those with a provider recommendation, compared to 0.5% to 44.7% for those without. In 2013, coverage difference by provider recommendation was 26.0% among females for one dose of HPV vaccine and 21.9% for three doses, and among males was 44.8% and 20.8%, respectively, while it was lower at 15% for MenACWY and 7.6% for Tdap. For each vaccine, coverage was higher with a provider recommendation; the largest difference was noted for HPV vaccine. This finding verifies for providers the importance of their recommendation, especially for the HPV vaccine.

KEYWORDS:

• Provider recommendation
• vaccine coverage
• adolescents

Acknowledgments

Research reported in this publication was supported by the National Institutes of Health under Award Numbers UG1OD024950, U54GM104938, and Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number D55HP23210. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsoring agency was not involved in study design, collection, analysis or interpretation of data, in the writing of the report or in the decision to submit this manuscript for publication.

Disclosure of Potential Conflicts of Interest

Alexandria C. Caldwell has no financial disclosures. Christi A. Madden has no financial disclosures. David M. Thompson has no financial disclosures. Michael C. Garbe has no financial disclosures. James R. Roberts has no financial disclosures. Robert M. Jacobson serves on external safety review committees for two post-licensure safety studies of HPV vaccine both funded by Merck & Co. and on an external data monitoring committee for a series of pre-licensure trials of a pneumococcal vaccine also funded by Merck & Co. Paul M. Darden has no financial disclosures.

Supplementary materials

Supplemental data for this article can be accessed online at http://dx.doi.org/10.1080/21645515.2020.1817713.

CASRO Response Rate

“The NIS-Teen CASRO response rate equals the product of the resolution rate (83.5%, Row E), the screening completion rate (86.1%, Row G), and the interview completion rate among eligible households (71.1%, Row I). The resolution rate is the percentage of the total telephone numbers selected that are classifiable as non-working, nonresidential, or residential. The screening completion rate is the percentage of known households that are successfully screened for the presence of age-eligible teens. The interview completion rate is the percentage of households with one or more age-eligible teen that complete the household interview.”

-Data User’s Guide for the 2013 NIS-Teen Public-Use Data File p.10

Additional information

Funding

This work was supported by the National Institutes of Health [UG1OD024950, U54GM104938]; HRSA [D55HP23210].