County-level correlates of missed opportunities for HPV vaccination in Indiana: An environmental scan |
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| Affiliation: | 1. Division of Hematology and Oncology, Department of Pediatrics, Washington University, School of Medicine, St. Louis, Missouri;2. Department of Pediatrics and Communicable Diseases, Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan;3. Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri;4. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;5. Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;1. Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois;2. Simons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois;3. Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida |
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| Abstract: | BackgroundThe goal of this study was to examine variability across the 92 Indiana counties in missed opportunities for HPV vaccination and to assess county-level correlates of missed opportunities.MethodsThe Indiana immunization registry provided county level data on 2017 missed opportunity rates for adolescents ages 11–18. A missed opportunity was an encounter when a patient eligible for HPV vaccination received one or more other recommended vaccines, but not HPV. Potential county-level correlates of missed opportunities included race, income, population density, education, primary care providers per capita, smoking rates, mammography screening, diabetes monitoring, and Pap testing.ResultsThe missed opportunity rate ranged from 31% to 85% across Indiana counties. Higher population density, mammography screening, income inequality, and diabetes monitoring were associated with fewer missed opportunities.ConclusionsWe found wide variability in missed opportunities across counties, which were associated with population density and county-level participation in other health-related behaviors.Sources of supportThis study was supported by the National Cancer Institute under Award Number P30 CA082709-18S4. |
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| Keywords: | Vaccination HPV vaccination Health status Adolescence Immunization surveillance |
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