Background: The 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.
Methods: The 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.
Results: The 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.
Conclusions: We 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 support: This study was supported by the National Cancer Institute under Award Number P30 CA082709-18S4.
Keywords: Adolescence; HPV vaccination; Health status; Immunization surveillance; Vaccination.
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