Well-child visits (WV) provide the best opportunities for vaccinations in the US. The Advisory Committee on Immunization Practices (ACIP) recommends vaccination of 11-12 year old females and males with HPV (Human Papillomavirus) vaccine. This study aims to estimate the % of preteenagers aged 11-12 years who had WV and the % received the first dose of HPV vaccine (HPV1) from 2007 to 2015 and to estimate, for those preteenagers who did not receive HPV1, the % of them had a WV in the future.
This was a retrospective database (MarketScan®) cohort study. Eligible subjects were 11-12 year old females and males who had continuous enrollment since January 1, 2007 or January 1 of the year they turned 9 years old and did not have HPV vaccine previously. Females were excluded if they had a medical claim related to pregnancy, delivery, cervical cancer, or hysterectomy. Percentages of WV and HPV1, overall and during WV, were estimated.
There were a total of 1,922,372 eligible subjects; 58.8% 11 years old vs. 41.2% 12 years old and 78.2% females vs. 21.8% males. From 2007-2015, 51.3% of 11 year olds and 53.4% of 12 year olds had WV; 9.8% of 11 year olds and 14.0% of 12 year olds initiated HPV1. Among those who initiated HPV1, approximately 53% were during WV for both 11 and 12 year olds. For those who did not receive HPV1 at 11-12 years old, less likely they would have a WV in the future, ranging from 36.6% at 12-13 years old to 5.2% at 19-20 years old.
This analysis suggests that WV at 11-12 years of age provide the best opportunity to maximize the potential of the HPV vaccination program in the US.