OBJECTIVES: Human papillomavirus (HPV) is estimated to cost $8 billion annually in the US, due to the treatment of cancers and other procedures attributable to HPV infection. The HPV vaccine may prevent infection if administered before initial exposure to the virus. HPV vaccination rates are currently based on results from nationally representative surveys. Large electronic health records (EHR) databases may be an alternative way to examine vaccination rates. We aim to evaluate whether vaccination records from our EHR database could be used to measure vaccination rates. To our knowledge, this is the first study examining initiation and completion rates for the HPV vaccine and patient demographics using EHR data.

METHODS: We used Optum’s EHR data from 2012-2017 to examine initiation and completion of the HPV vaccination series. We assessed vaccination initiation rates in each year for males and females separately, and by race/ethnicity and age. Among individuals who initiated at least one dose, we examined the percentage of individuals completing the vaccination series. Our final sample consisted of a nationally-representative sample of U.S. adolescents aged 9-26 (n= 1,922,298).

RESULTS: From 2012-2017, HPV initiation rates increased from 23.8% to 32.9% among individuals with at least one office visit during the year. The largest increases in vaccination initiation rates occurred amongst Asians (relative to African Americans, Caucasians and other/unknown), and males. Completion rates for those that received at least one vaccination dose was 62.7% but completion rates were lower for African Americans and males.

CONCLUSIONS : Our study uses a unique dataset to document how vaccination rates differ among patient populations. We find that the initiation rates of HPV are rising, but rates of vaccinations in our EHR data are lower than those reported by national surveys. More research is needed to evaluate the validity of using EHR data to examine HPV.