Low Uptake of Human Papillomavirus Vaccine Among Postpartum Women 2006–2012

摘要

>Background: Young adult women find it acceptable to be offered the human papillomavirus (HPV) vaccine postpartum. Little is known about the practice of administering the HPV vaccine during the postpartum period.>Materials and Methods: The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to develop a cohort of privately insured 18 to 26–year-old women with uncomplicated live-born pregnancies. Eligibility required no previous doses of HPV vaccine before delivery and continuous insurance enrollment from June 2006 through 1 year postpartum. Descriptive statistics were performed.>Results: A total of 51,913 women meet age and enrollment criteria, with 3912 (7.5%) having received any doses of vaccine before their delivery, leaving 48,001 women in this cohort. In the year postpartum, 861 women (1.8%) received any HPV vaccine. Of the women initiating the vaccine, only 337 (39%) completed the three-vaccine series. Women who received the vaccine, compared with women who did not, were younger (21 vs. 23 years old), more often the dependent to the insurance beneficiary (56% vs. 30%), and were more likely to have had an abnormal pap smear in the year prior (19.6% vs. 9.1%) or postdelivery (16.4% vs. 4.9). More women completed the HPV vaccine series when initiated within 2 months postpartum compared with women initiating the vaccine series >2 months postpartum (44% vs. 38%).>Conclusions: Postpartum women are eligible for the HPV vaccine, yet very few are receiving it. The postpartum period is a missed opportunity for administration of this cancer-preventing vaccine.