Missed Opportunities for Human Papillomavirus Vaccination at Office Visits During Which Influenza Vaccine Was Administered: An AAP Pediatric Research in Office Settings (PROS) National Primary Care Research Network Study

Introduction Little is known about missed opportunities (MOs) for HPV vaccination during primary care visits at which influenza vaccination is delivered. Methods We extracted electronic health records for HPV vaccine-eligible 11-to-17-year-olds. We assessed the proportion of visits during which an influenza vaccine was given and an HPV vaccine was due, but not given (i.e., MOs). Results Of 56,135 eligible visits, 57.5% represented MOs for HPV vaccination. MOs were more common at visits where an initial versus subsequent HPV vaccine dose was due (68.6% vs. 31.3%) and for acute/chronic and nurse-only visits compared to preventive visits (74.0% and 80.2% vs. 36.7%). In a multivariable model, MOs were more likely for the initial HPV dose and for non-preventive visits, but did not vary by patient sex/age. Conclusions HPV vaccine MOs were common during visits where influenza vaccine was administered. Increasing simultaneous administration of HPV and influenza vaccines could increase HPV vaccine coverage.