BACKGROUND: In Kansas, a single dose of Tdap is required for 7th graders in public and private schools; the three-dose series of human papillomavirus vaccine (HPV) and the first dose of meningococcal conjugate vaccine (MenACWY) are recommended, but not required. According to the 2014 National Immunization Survey for children 13-17 years, Kansas had the lowest coverage for females with at least one HPV dose (38.3%), one dose HPV coverage among males was also low (32.8%), but Tdap coverage was 80%. The Kansas Department of Health and Environment began a collaborative pilot project with all local health departments (LHDs) in 2015 to reduce missed opportunities, increase HPV vaccination coverage, and to help foster LHD collaboration.
METHODS: LHDs submit immunization data to the Kansas immunization information system (KSWebIZ). Each quarter in 2015, data was downloaded from KSWebIZ for adolescent children 11-13 years. Immunization visits were categorized as receiving one dose, two doses, or three doses of recommended vaccines: Tdap, the first dose of HPV, and the first dose of MenACWY. County-level reports were sent to all LHDs quarterly. Conference calls were held to discuss best practices and challenges. Additional analyses were completed to assess the success of this project.
RESULTS: The number of LHD immunization visits for children 11-13 years was 9,873 in 2014 and 9,241 in 2015. The number of visits where adolescent children received only one of three recommended vaccines was 4,632 in 2014 and 3,429 in 2015, a 26% decrease. The number and percent of visits for adolescent children who received two of the three recommended vaccines were similar in 2014 and 2015. The number of visits where children received all three recommended vaccines was 2,640 in 2014 and 3,283 in 2015, a 24% increase. In 2014, 3,873 children received their first dose of HPV and in 2015, 4,498 received their first dose of HPV; a 16% increase. These trends were similar for both males and females.
CONCLUSIONS: This LHD collaboration is one of several initiatives to help increase HPV coverage in Kansas. This project was successful at decreasing missed opportunities and increasing the number of children receiving their first dose of HPV. Successful LHDs shared ideas for improving coverage by having parents sign or initial refusal forms, not differentiating between recommended and required vaccines, partnering with clinics performing sports physicals, and conducting school-located vaccination clinics. This project will continue in 2016 and will expand to evaluate HPV series completion.