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.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Fiks had an independent research grant from Pfizer. He did not receive salary support, but the grant supported his research team. Dr. Fiks is the co-inventor of the Care Assistant decision and workflow support software. He has earned no income and no licensing agreement exists for the intervention. In the past year, Dr. Humiston has been a consultant to Sanofi Pasteur, which manufactures vaccines, although not HPV vaccine. No other disclosures were reported.].
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