Increases in Human Papillomavirus Vaccine (HPV) coverage among adolescent girls in metropolitan Oregon: A report from Oregon's CDC Sentinel Immunization Information Systems (IIS) Surveillance Site

IIS provide clinicians consolidated, multi-source immunization records that are useful for public health surveillance. Oregon's IIS, ALERT, hosts a CDC-funded IIS Sentinel site, using data from 12-zipcodes in the growing Portland metroplitan area to monitor immunization coverage and meet CDC reporting completeness and timeliness measures. In June 2006, the Advisory Committee on Immunization Practices (ACIP) recommended HPV for adolescents—the first vaccine to prevent cancer. Oregon issued clinic standing orders in October and began shipments in December. MMWR published HPV recommendations in March 2007.

Quarterly, since October 2006, vaccination records for rolling cohorts of 20,631-22,675 girls aged 11-18 years with sentinel-area addresses are extracted to monitor vaccine uptake. Up-to-date rates are calculated using assessment dates 1-1.5 months prior to extracts allowing report catch-up.

Rates for > 1 HPV doses rose steadily from 0.06% to 13.45% for 11-12 year olds; 0.18% to 23.48% for 13-15 year olds; and 0.24% to 24.92% for 16-18 year olds from October 2006 to January 2008, increasing over a thousandfold from January to July 2007. Rates for > 3 HPV doses rose steadily, albeit more slowly from 0.0% to 1.70% for 11-12 year olds; 0.0% to 3.68% for 13-15 year olds; and 0.0% to 4.53% for 16-18 year olds from October 2006 to January 2008.

Dramatic HPV rate increases among sentinel-area girls document successes in real-time using IIS data. Further monitoring and barrier identification are needed. With an expanded sentinel area planned for later in 2008, more complete HPV coverage information will become available.