Completion of HPV vaccine series among Florida low-income adolescents

Most cases of cervical cancer are preventable with the human papillomavirus (HPV) vaccine. To best prevent cervical cancer, girls should receive three doses of the HPV vaccine as recommended by the Advisory Committee on Immunization Practices. To determine the percent of 9-17 year old girls participating in Florida Medicaid or Children's Health Insurance Program (CHIP) who completed the three-dose series within 10 months (4 months beyond recommended time period), we assessed claims for the HPV vaccine (current procedural terminology codes 90649 or 90649-SL) among girls who received their first dose of the vaccine between June 2006 and February 2008 and maintained membership in Medicaid or CHIP for at least 10 months. Within the 20,256 Florida Medicaid and CHIP girls who received at least one dose of the HPV vaccine, 40% completed the series. Completion rates within CHIP (46%) were higher than within Medicaid (36%). Within Medicaid, non-Hispanic black (28%) and Hispanic (37%) girls were less likely than non-Hispanic white girls (42%) to complete the series. Girls with Medicaid Fee for Service providers (16%) were less likely than girls in other Medicaid programs (37%) to complete the series. Within both Medicaid and CHIP, girls living in urban and rural areas were equally likely to complete the vaccine series. Overall completion rates and racial/ethnic disparities found within Florida Medicaid and CHIP are consistent with reports from private managed care programs. Vaccine programs should strive to reduce differences in vaccine series completion by race/ethnicity and program components.