CHOP Primary Care Network Increases HPV Vaccination Rates

Human papillomavirus (HPV) is a sexually transmitted infection that can put people at risk for cancer later in life. The HPV vaccine, which is given between the ages of 9 and 12, prevents cancer, but only about 45% of U.S. teens complete the HPV series by the time they are 13 years old.

To address this shortfall, in June 2019 the Children’s Hospital of Philadelphia (CHOP) Care Network implemented an improvement program to boost vaccination rates at its outpatient practices, which together see more than 260,000 pediatric patients each year.

By engaging doctors, nurses and administrative leaders at each office, the interprofessional team identified key drivers to improve HPV vaccination. The team implemented four main interventions at all sites:

1. They made receiving the vaccine opt-out rather than opt-in, beginning at age 9;
2. They sent HPV vaccine data regularly to providers;
3. They provided focused online educational sessions about HPV disease and the HPV vaccine; and
4. They instituted standing orders for all HPV doses.

Between June 2019 and December 2020, 90% of offices in CHOP's Care Network increased the administration of the first dose of the HPV vaccine by at least 15%; some locations increased rates by more than 50%. Although rates of administering the second dose dropped in the early part of the COVID-19 pandemic, by December 2020 those rates had swiftly rebounded, and some 83% of Care Network patients who were eligible for the second dose received it.

“By engaging our providers and prioritizing HPV vaccination, we were able to increase the number of patients receiving this important vaccine,” said Elena Huang, MD, pediatrician at Karabots Pediatric Care Center and project leader for the improvement program. “Given that the vaccine is more effective at preventing cancer the earlier it is given, primary care practices should find ways to provide the HPV vaccine to as many patients as possible at the earliest opportunity.”