{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:41:47Z","timestamp":1777898507933,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,5,1]],"date-time":"2016-05-01T00:00:00Z","timestamp":1462060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>Human papillomavirus (HPV) causes almost all cervical cancer in women and contributes to vaginal, anal, oropharyngeal, and penile cancer morbidity and mortality. Although vaccines effective in preventing up to nine types of HPV are available, vaccination rates are low nationally. We assessed HPV vaccination coverage by age, sex, and county using Washington State Immunization Information System data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>We calculated on-time dose coverage by county and statewide among adolescents aged 11\u201312 years and assessed coverage by age 18 years. We calculated missed opportunities as the number of visits at which doses of other adolescent vaccines were administered without administration of the first dose of HPV vaccine (HPV1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>In 2013, HPV vaccination coverage estimates with one, two, and three doses (HPV1-3) for adolescents aged 11\u201312 years were 48.5%, 32.4%, and 18.3% among girls and 31.2%, 17.1%, and 8.1% among boys. The three-dose HPV vaccine coverage estimate increased to 40.1% among girls by age 18 but was unchanged for boys. Coverage estimates varied by age, sex, and county. One-third of eligible unvaccinated girls and two of five eligible boys aged 11\u201317 years had at least one missed opportunity to receive HPV1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Despite a recommendation to vaccinate adolescents aged 11\u201312 years, HPV vaccination is often delayed and coverage levels among all age groups are below national target levels. Improved understanding of the variability of HPV vaccination coverage rates by age, sex, and county can inform targeted interventions statewide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/003335491613100313","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T15:47:01Z","timestamp":1467215221000},"page":"474-482","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Human Papillomavirus Vaccination in Washington State: Estimated Coverage and Missed Opportunities, 2006\u20132013"],"prefix":"10.1177","volume":"131","author":[{"given":"Hanna N.","family":"Oltean","sequence":"first","affiliation":[{"name":"Washington State Department of Health, Office of Communicable Disease Epidemiology, Shoreline, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn H.","family":"Lofy","sequence":"additional","affiliation":[{"name":"Washington State Department of Health, Office of Communicable Disease Epidemiology, Shoreline, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia J.","family":"Goldoft","sequence":"additional","affiliation":[{"name":"Washington State Department of Health, Office of Communicable Disease Epidemiology, Shoreline, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charla A.","family":"DeBolt","sequence":"additional","affiliation":[{"name":"Washington State Department of Health, Office of Communicable Disease Epidemiology, Shoreline, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,5,1]]},"reference":[{"issue":"4","key":"bibr1-003335491613100313","first-page":"69","volume":"63","author":"Dunne EF","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr2-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs491"},{"key":"bibr3-003335491613100313","unstructured":"Food and Drug Administration (US). June 8, 2006, approval letter\u2014human papillomavirus quadrivalent (types 6, 11, 16, 18) vaccine, recombinant [cited 2014 Aug 7]. Available from: http:\/\/www.fda.gov\/BiologicsBloodVaccines\/Vaccines\/ApprovedProducts\/ucm111283.htm."},{"key":"bibr4-003335491613100313","unstructured":"Food and Drug Administration (US). October 16, 2009, approval letter\u2014Gardasil [cited 2014 Aug 7]. Available from: http:\/\/www.fda.gov\/BiologicsBloodVaccines\/Vaccines\/ApprovedProducts\/ucm186991.htm."},{"key":"bibr5-003335491613100313","unstructured":"Food and Drug Administration (US). October 16, 2009, approval letter\u2014Cervarix [cited 2014 Aug 7]. Available from: http:\/\/www.fda.gov\/BiologicsBloodVaccines\/Vaccines\/ApprovedProducts\/ucm186959.htm."},{"key":"bibr6-003335491613100313","unstructured":"Food and Drug Administration (US). December 10, 2014, approval letter\u2014Gardasil 9 [cited 2014 Aug 7]. Available from: http:\/\/www.fda.gov\/BiologicsBloodVaccines\/Vaccines\/ApprovedProducts\/ucm426520.htm."},{"key":"bibr7-003335491613100313","first-page":"1","volume":"56","author":"Markowitz LE","year":"2007","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"50","key":"bibr8-003335491613100313","first-page":"1705","volume":"60","author":"Dunne ER","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr9-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2014.01.084"},{"issue":"29","key":"bibr10-003335491613100313","first-page":"620","volume":"63","author":"Stokley S","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr11-003335491613100313","unstructured":"Centers for Disease Control and Prevention (US). CDC looks back at 2013 health challenges, ahead to 2014 health worries; press release 2013 Dec 16 [cited 2015 Aug 7]. Available from: http:\/\/www.cdc.gov\/media\/releases\/2013\/p1216-eoy2013.html."},{"key":"bibr12-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181f12dbf"},{"key":"bibr13-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt049"},{"key":"bibr14-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2011.3364"},{"key":"bibr15-003335491613100313","doi-asserted-by":"publisher","DOI":"10.4161\/hv.7.1.13500"},{"key":"bibr16-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2009.10.133"},{"key":"bibr17-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2011.3284"},{"key":"bibr18-003335491613100313","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.03.067"},{"key":"bibr19-003335491613100313","volume-title":"How state and local immunization programs can help improve HPV vaccination rates to reduce future cancers","author":"Centers for Disease Control and Prevention (US)","year":"2014"},{"key":"bibr20-003335491613100313","first-page":"340","volume":"2012","author":"Hills RA","year":"2012","journal-title":"AMIA Annu Symp Proc"},{"key":"bibr21-003335491613100313","unstructured":"Centers for Disease Control and Prevention (US). 2012 IISAR data participation rates [cited 2014 Aug 8]. 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