{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:58:03Z","timestamp":1778695083872,"version":"3.51.4"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"\n BACKGROUND AND OBJECTIVE:<\/jats:title>\n Despite national recommendations for adolescent human papillomavirus (HPV) vaccination, rates have lagged behind those of other adolescent vaccines. We implemented interventions and examined rates of vaccination coverage in a large, urban, safety net health care system to understand whether our tactics for achieving high rates of adolescent vaccination were successful.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Denver Health is an integrated urban safety net health system serving &gt;17\u2009000 adolescents annually. The process for achieving high vaccination rates in our health system includes \u201cbundling\u201d of vaccines, offering vaccines at every visit, and standard orders. Data from vaccine registry and utilization statistics were used to determine vaccination rates in adolescents aged 13 to 17 years from 2004 to 2014, and these findings were compared with state and national rates for 2013. Regression analysis was used to identify characteristics associated with vaccination.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n In 2013 (N = 11\u2009463), HPV coverage of \u22651 dose was 89.8% (female subjects) and 89.3% (male subjects), compared with national rates of 57.3% and 34.6%. Rates of HPV coverage (\u22653 doses) were 66.0% for female subjects and 52.5% for male subjects, versus 37.6% and 13.9% nationally. For both sexes, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed, vaccine coverage was 95.9% (86.0% nationally), and meningococcal conjugate vaccine coverage was 93.5% (77.8% nationally). Female subjects, Hispanic subjects, non-English speakers, and teenagers &lt;200% below the federal poverty level were more likely to have received 3 doses of HPV.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Through low-cost, system-wide standard procedures, Denver Health achieved adolescent vaccination rates well above national coverage rates. Avoiding missed opportunities for vaccination and normalizing the HPV vaccine were key procedures that contributed to high coverage rates.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2015-2653","type":"journal-article","created":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T09:08:59Z","timestamp":1475658539000},"source":"Crossref","is-referenced-by-count":49,"title":["Achieving High Adolescent HPV Vaccination Coverage"],"prefix":"10.1542","volume":"138","author":[{"given":"Anna-Lisa M.","family":"Farmar","sequence":"first","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"},{"name":"Department of Pediatrics, University of Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Love-Osborne","sequence":"additional","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"},{"name":"Department of Pediatrics, University of Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Chichester","sequence":"additional","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Breslin","sequence":"additional","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristi","family":"Bronkan","sequence":"additional","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon J.","family":"Hambidge","sequence":"additional","affiliation":[{"name":"Ambulatory Care Services, Denver Health, Denver, Colorado; and"},{"name":"Department of Pediatrics, University of Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2016,11,1]]},"reference":[{"issue":"3","key":"2021121020350232200_B1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/OLQ.0b013e318286bb53","article-title":"Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008.","volume":"40","author":"Satterwhite","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2021121020350232200_B2","first-page":"258","article-title":"Human papillomavirus-associated cancers\u2014United States, 2004-2008.","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"29","key":"2021121020350232200_B3","first-page":"625","article-title":"National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years\u2014United States, 2013.","volume":"63","author":"Elam-Evans","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"33","key":"2021121020350232200_B4","doi-asserted-by":"crossref","first-page":"4081","DOI":"10.1016\/j.vaccine.2015.06.085","article-title":"A model of health care provider decision making about HPV vaccination in adolescent males.","volume":"33","author":"Alexander","year":"2015","journal-title":"Vaccine"},{"issue":"1","key":"2021121020350232200_B5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1001\/jamapediatrics.2013.2752","article-title":"Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature.","volume":"168","author":"Holman","year":"2014","journal-title":"JAMA Pediatr"},{"issue":"45","key":"2021121020350232200_B6","doi-asserted-by":"crossref","first-page":"5152","DOI":"10.1016\/j.vaccine.2013.08.091","article-title":"\u201cHPV? 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