Retrospective study of effectiveness of electronic health record alerts for early human papillomavirus vaccination

Despite recommendations to begin human papillomavirus (HPV) vaccination als early a 9 years of age, uptake remains low. A retrospective quality improvement study at 21 outpatient primary cancer centers in Maryland compared early vaccine initiation between 2 interventions: a electronic health record (EHR) best practice alert (BPA) recommending HPV vaccination beginning at 9 years of age implemented with or without an added clinician education component. A total of 15 743 youths participated in the study. Overall, 10 102 (64.2%) initiated and 5198 (33.0%) completed the vaccine series. In the group aged 9 to 10 years, the BPA plus education arm had a significantly higher likelihood of initiating vaccination than the BPA-only arm (aHR 1.39; p<0.001). Completion increased from 2.2% to 19.6% among youths aged 9 to 10 years and from 13.9% to 66.6% among youths aged 11 to 14 years. The authors conclude that a clinician education module added to an HER BPA was associated with higher early HPV vaccination uptake.