Impact of an Electronic Health Record (EHR) Reminder on Human Papillomavirus (HPV) Vaccine Initiation and Timely Completion

Odds ratios (95% confidence intervals) of series completion at the prompted site versus the unprompted site, at levels of covariates, among patients who initiated the human papillomavirus vaccine series and had the opportunity to complete the series during the observation period. The odds ratios from clustered logistic regression predicting receipt of all 3 vaccination doses versus any (i.e., 1 or 2) doses during observation, including age, race, number of visits, and interaction of all variables with study site. Analysis also adjusted for practice clustering using generalized estimated equations with an exchangeable working correlation structure. A total of 1936 patients at the prompted site and 1706 at the unprompted site had an opportunity to complete the series. The dotted line represents an odds ratio of 1, which would indicate no significant site effect.

Time to each vaccine dose. The shaded boxes represent the interquartile range (25th to 75th percentile); the solid vertical lines within the shaded boxes represent the median. Dots are outliers beyond 1.5 times the interquartile range from the 75th percentile. The red dashed lines in each panel represent the “on time” time range for each interval.