Understanding Human Papillomavirus (HPV) Vaccination Before and During the COVID-19 Pandemic Using Project NeLL Restricted; Files Only

Abstract

Background

Assessment of the full impact of the COVID-19 pandemic on public health and healthcare systems is still ongoing, but an area of particular interest is the effect on human papillomavirus (HPV) vaccination uptake which was already suboptimal prior to the pandemic. HPV is the most common sexually transmitted infection in the United States (U.S.) and some subtypes are associated with cancers such as cervical and oropharyngeal among others. Prior to the pandemic, the percentage of adolescents receiving recommended doses of the HPV vaccine was increasing, but the national vaccination rate of 52.3% remained short of the 80% goal set by Healthy People 2030. In Georgia, 67% of adolescents initiated the vaccine series and 45.6 % of adolescents completed the series prior to the COVID-19 pandemic.

Purpose

The purpose of this study was to evaluate HPV vaccine uptake in pediatric patients in Georgia who are eligible for the HPV vaccine series prior to and during the height of the COVID-19 pandemic using a deidentified electronic health record (EHR) database

Methods

This retrospective data analysis used EHR data from Emory University’s Project NeLL big data repository to examine HPV vaccine uptake in children and young adults ages 9-21 in the greater Atlanta metropolitan area before and after the height of the COVID-19 pandemic. Yearly trend data and an unpaired two-tailed t-test were used to compare average HPV vaccine uptake and overall vaccine refusal between 2020 to 2021 and 2018 to 2019.

Results

A statistically significant decrease in average HPV vaccine uptake were noted in 2020 and 2021 in comparison to 2018 and 2019. There was no significant difference in overall average vaccine refusal in 2020 and 2021 in comparison to 2018 and 2019.

Conclusion

The statistically significant decrease in average HPV vaccine uptake during the height of the COVID-19 pandemic does not appear to be related to vaccine refusal and indicates that catch-up HPV vaccination is necessary. 

Table of Contents

Background and Significance. 5

Background. 5

Significance. 6

Purpose Statement 7

Clinical Questions. 7

Project Objectives. 7

Project Assumptions. 7

Project Limitations. 8

Theoretical Framework. 10

Literature Review.. 12

Methods. 13

Themes. 14

Practice Implications. 19

Future Research Suggestions. 20

Setting. 21

Sample. 21

Inclusion and Exclusion Criteria. 22

Methods. 23

Data Collection. 23

Timetable for Scholarly Project 23

Resources. 24

Dissemination Plan. 24

Data Analysis. 25

Results. 25

Discussion and Conclusion. 29

Recommendations and Implications. 29

Evaluation of the Process and Experience. 30

References. 31

About this Scholarly Project

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Nell Hodgson Woodruff School of Nursing
Specialty	Pediatric Primary Care Nursing Practice
Degree	D.N.P.
Submission	Scholarly Project
Language	English
Research Field	Health Sciences, Nursing
Keyword	Human Papillomavirus COVID-19 pandemic Vaccine Uptake Big Data
Committee Chair / Thesis Advisor	Stacy B. Buchanan, Emory University

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