(1086) Past pregnancy, medical history, and sociodemographics are predictive of HPV vaccination status

The quadrivalent human papilloma virus (HPV) protein sub-unit vaccine nearly abolishes cervical cancer risk by preventing persistent infection with oncogenic subtypes of HPV. Unfortunately, HPV vaccination rates remain lower than anticipated. We aimed to study this trend within our region to identify what patient-specific factors influence HPV vaccination status.

Study Design:

This was a retrospective cohort study of a prospectively collected perinatal database with >55,000 subjects from a large academic center between 2011-2022. Coded into this database is patient reported vaccination, as well as abstracted data from the electronic medical record. We categorized demographic and patient medical history data in association with receipt of the HPV vaccine series and analyzed in uni- and multivariate analyses by chi-squared. A multivariable regression model adjusted for potential confounders (p-value < 0.05 considered significant for all analyses). 

Results:

38,379 patients were included in the analysis; 952 (2.7%) were vaccinated for HPV. Univariate regression identified 38 factors predictive of a positive history of HPV vaccination, and 9 of these factors remained significant on multivariate regression (Tables 1 and 2). Older age, absence of occupation, and absence of health insurance predicted no HPV vaccination, while receipt of prenatal care, other vaccines, and history of an abnormal pap smear were associated with having received the HPV vaccine (Table 2).

Conclusion:

Although the CDC does not currently recommend the HPV vaccine in pregnancy, published data suggests it is safe (https://www.nejm.org/doi/10.1056/NEJMoa1612296) and our data suggests that the antenatal interval may provide an opportunity to improve current very low vaccine uptake. Due to its recombinant protein nature with no known teratogenicity, clinical trials are warranted to determine if introduction of HPV vaccination to an expanding number of vaccines given to gravidae during pregnancy might be of maternal value and absent of fetal risk.