Missed Opportunities

Our primary outcome was adolescents who had missed opportunities for HPV vaccination. We defined a missed opportunity as receipt of any vaccine between ages 11 and 14 without receipt of the HPV vaccine; vaccination encounters that could result in missed opportunities included routine adolescent vaccines such as meningococcal, Tdap, or other catchup or booster vaccines. We omitted the seasonal influenza vaccine because it may be administered in schools and pharmacies and would not represent a missed opportunity for HPV vaccination. We assessed this outcome among adolescents born during 2004-2007 who had at least 1 MIIC record as of 2018 and, therefore, had ever been vaccinated in Minnesota. We determined eligibility for the HPV vaccine by the adolescent’s age at the time of the visit and whether the adolescent had already completed the HPV vaccination series. We defined adolescence starting at age 11, corresponding to the recommended age for routine HPV vaccination. ¹⁹ Adolescents were aged 11-14 years given the available years of vaccination records for this birth cohort.