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Recall of Human Papillomavirus (HPV) Vaccination History among Adolescents

David A. Klein, Amy M. Thompson, Barbara L. Bowsher, Anneke C. Bush and Jane Shen-Gunther

Objective: Data examining the accuracy of patients’ ability to recall their HPV vaccination history are sparse and conflicting, and generally suggest that adolescents often report this information inaccurately. This study aims to elucidate accuracy of HPV vaccination recall among a diverse sample of female and male adolescents. Methods: Adolescents (N=224, ages 12-23) recruited from a large military primary care clinic completed a questionnaire regarding sociodemographics, clinical variables, and HPV vaccination history. Electronic databases were searched to determine each participant’s recorded vaccination history. Accuracy of recall was calculated for initiation and completion of the series; and age- and gender-based comparisons were conducted. Results: 224 adolescents aged 12-23 enrolled in the study; 217 provided complete data. Electronic records showed that 59.5% of the adolescents initiated, whereas 40.1% completed the 3-shot series. Of the 217 participants, 65.9% correctly recalled initiation (or lack of initiation) and 56.2% correctly recalled completion (or lack of completion). In bivariate analysis, older adolescents had more accurate recall of initiation compared to younger adolescents (p<0.002); however, there was no difference between gender (P<0.195), race (P<0.104), or sexual debut (P<0.196). Furthermore, 40.5% of adolescents who have had vaginal, oral, or anal intercourse completed the series. Conclusion: Among adolescents in a diverse, vaccination-centric clinical setting, recall of HPV-related vaccination status is often inaccurate, and should be interpreted with caution. The level of inaccuracy found in this study, which is consistent with prior studies, has important implications for clinicians and researchers who depend on self-reporting of vaccination status for vaccine-related efforts.