15AMGA.ORG OC TOBER 2019
Every year in the United States, human papilloma- virus (HPV) is responsible for more than 33,000
cases of cancer and 10 times
as many precancers.
1 This virus
affects both men and women,
causing cancers of the orophar-ynx, cervix, anus, vagina, vulva,
and penis. But infection with the
strains of HPV that cause about
90% of these cancers is prevent-
able with the HPV vaccine.
Saslow, Ph.D., managing director
of Cancer Control Intervention
for HPV Vaccination and Women’s
Cancers for the American Cancer
Society (ACS), explains:
Never in history has a cancer
been eliminated, but the elimina-
tion of cervical cancer is a very
real possibility if two conditions
are met: ( 1) sustained 80% HPV
vaccination coverage for pre-teen
boys and girls, and ( 2) continued
routine screening and treatment for
In the United States, we still
have a lot of work to do to achieve
80% HPV vaccination coverage.
While rates have been increasing, currently fewer than 50% of
adolescents ages 13–17 years have
completed the series.
4 A recent
analysis of HPV vaccination rates
among 18 AMGA healthcare organizations that pool their electronic
health record (EHR) data as part
of a national learning collaborative found average rates among
13-year-old adolescents who have
initiated the HPV vaccination series
was 57.5% overall in 2018 and
ranged from 36% to 81% across
the organizations (see Figure 1).
While the overall average rate
aligns with nationally reported
rates, several AMGA members
exceeded these rates and are
clearly leading the way. In addition,
all 18 organizations improved their
vaccination rates (initiation among
13-year-olds) between 2016 and
2018 (see Figure 2).
Moving from volume
to value through
By Kristin Oliver, M.D., M.H.S., Melanie Mouzoon, M.D., FAAP, FABM,
Jennifer L.Z. Nkonga, M.S., and Elizabeth Ciemins, Ph.D., M.P.H., M.A.
Improving HPV vaccination rates
is a winnable battle, but to reach
80% HPV vaccination coverage and
meet the goal of cervical cancer
elimination, we need to leverage the
tools of healthcare systems: integrated provider networks, health
information technology, and population health management. Several
AMGA health systems across the
country are leading the way.
Kelsey-Seybold Clinic is a large,
multispecialty system located
in Greater Houston, Texas. Their
system includes 425 providers who
care for a half-million patients
annually in more than 55 medical specialties at 20 locations.
Kelsey-Seybold was the first
accredited accountable care organization (ACO) in the United States.
In 2013, their leaders realized that
HPV vaccination rates were not
comparable to other childhood