American Journal of Public Health
Volume 105, Issue 12 (December 2015)
http://ajph.aphapublications.org/toc/ajph/current

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EDITOR’S CHOICE
Preserving the Social Contract of Health Care—A Call to Action
Kumaran Senthil, Evan Russell, Hannah Lantos
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2404–2404.
[No abstract]

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EDITORIALS
Middle East Refugees The Refugee Crisis in the Middle East and Public Health
Alfredo Morabia, Georges C. Benjamin
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2405–2406.

Syrian and Iraqi Refugees: A Palestinian Perspective
Rita Giacaman
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2406–2407.

Let’s Not Forget the Health of the Syrians Within Their Own Country
Hyam Bashour
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2407–2408.

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RESEARCH AND PRACTICE
Human Papillomavirus Predictors of Human Papillomavirus Vaccine Completion Among Female and Male Vaccine Initiators in Family Planning Centers
Hannah R. Simons, Zoe D. Unger, Priscilla M. Lopez, Julia E. Kohn
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2541–2548.
Abstract
Objectives. We estimated human papillomavirus (HPV) vaccine series completion and examined predictors of completion among adolescents and young adults in a large family planning network.
Methods. Our retrospective cohort study of vaccine completion within 12 months and time to completion used electronic health record data from 119 Planned Parenthood health centers in 11 US states for 9648 patients who initiated HPV vaccination between January 2011 and January 2013.
Results. Among vaccine initiators, 29% completed the series within 12 months. Patients who were male, younger than 22 years, or non-Hispanic Black or who had public insurance were less likely to complete within 12 months and completed more slowly than their counterparts. Gender appeared to modify the effect of public versus private insurance on completion (adjusted hazard ratio = 0.76 for women and 0.95 for men; relative excess risk due to interaction = 0.41; 95% confidence interval = 0.09, 0.73).
Conclusions. Completion was low yet similar to previous studies conducted in safety net settings.

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Quadrivalent Human Papillomavirus Vaccine Initiation in Boys Before and Since Routine Use: Southern California, 2009–2013
Rulin C. Hechter, Chun R. Chao, Margo A. Sidell, Lina S. Sy, Bradley K. Ackerson, Jeff M. Slezak, Nilesh J. Patel, Hung Fu Tseng, Steven J. Jacobsen
American Journal of Public Health: December 2015, Vol. 105, No. 12: 2549–2556.
Abstract
Objectives. We examined the trends and correlates of quadrivalent human papillomavirus vaccine (HPV4) initiation in insured boys during the periods before and after routine use recommendation.
Methods. We grouped data from electronic medical records of boys aged 9 to 17 years from the Kaiser Permanente Southern California prepaid health plan into 3 open cohorts: permissive use: 2009 to 2010; anal cancer indication added: 2010 to 2011; and routine use: 2011 to 2013. We estimated adjusted risk ratios (ARRs) between demographics and vaccination initiation using Poisson regression.
Results. HPV4 initiation increased across cohorts—1.6%, 3.4%, and 18.5%—with the greatest increase among boys aged 11 to 12 years in cohort 3. Initiation was associated with receiving influenza vaccination in the previous year in all cohorts (cohort 3: ARR = 1.48; 95% confidence interval [CI] = 1.46, 1.51) and with non-White race/ethnicity following routine recommendation (cohort 3, non-Hispanic Black: ARR = 1.18; 95% CI = 1.08, 1.30; Hispanic: ARR = 1.23; 95% CI = 1.17, 1.29; Asian/Pacific Islanders: ARR = 1.16; 95% CI = 1.11, 1.20).
Conclusions. Routine use recommendation increased the uptake of HPV4 in boys. System-level interventions to encourage providers to routinely recommend HPV4 vaccination may help increase HPV4 uptake in boys.