Feasibility and Accuracy of a Computer-Assisted Self-Interviewing Instrument to Ascertain Prior Immunization With Human Papillomavirus Vaccine by Self-Report: Cross-Sectional Analysis

Abstract

Background Ascertaining history of prior immunization with human papillomavirus (HPV) vaccine can be challenging and resource-intensive. Computer-assisted self-interviewing instruments have the potential to address some of the challenges of self-reporting, and may also reduce the time, costs, and efforts associated with ascertaining immunization status. Objective This study assesses both the feasibility and the accuracy of a computer-assisted self-interviewing instrument to ascertain a patient’s history of immunization with the HPV vaccine. Methods We developed both a survey and a Web-based data collection system using computer-assisted self-interviewing to ascertain self-reported HPV vaccine immunization history. We implemented the instrument in a sample of adult women enrolled in an ongoing study of the HPV vaccine. Vaccine records from prior sources of care were reviewed to verify reported immunization history. Results Among the 312 participants who provided HPV vaccine immunization history by self-report, almost all (99%) were able to do so using the computer-assisted self-interviewing instrument. The median survey completion time was 10 minutes (IQR 7-17). The accuracy of self-report was 84%, sensitivity was 89%, specificity was 80%, and the negative predictive value was 92%. Conclusions We found that it is feasible to collect a history of immunization with the HPV vaccine using a computer-assisted self-interviewing instrument. This approach is likely to be acceptable to adult women and is reasonably accurate in a clinical research setting.

Sensitivity of Self-Reported Human Papillomavirus Vaccination History Among 18- to 26-Year-Old Men Who Have Sex With Men: Seattle, WA, 2016 to 2018

“…Similarly, in a study of 14-to 17-year-old adolescent girls, the sensitivity of self-report was lower for ≥3 doses (35%) than for any dose of HPV vaccine (54%), 10 and in a study of adult women, 89% correctly self-reported having been vaccinated, whereas only 65% accurately recalled the number of doses. 12 In the study of males, participants' accuracy of self-reporting the correct number of doses received (including zero doses) was decreased compared with accurately reporting whether or not they received any doses (73% vs. 80%). 16 Furthermore, in the National Health and Nutrition Examination Survey pilot study, 17 the sensitivity of self-/parent-reported HPV vaccination in 14-to 29-yearolds with provider-verified vaccination records was higher for ≥1 dose (87%) than for 3 doses (67%).…”

“…In our study, the sensitivity of self-report for ≥1 dose of HPV vaccine in 18-to 26-year-old MSM (83%) was higher than previously reported in a small study of female adolescents (54%), but slightly lower than in studies of adult females (85%-96%) and adolescent to adult females combined (92%). [10][11][12][13][14][15] Comparisons are complicated by differences in ages and timing of vaccination across study populations. Greater historical efforts in educating females versus males about the risks of HPV infection and HPV vaccines might contribute to observed gender-based differences in HPV vaccination recall.…”

“…16 A study of females reported that age was not associated with self-report accuracy (not sensitivity) in 23to 38-year-old females. 12 *One or more HPV vaccine doses documented in either the clinic EMR or the WAIIS or both. † One participant did not report age at first sex.…”

Effectiveness of HPV vaccine by age at vaccination and number of doses: protocol for a population-based matched case–control study

“…[33][34][35][36][37][38][39][40] Participants will be given the option to complete the survey electronically, in-person or over the telephone, using previously validated instruments. 41 Patient and public involvement Patients or public involvement is not applicable to this study. Neither patients nor the public were involved in the design, or conduct, or reporting or dissemination plans of our research.…”

Accuracy of Self-reported Human Papillomavirus Vaccination Status Among Gay and Bisexual Adolescent Males: Cross-sectional Study

“…Additionally, Australia established robust population-based vaccination registries to document HPV vaccination coverage [5]. Several studies have examined the accuracy of self-reported HPV vaccination status among women and adolescent girls; however, the proportion who report their HPV vaccination status correctly varies across populations and settings, ranging from 54% to 92% [6][7][8][9][10][11][12][13][14][15]. Low sensitivity (54%) of self-reported HPV vaccination status against medical records is reported among adolescent girls aged 14-17 years in the United States [6].…”