1. Reasons for Incomplete Follow Up for HPV Vaccination in Females Attending an Urban Public Immunization Clinic Fiona G. Kouyoumdjian, 1 MD, MPH, CCFP, Anne Bailowitz, 2 MD, MPH 1 Dalla Lana School of Public Health, University of Toronto; 2 Division of Maternal and Child Health, Baltimore City Health Department Fiona G. Kouyoumdjian, 1 MD, MPH, CCFP, Anne Bailowitz, 2 MD, MPH 1 Dalla Lana School of Public Health, University of Toronto; 2 Division of Maternal and Child Health, Baltimore City Health Department Background Conclusions Abstract Methods -9-5-6-7-8 * * Background: Incomplete vaccination results in suboptimal protection against vaccine-preventable diseases, with implications for individual patients as well as population health. This project aimed to identify reasons for failure to complete the HPV vaccination series for female attendees at an urban public immunization clinic. Methods: A list of female attendees who had obtained 1 or 2 doses of the 3-dose HPV vaccine series at the Baltimore City Health Department, and whose last visit was prior to September 1, 2008,was generated from the Baltimore Immunization Registry in January 2009. Up to three attempts by phone were made to contact either the vaccine recipient if ≥18 years or a parent of the vaccine recipient for those <18. Phone interviews were conducted with respondents regarding the reasons for lack of follow up. Results: Of the 185 people who initiated HPV vaccination from 2007- 2009, 115 (62.2%) did not complete the series. Twenty-three (23) phone interviews were conducted. The remainder were not reachable by phone. Of those who were contacted, 4 had completed their vaccination series and 19 had not. Of the 19, 5 (26.3%) had forgotten about following up, 3 (15.8%) were too busy to follow up, and 3 (15.8%) said the clinic timing was inconvenient. Conclusions: Efforts should be made to improve vaccination series completion. Patients should be informed to return for subsequent vaccine doses to optimize protection, which could be done at the time of the first vaccination or through a reminder -recall system. 1.Efforts are needed to ensure timely and complete follow up, potentially including: ensuring the provision of information in appropriate written and oral forms at the time of vaccination implementing a reminder-recall system 2.Vaccine providers need to tailor programs to the specific populations which they serve. In this context, follow up by phone may not be appropriate, which precludes the use of innovative strategies including text messaging. 3.Further research on follow up rates, reasons for not completing the HPV series and reminder and recall methods would be valuable. In January 2009, a list of those who received at least 1 dose of Gardasil was generated from a computerized database of all vaccinations provided by the Baltimore City Health Department. Given that the dosing schedule is 0, 2, and 6 months, an incomplete series was defined as having obtained only 1 dose before October 2008 or only 2 doses with the most recent dose before August 2008. Up to 3 attempts were made by phone to reach the person who had received the vaccine for those 18 years and older at the time of calling, or to reach a parent of the person who received the vaccine for those younger than 18 years. Results Of 185 girls and women initiated the HPV series between February and January 2009, 127 should have completed their series. Of these, only 12 (9.4%) completed all 3 doses, while 42 (33.1%) received 2 doses and 73 (57.5%) received1 dose. Of the 115 girls and women with a documented incomplete vaccination series: Background Baltimore City Health Department provides free immunizations to eligible persons in Baltimore City through dedicated clinics. Since February 2007, Gardasil, a three dose quadrivalent HPV vaccine, has been offered to females aged 9 to 26. To determine (1) vaccine recipient completion rates and (2) reasons for incomplete follow up. Objectives