Staying on track: A cluster randomized controlled trial of automated reminders aimed at increasing human papillomavirus vaccine completion

Objectives: To evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series. Methods: Ten reproductive health centers enrolled 365 women aged 19-26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders - text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks. Results: The reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p = 0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR = 1.15,95% CI 1.01-1.31), report having completed a four-year college degree or more (age-adjusted OR= 2.51, 95% CI 1.29-4.90), and report three or more lifetime sexual partners (age-adjusted OR= 3.45, 95% CI 1.20-9.92). Conclusions: The study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low. (C) 2014 Elsevier Ltd. All rights reserved.