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4% to 31.6% vs. 98.7% to 70.4%, respectively). MOs for MenACWY (74.5% to 35.0%; adjusted RR=0.47, p less then 0.0001) and influenza (86.7% to 69.3%; adjusted RR=0.792, p less then 0.0001) vaccination also decreased during non-confidential visits. Vaccine refusal was the most frequently documented reason for HPV vaccine MOs both during physical examination and confidential visits. CONCLUSIONS A pragmatic, multicomponent SBHC intervention reduced MOs for HPV vaccination during all visit types. MOs for MenACWY and influenza vaccination also