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HPV Vaccination Rates in Younger Adolescents

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Key Points

  • 43.4% of adolescents aged 13 to 17 were fully vaccinated against HPV—but only 15.8% of adolescents had received all recommended HPV vaccine doses by their 13th birthday.
  • Adolescents with more than one health-care provider were not as likely to be up to date on their HPV vaccination by age 13 or 15.

Only about 16% of U.S. adolescents have been fully vaccinated against human papillomavirus (HPV) by the time they turn 13, despite national recommendations that call for vaccination at 11 to 12 years of age. These findings, published by Bednarczyk et al in the Journal of Infectious Diseases, highlight the need for stronger efforts to encourage HPV vaccination and to improve immunization rates in this key age group.

“Providers need to be aware that, while we have seen gains in HPV vaccination coverage, we are still falling behind at the younger ages,” said lead study author Robert A. Bednarczyk, PhD, of Emory University Rollins School of Public Health. “In general, we need to do a better job of recommending the HPV vaccine at the routine, adolescent, and well-child visits, with a particular focus on 11 to 12 years of age.”

Advantages of Timely Vaccination

Timely HPV vaccination at 11 to 12 years of age has several advantages. The immune response to the vaccine is stronger at a younger age, providing better protection against HPV infections and the cancers they can cause later in life. If an adolescent is vaccinated before age 15, only two doses of the HPV vaccine are required, instead of the three doses that are recommended for vaccination after this age. In addition, the HPV vaccine is one of three vaccines recommended for adolescents aged 11 to 12 that can be given at the same time. (The tetanus, diphtheria, and acellular pertussis [Tdap] vaccine and the meningococcal conjugate vaccine are the other recommended immunizations at these ages.)

Findings

For the study, researchers analyzed 2016 data from a nationwide survey of parents conducted annually by the Centers for Disease Control and Prevention that includes vaccination information verified by providers. Overall, an estimated 43.4% of adolescents aged 13 to 17 were fully vaccinated against HPV—but only 15.8% of adolescents had received all recommended HPV vaccine doses by their 13th birthday. Among older teens, an estimated 34.8% of teens were up-to-date on their HPV vaccination by the time they turned 15.

The new analysis also found that adolescents with more than one health-care provider were not as likely to be up to date on their HPV vaccination by age 13 or 15. These results highlight the need for good record keeping, effective use of state immunization information systems, and increased provider awareness to make sure these patients are not overlooked when considering vaccination opportunities, Dr. Bednarczyk said.

Commentary

In a related editorial commentary, Melissa B. Gilkey, PhD, and Marjorie A. Margolis, MPSH, both of the University of North Carolina at Chapel Hill, and who were not involved with the new study, noted that the results indicate much work remains to achieve HPV vaccination rates in line with current U.S. guidelines.

“Fully realizing the potential of HPV vaccination will require a multifaceted effort involving scalable health systems interventions, a greater understanding of geographic disparities in HPV vaccination coverage, and improved data on HPV vaccination,” they wrote in their commentary. “Vaccination timeliness is critically low and our work is far from complete,” they concluded.

Disclosures: The study authors’ full disclosures can be found at academic.oup.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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