New research finds gaps in use of cancer-preventing HPV vaccine

New research from Humana Inc. and the University of Louisville clearly demonstrates substantial missed opportunities for HPV vaccine administration in young girls. The findings, published in a peer-reviewed paper — “Missed Opportunities for Human Papillomavirus Vaccine Initiation in an Insured Adolescent Female Population,” in the Journal of the Pediatric Infectious Diseases Society — illustrate that efforts are needed to improve vaccination rates to ultimately prevent certain types of cancer.

The results of the study are summarized in this helpful infographic.

Routine HPV vaccination of females has been recommended in the U.S. for a decade, and in males since 2009 by the U.S. Centers for Disease Control and Prevention (CDC). The prime age is 11 to 12 years, but it can be administered as early as age 9, with “catch-up” from 13 to 26 years in females.(1) The human papilloma virus (HPV) can cause cervical and other types of cancer.   Approximately 27,000 HPV-attributable cancers occur each year.(2)

This study evaluated how frequently doctor and provider visits are used as opportunities to administer the HPV vaccine in adolescent girls age 11 to 13 years when other adolescent vaccines, such as the meningococcal conjugate vaccine (MenACWY) or tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, are administered.

Of 14,588 adolescent girls in the study, only 42 percent initiated the HPV vaccination series.  The rates of HPV vaccine varied from 26 percent to 42 percent of provider visits, depending on the type of visit.  Nationally, approximately 88 percent of adolescent boys and girls receive vaccination for Tdap and 79 percent for (MenACWY), but  only 40 percent of girls and 22 percent of boys receive HPV vaccination.(3)

Low vaccination rates are considered a public health concern.  Previous research in this area has identified potential barriers to HPV vaccination, including parents’ attitudes toward the vaccine, inadequate insurance coverage and reimbursement, financial concerns, preference for vaccinating older adolescents, and knowledge gaps. Additional factors might be not receiving a provider’s recommendation, lack of information, concerns about timing of vaccination (child’s age), misconceptions about efficacy and safety, cost and availability.(4)

This study indicates that future research should focus on communication strategies that might facilitate the conceptual ‘bundling’ of HPV vaccine with other adolescent vaccines in the provider’s office.   Additionally, healthcare organizations should develop action plans that help providers avoid missed opportunities, and public health agencies should continue to focus public awareness campaigns on HPV vaccination as a critical element of community cancer prevention strategies.

Read the full study here.

The paper was authored by the following individuals:  Claudia M. Espinosa,1 Gary S. Marshall,1 Charles R. Woods,1 Qianli Ma,2 Derek Ems,2 Irene Nsiah,2 Laura E. Happe,3 and Michael J. Smith1

1 Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Kentucky;
2 Comprehensive Health Insights, Humana, Louisville, Kentucky;

3 Office of the Chief Medical Officer, Humana, Louisville, Kentucky

1. Centers for Disease Control and Prevention. Recommendations on the use of
quadrivalent human papillomavirus vaccine in males—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep
2. CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013;40:187–93.
3. Regan-Steiner S, Yankey D, Jeyarajah J, et al. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2014. MMWR. 2015;64(29);784-792.
4. Holman DM, Benard V, Roland KB, et al. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA Pediatr 2014; 168:76–82.

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