Will HPV vaccination coverage hit the mark?

Routine immunization has been a topic of much discussion over at least the past decade. Many of those vaccinations still occur in enough high enough numbers to do good. However, the human papillomavirus (HPV) vaccine has fought an uphill battle to be accepted in the United States. Other countries are well on their way to meeting their HPV vaccination goals, but the United States has frequently lagged behind. A new report in Pediatrics looks at whether the country will meet the Healthy People 2020 goal of 80% vaccine coverage.¹

Investigators used the MarketScan health care database to find participants. The children included in the study were followed from when they reached their 9th birthday until they received the HPV vaccination, were disenrolled from insurance, or had reached their 17th birthday, whichever came first.

The investigators included 7,837,480 children who represented a total of 19.8 million person-years. They found that proportion of girls and boys aged 15 years who had been administered at least 1 dose of the HPV vaccination increased from 38% and 5% in 2011 to 57% to 51% in 2017. Similarly, the proportion of 15-year-old girls and boys who had been given 2 doses of the HPV vaccine increased from 30% and 2% in 2011 to 46% and 39% in 2017. The investigators also found variation in vaccination according to geography. In 2017, the 2-dose HPV vaccine coverage ranged from 80% in the District of Columbia among girls to 15% in Mississippi among boys. The geographic range has a positive correlation with legislation for HPV vaccine education as well as pediatrician availability.

The investigators concluded that the current HPV coverage in children who are commercially insured was behind the set target of 80% total coverage. There were also frustrating disparities across states. A number of interventions have been tried to increase the vaccination’s coverage, but this investigation indicates that the most likely path to better coverage includes education legislation as well as better access to care.

Reference

1. Chen S, Huybrechts K, Bateman B, Hernández-Díaz S. Trends in human papillomavirus vaccination in commercially insured children in the United States. Pediatrics. September 14, 2020. Epub ahead of print. doi:10.1542/peds.2019-3557