HPV: 1.1 Million More Women Started Vaccine After ACA Passed

Diedtra Henderson

May 07, 2015

Passage of the Affordable Care Act (ACA), which extended health coverage to more young adults and erased copayments for certain preventive treatments, was associated with an additional 1.1 million women aged 19 to 25 years initiating the three-dose human papillomavirus (HPV) vaccine, according to a study.

Brandy J. Lipton, PhD, a senior service fellow in the Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, Maryland, and Sandra L. Decker, PhD, a consultant in the Office of Analysis and Epidemiology, National Center for Health Statistics, report their findings in an article published in the May issue of Health Affairs.

HPV ranks as the most common sexually transmitted disease and, depending on the strain and duration of infection, can cause cervical cancer. In addition to Papanicolaou testing, which is credited with reducing cervical cancer rates in the United States, two HPV vaccines approved in 2006 and 2009 target two strains of HPV that cause 70% of cervical cancers. However, in 2010, just 21% of women aged 19 to 26 years reported having gotten the pricy vaccine, which runs $390 for all three doses, the authors write.

The authors analyzed annual data from 2008 to 2012 from the National Health Interview Survey that, among its queries, asked whether people received at least one dose of the HPV vaccine as well as whether they received the full complement of three doses. They included 10,010 women in their sample: 7975 aged 19 to 25 years and 2035 who were either aged 18 or 26 years as a control group.

"We estimated that the likelihood of initiating and completing the HPV vaccine among women ages 19–25 relative to those age 18 or 26 increased by 7.7 and 5.8 percentage points, respectively, after compared to before policy implementation," the authors write. "These estimates imply that about 1.1 million additional women ages 19–25 initiated and 854,000 completed the vaccine, respectively, given the size of this population."

Dr Lipton and Dr Decker note that two of the ACA's provisions may have encouraged this uptick: extension of the age young adults remained eligible for coverage under their parents' healthcare plans and improved coverage of select preventive services. "Parsing out these effects may continue to be a challenging although important focus for research going forward," the authors write. Likewise, they suggest there might be a similar effect of the ACA in increasing uptake of the hepatitis A vaccine, which can exceed $200 a shot.

"Most of those who gain health insurance will have access to recommended vaccines and evidence-based screening and counseling services specified in the prevention provisions at no cost," the authors conclude. "This has the potential to enhance the effects of increased insurance coverage on access to and use of recommended care."

Health Aff. 2015;34:757-764. Abstract


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