The HPV Vaccine: Then and Now

Linda Brookes, MSc

Disclosures

August 01, 2016

In This Article

Vaccination Coverage Still Low

The HPV vaccine is currently part of national immunization programs in 67 countries, including the United States.[27] Although the United States was among the first countries to adopt the vaccine,[28] coverage has been low[29] compared with other high-income countries, such as Australia[30] and the United Kingdom.[31] The most recent CDC data show that full-course HPV vaccination coverage for adolescent girls was 40% in 2014, compared with 38% in 2013; for boys, it was 22% in 2014 and 13% in 2013.[29] "The increase in coverage is slower than we would like," Dr Markowitz admits. "We know that we cannot achieve a sharp increase in coverage like that seen in countries with school-based vaccination, but we would like to see a higher rate of coverage. A lot of work is being done to try to achieve that." The Department of Health and Human Services' Healthy People 2020 goal for HPV vaccination is full-course completion by 80% of girls and boys 13 to 15 years of age,[32] but some organizations, such as the American Society of Clinical Oncology, doubt that this can be achieved at current rates of coverage.[33]

Barriers to HPV Vaccination

Medscape has examined trends in vaccine acceptance in the United States, including for HPV vaccine, and the reasons for relatively low uptake. In a 2016 Medscape survey of family practitioners, pediatricians, physician assistants, and nurse practitioners, over 60% of respondents reported that HPV vaccine was the vaccine that parents were most likely to refuse or request be given on an alternative schedule. [34.]Figure 1 illustrates the main reasons cited by parents for vaccine reluctance.

These findings are consistent with those from previous studies, which have shown that there are more negative parental attitudes and misunderstandings about the HPV vaccine than about other vaccines,[33,35,36,37] especially with respect to the vaccination of boys. Several studies have linked lower completion rates of HPV vaccine series to lack of a recommendation from or discussion with a healthcare provider, usually a primary care provider,[38] but hesitancy to discuss vaccination has been identified among pediatricians.[39]

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