HPV Vaccination: Are We Meeting Our Targets in Cervical Cancer Prevention?
- Current Obstetrics and Gynecology Reports
Authors: Anna L. Beavis, Anne F. Rositch, Melinda Krakow, Kimberly L. Levinson
Publisher: Springer US
The purpose of this review is to update the reader on the most recent HPV vaccine uptake rates in boys and girls in the United States and to summarize the recent recommendations for vaccination. The review also evaluates a decade of data demonstrating the safety and efficacy of the HPV vaccine and discusses disparities in vaccine uptake in the US. Finally, we will summarize the scope of attempted and proposed interventions to improve vaccine uptake in the United States.
Topics discussed in this review include the recommendations for the nine-valent HPV vaccine and the two-dose injection regimen. Additionally, many studies reviewed demonstrate continued disparities in HPV vaccine uptake in the US. An update on various interventions to address poor uptake is provided.
Despite being FDA-approved since 2006, only 42% of US adolescent girls and 28% of boys had completed the HPV vaccine series in 2015, well below the Healthy People 2020 goal of 80%. A decade of data has proven that the vaccine is safe and effective. Physician recommendation is consistently the strongest predictor of vaccine uptake, and initiation and recommendation rates differ by region, race, sexual orientation, and socioeconomic status. Special populations, including sexual minorities and children with chronic medical conditions, have particularly low rates of vaccination, representing addressable missed opportunities for vaccination. Interventions to improve uptake have ranged from education to state mandates, with variable effectiveness. Culturally sensitive, multimodal, tailored interventions to improve uptake may hold the most promise, including the use of novel delivery locations such as pharmacies, schools, and the postpartum visit. This article reviews a decade of data on vaccine safety, efficacy, disparities, and interventions to improve vaccination rates, focusing on the most recent year of published data.