Medicaid in ‘most states’ provides HPV vaccination coverage through age 45 years
Click Here to Manage Email Alerts
Medicaid covers HPV vaccination in individuals aged up to 45 years in 43 out of 50 states, according to a study.
“While vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) are generally covered by the majority of insurance providers, insurance coverage for medically necessary vaccines outside of the full recommendation are not well understood,” study author Megan H. Noe, MD, assistant professor of dermatology at Brigham and Women’s Hospital and Harvard Medical School, told Healio. “Routine HPV vaccination is recommended for everyone beginning at age 11 or 12 years through age 26 years.”
Noe added that for adults aged 27 to 45 years, clinicians can consider discussing HPV vaccination with people who are most likely to benefit.
“Dermatologists care for patients with human papillomavirus and associated sequelae who may benefit from HPV vaccination,” she said.
In the current study, the researchers aimed to explore state Medicaid coverage policies for the HPV vaccine for those aged 27 to 45 years to determine whether it is feasible for dermatologists to make this recommendation to their high-risk patients.
“We chose to examine Medicaid coverage because Medicaid formularies and plan coverage is often managed at the state level and information is publicly available, as compared to private insurance companies, where coverage can vary by policy is not always publicly available,” Noe said.
The researchers collected data between Sept. 14 and Dec. 8, 2021.
Results showed that 33 of the 50 states had formal statewide policies in place for adult HPV vaccination coverage. Patients could find this information online or at a state Medicaid office.
“We were pleasantly surprised to learn that in most states, Medicaid provides coverage for the HPV vaccine through age 45 years,” Noe said.
There were four states with formal adult vaccination programs that covered vaccination, while 11 states provided coverage through Medicaid managed care organizations, according to the findings.
Researchers found no information available for two states.
HPV vaccination was covered with no need for prior authorization through age 45 years in 43 states. Four states required prior authorization for HPV vaccination in adults aged older than 26 years, and no coverage was provided for adults older than 26 years in Mississippi, according to the results.
“Dermatologists care for patients who may be at an increased risk of vaccine-preventable illnesses, either from a skin disease or a dermatology medication,” Noe told Healio. “All physicians, whether they provide vaccinations or not, can play an important role in discussing vaccines with their patients. Dermatologist should talk to their patients about the HPV vaccine and recommend vaccination for all adults 11 to 26 years of age and in those 26 to 45 who may benefit.”