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HPV vaccination rates increase substantially among males in US
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HPV vaccination rates increased substantially among adolescent and young adult males in the first 6 years after routine vaccination was recommended for males in the United States in 2011, researchers reported in The Journal of Infectious Diseases.
However, data showed that minimal vaccination gains were seen among females during the same period, and that coverage among males and females remains below national targets, according to Eshan U. Patel, MPH, researcher in the department of pathology at the Johns Hopkins School of Medicine, and colleagues.
Patel and colleagues noted that all three HPV vaccines licensed in the U.S. protect against the two types — 16 and 18 — that are responsible for 63% of HPV-associated cancers, and that the nine-valent vaccine (Gardasil-9, Merck) confers protection against five additional tumor-causing types responsible for approximately 10% of HPV-associated cancers. The nine-valent and quadrivalent (Gardasil, Merck) vaccines also protect against types 6 and 11, which cause genital warts.
In the U.S., the Advisory Committee on Immunization Practices (ACIP) has recommended routine HPV vaccination for females since 2006 and for males since 2011, initiated as early as 9 years of age, the researchers noted.
“As evidence of HPV vaccine immunogenicity, safety, and effectiveness has rapidly accumulated, recommendations for early vaccination have evolved accordingly,” Patel and colleagues wrote.
For their study, Patel and colleagues used data from the National Health and Nutritional Examination Survey (NHANES) to measure changes in HPV vaccine uptake from 2011 through 2016 in males and females aged 9 to 26 years.
According to the report, HPV vaccination in males increased overall from 7.8% to 27.4% and among every stratum of age, race/ethnicity, health insurance, poverty level and immigration status, although Patel and colleagues noted that increases were lowest in males without health insurance.
Meanwhile, vaccination coverage increased from 37.7% to 45.7% among all females, but Patel and colleagues said the gains were driven primarily by increases among young adults aged 18 to 26 years — with the only statistically significant increases being seen in those aged 22 to 26 years. In adolescent females, uptake remained stable.
“The increases in HPV vaccination documented among male adolescents and young adults in this study are indeed encouraging. However, HPV vaccine coverage among males and females in the general U.S. population clearly remains well below national targets, including the Healthy People 2020 goal to achieve more than 80% up-to-date coverage among” patients aged 13 to 15 years, Patel and colleagues concluded.
“There is a critical need to develop and implement evidence-based strategies to overcome residual barriers to HPV vaccination,” they continued. “Coupled with interventions at the systems level, clinicians should be encouraged to desexualize, educate and strongly advocate early HPV vaccination to maximize individual- and population-level benefits. Continuing to monitor trends in HPV vaccination is needed to guide effective policy on vaccine implementation and estimate the projected burden of vaccine-associated HPV infections and incidence of HPV-related cancers.” – by Gerard Gallagher
For more information:
CDC. Human papillomavirus (HPV) ACIP vaccine recommendations. https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hpv.html. Accessed March 26, 2018.
Disclosures: The authors report no relevant financial disclosures.
Perspective
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The nine-valent HPV vaccine will prevent about 29,000 cases of head, neck, anal, genital and cervical cancers every year in the United States. It will also prevent about 5,000 deaths a year from these cancers. Although Patel and colleagues found that the rate of immunization for HPV in males increased dramatically between 2011 and 2016, the fact remains that for both girls and boys, immunization rates remain woefully inadequate. Given current rates, about 2,000 children will die later in life from preventable cancers caused by HPV every year. It is unconscionable. We simply have to find a better way to make the public aware of what is at stake here.
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