• Posted August 24, 2023

U.S. Kids' HPV Vaccination Rate Has Stalled

For the first time in a decade, the rate at which American adolescents received the human papillomavirus (HPV) vaccine has not increased, new data show.

Current guidelines from the U.S. Centers for Disease Control and Prevention recommend that both girls and boys receive the vaccine at ages 11 or 12, although vaccination can begin as early as age 9. HPV vaccines protect against cervical and other cancers strongly linked to the virus. They are typically delivered in two doses given over a period of six months to a year.

A new report says uptake of the vaccine by adolescents had risen steadily since 2013. But an analysis of 2022 data found that “for the first time since 2013, HPV vaccination initiation did not increase among adolescents aged 13 to 17 years,” according to a team led by agency researcher Cassandra Pingali.

The data comes from an annual federal survey of U.S. households.

In 2022, 76% of children aged 13 to 17 were found to have received at least one dose of the HPV vaccine, the new report found. Looking specifically at 13-year-olds, 52.7% of those who turned 13 in 2022 had gotten at least one dose of the vaccine — no real change from the 52.9% observed in 2020.

Much of the stagnation in immunization rates occurred among children covered by Medicaid, the researchers noted.

Between 2015 and 2021, rates of vaccination against HPV were higher among kids covered by Medicaid than those covered by private insurance, Pingali's group said. But that changed in 2022. Last year, coverage among Medicaid beneficiaries “declined by 3.3 percentage points compared with coverage in 2021,” even as coverage among kids covered by private insurance remained stable.

As has long been the case, kids not covered by any form of insurance continued to have the lowest rate of vaccination in 2022 — just over 39% of uninsured kids who turned 13 in 2022 had gotten vaccinated, the report found.

Paying out of pocket can prove expensive for families: According to Merck, which makes the HPV vaccine Gardasil, the shots cost about $268 per dose.

Rates of uptake of the HPV vaccine also varied widely by state. For example, while almost 95% of kids in Rhode Island had received at least one dose of the HPV vaccine by 13 to 17 years of age, that number fell to 61% for children living in Mississippi, Pingali's group reported.

The investigators noted that many of the kids going without vaccines are eligible for free immunization through the federal government's Vaccine for Children (VFC) program, which provides no-cost vaccines to children who lack health insurance or otherwise can't afford the cost.

The impact of the COVID-19 pandemic was clearly a factor: Compared to 2019, “VFC provider orders for HPV vaccines decreased 24% during 2020, 9% during 2021, and 12% during 2022,” the study authors noted.

All of this highlights “the continued need for outreach among adolescents eligible for VFC,” they said.

“The VFC program is vital to reach and administer vaccines to eligible adolescents to maintain vaccination coverage in underserved communities,” Pingali's team added.

Pediatricians and family doctors can do their part as well: “Providers should review adolescent immunization histories … to ensure that adolescents are up to date with all recommended vaccines,” the CDC team advised.

The new report was published Aug. 25 in the CDC's Morbidity and Mortality Weekly Report.

More information

The U.S. Centers for Disease Control and Prevention has a primer for parents about the HPV vaccine.

SOURCE: Morbidity and Mortality Weekly Report, Aug. 25, 2023