Why HPV vaccination is low among U.S. adolescents

December 3, 2013 | by Hiu Chung So

Although the human papillomavirus (HPV) vaccine was approved by the Food and Drug Administration in 2006, vaccination rates among U.S. adolescents remain low.

In a review article published online in JAMA Pediatrics on Nov. 25, researchers reported that 34.8 percent of girls 13 to 17 had completed the three-cycle series of HPV vaccines and that only 8.3 percent of boys in the same age range had even initiated it. The federal Centers for Disease Control and Prevention (CDC) has recommended the vaccine for all girls and young women ages 11 through 26 — as well as all boys and young men ages 11 through 21.

The authors examined 55 studies to determine barriers to adolescents getting, and completing, their HPV immunization shot cycle. Recurring barriers that they found in these studies include:

• Financial constraints and inadequate insurance coverage. (Each dose of HPV vaccine costs approximately $135, according to the CDC, making it one of the most expensive vaccines on the market.)
• Lack of information about, or a recommendation to get, the vaccine from a health care provider.
• Limited knowledge about HPV, its prevalence and the diseases linked to it, including several cancers and genital warts.
• Limited accessibility to health care among underserved populations.
• Social and cultural stigmas regarding HPV as a sexually transmitted infection and perceived effect of the vaccine on sexual behavior.

Regarding the last barrier, Mark Wakabayashi, M.D., M.P.H., co-director of City of Hope's gynecological cancers program, told HealthDay that "if this was like the chickenpox vaccine, there would be a higher rate of acceptance."

If more education were provided to health care providers and to parents, it could overcome the stigmas tied to this vaccine, Wakabayashi said. That would mean that more adolescents would start — and complete — the vaccination series.

The article's authors concur, noting that "continued efforts are needed to ensure that health care professionals and parents understand the importance of vaccinating adolescents before they become sexually active."

They also said that more should be done to "reduce missed opportunities for HPV vaccination" when adolescents engage with health care providers, such as during check-ups with a family physician, in a community/school clinic or at a health fair.

The U.S. Department of Health and Human Services currently aims to have 80 percent of girls ages 13 through 15 complete the three-shot cycle of HPV vaccination by the year 2020.