HPV vaccination rates continue to rise among young adults in the US

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Although vaccination rates against the human papilloma virus (HPV) remain low for young adults in the United States, the number of self-reported HPV vaccines among women and men between the ages of 18 and 21 has increased markedly since 2010, according to new research results.

The conclusions were published online On April 27 as a research letter to JAMA.

In 2006, the U.S. Food and Drug Administration approved the HPV vaccine for virus prevention. cervical cancer i genital warts in female patients. Three years later, the FDA approved the vaccine for the prevention of anogenital cancer and warts in male patients.

The Advisory Committee on Immunization Practices and Disease Control and Prevention Centers recommend two doses of the HPV vaccine for children 11 to 12 years of age. Adolescents and young adults may need three doses over the course of 6 months if they begin their series of vaccines at age 15 or later.

For people who have not previously received the HPV vaccine or who did not receive adequate doses, the HPV vaccine is recommended until age 26. Data on vaccination rates among 18- to 21-year-olds in the United States are scarce. and the progress of vaccination programs in the country is unknown.

In the recently published JAMA Research letter, University of Michigan researchers Ann Arbor examined data from the 2010–2018 cross-sectional survey of national health interviews. Respondents included in the analysis were between 18 and 21 years old. They were asked if they had received the HPV vaccine before the age of 18 and at what age they had been vaccinated against the virus.

The researchers also assessed whether respondents had received any dose of HPV vaccine between the ages of 18 and 21. Results were limited to self-reported vaccination status.

In total, 6606 women and 6038 men were included in the analysis. Approximately 42% of women and 16% of men said they had received at least one dose of HPV vaccine at any age. The proportion of female patients who reported receiving a dose of HPV vaccine increased significantly from 32% in 2010 to 55% in 2018 (Pg = .001). Similarly, among men, the percentage increased significantly from 2% in 2010 to 34% in 2018 (Pg <.001).

Approximately 4% of women surveyed and 3% of men surveyed reported having received an HPV vaccine between the ages of 18 and 21; 46% of women and 29% of men who received the vaccine between these ages completed the recommended series of vaccinations.

The results of the study highlight the continuing need to improve vaccination rates among vulnerable populations. The study’s lead author, Michelle Chen, MD, MHS, a professor in the Department of Otorhinolaryngology – Head and Neck Surgery at the University of Michigan, explained in an email to Medscape Medical News that there are multiple barriers to HPV vaccination among young adults. “These barriers to vaccination among young adults mainly include cost, lack of knowledge and awareness, missed vaccination opportunities, rapidly changing guidelines, and initial gender-based guidelines,” Chen said.

Clinicians play an important role in improving vaccination rates among young adults, who may not be aware of the overall importance of inoculation against the potentially debilitating and deadly virus. Chen noted that physicians can lead the way by raising inclusive gender awareness of HPV-associated diseases and HPV vaccination, by conducting routine assessments of vaccine eligibility for young adults regardless of gender, by developing robust reminder and reminder strategies to improve series completion rates. providing patients with resources on care programs to address cost barriers for uninsured patients.

“Young adult men are particularly vulnerable [to HPV], because they are starting to age out of pediatric health practices, “Chen added.” Therefore, a multilevel approach that includes gender is needed to address physicians, patients, parents, and community organizations. “

This was said by Gypsyamber D’Souza, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Medscape Medical News that the initial uptake of HPV vaccination was slow in the United States, but that it has advanced in recent years among people in the target age range of 11 to 12 years. “However, vaccination to recover has lagged behind and unfortunately we still see a low uptake at those older ages who are still eligible and where we know there is still a huge benefit,” he said.

D’Souza is a principal investigator of the MOUTH test, which is currently enrolling patients. This trial will examine possible biomarkers of oropharyngeal cancer risk among people with known HPV risk factors who reached adulthood before the vaccine was launched.

He explained that many parents want their children to be vaccinated against HPV after they hear about the vaccine, but because the U.S. health care system is an “opt in” system, rather than an “opt out”, parents they must actively seek vaccination. Children move into adulthood without having received the recommended vaccination course. “There are people who didn’t get vaccinated at the age of 11 and 12 and then forget to ask later, or the provider asks and patients don’t have enough information,” D ‘said. Souza.

He noted that one of the reasons HPV vaccination rates remain low among young adults is that the vaccine is not often kept in stock other than in pediatric clinics. “Because vaccines expire and clinics don’t have a lot of people in this age group getting vaccinated, they may not have them in stock regularly, making it difficult for someone to get vaccinated.” , he said.

The HPV vaccine is not effective in eliminating HPV once a patient acquires the infection, he added. “So adult youth is a critical time when we have people who can still benefit from the vaccine, but if we wait too long, they age outside the ages at which we see maximum effectiveness.”

Ultimately, D’Souza said, clinicians need to catch people at various times and work to remove barriers to vaccination, including letting patients know that HPV vaccination is covered by insurance. “There are many opportunities to prevent future cancers in young adults by getting caregivers in this age group to talk about the vaccine and remember to offer it,” he added.

JAMA. Published online April 27, 2021. Full text

Brandon May is a freelance medical journalist who has written over 900 articles for medical publications in the United States and the United Kingdom. He resides in downtown Brooklyn, New York. Twitter: @brandonmilesmay.

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