HPV vaccination: are we initiating too late?

Area of Science:

• Public Health
• Vaccinology
• Adolescent Medicine

Background:

• Human papillomavirus (HPV) vaccination is recommended for early adolescent females.
• Limited data exist on age-based variability and clinical relevance of HPV vaccination initiation delays.
• Characterizing HPV vaccination delay is crucial for improving public health outcomes.

Purpose of the Study:

• To characterize HPV vaccination delay among adolescent and young adult females.
• To examine age at HPV vaccination initiation and missed opportunities for the first dose (HPV1).
• To identify predictors of timely vaccination and trends in age at HPV1 receipt.

Main Methods:

• Retrospective cohort study of 22,900 females aged 11-26 years between 2007-2011.
• Analysis of age at HPV vaccination initiation and missed opportunities for HPV1.
• Multivariable logistic regression and generalized linear mixed models used to assess predictors and trends.

Main Results:

• The proportion of 11-12 year-olds initiating HPV vaccination increased from 44.4% in 2007 to 74.5% in 2011.
• Mean age at HPV1 receipt remained stable around 15.9-16.0 years.
• Majority of unvaccinated subjects missed vaccination opportunities; prior sexual activity and morbidity were noted in a subcohort.

Conclusions:

• Low-income, minority females frequently delayed HPV vaccination initiation.
• Many demonstrated prior sexual experience and associated morbidity, increasing HPV-related complication risk.
• Timely HPV vaccination and reduced missed opportunities are essential.