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Study highlights state-level differences in HPV vaccine uptake
Chris Dall, MA
51 minutes ago.
Human Papillomavirus (HPV)
Childhood Vaccines
Adult (non-flu) Vaccines
A new study shows wide state-level variation in the uptake of the human papillomavirus (HPV) vaccine.
The study, which analyzed data from the 2023 National Immunization Survey-Teen (NIS-Teen), found that states in the Northeast census region had significantly higher odds of HPV vaccine uptake, while states in the South had significantly lower odds. But even within regions, there was wide variability.
In the Northeast, for example, adolescents aged 13 to 17 in states like Massachusetts and Rhode Island were two to three times more likely than the reference state (Alabama) to receive at least one dose of the HPV vaccine. But teens in New Jersey had 52% lower odds of receiving the vaccine. And while most of the South underperformed, teens in Virginia were 75% more likely to get the vaccine.
“The coexistence of high and low HPV vaccination rates within regions underscores the need for further research to understand the underlying factors driving these disparities,” the study authors wrote.
Nationwide uptake has been suboptimal
The benefits of HPV vaccines have become abundantly clear since the first licensed vaccine, Gardasil, was approved in 2006. According to a new evidence review conducted by the Vaccine Integrity Project, an initiative of the University of Minnesota’s Center for Infectious Disease Research and Policy (publisher of CIDRAP News), HPV vaccines have reduced the risk of cervical cancer by 80% in women vaccinated by age 16 and by 66% in those vaccinated after 16. The review also found no association with severe side effects.
HPV is the most common sexually transmitted infection globally, and it’s the primary cause of cervical cancer and cancers of the vagina, vulva, penis, anus, and oropharynx (middle part of the throat). At least 79 million Americans are infected with at least one type of HPV.
The Centers for Disease Control and Prevention (CDC) in 2006 recommended the HPV vaccine for girls aged 11 to 12 and extended that recommendation to boys in 2011. But uptake in the United States has been lower than what public health officials would like to see. According to a previous analysis of the 2023 NIS-Teen survey by CDC researchers, only 61.4% US teens aged 13 to 17 were up to date with the full schedule of the HPV vaccine, below the 80% national target set by the Department of Health and Human Services, which oversees the CDC.
The coexistence of high and low HPV vaccination rates within regions underscores the need for further research to understand the underlying factors driving these disparities.
Uptake in the South has long been lower than in other parts of the country. In the new analysis, published earlier this week in JAMA Pediatrics, researchers wanted to get a better understanding of state-level uptake. To assess the probability of HPV vaccine uptake across states, they analyzed 2023 NIS-Teen responses from the parents of 16,057 adolescents.
After adjusting for age, sex, race and ethnicity, insurance status, and household poverty level, they found that states in the Northeast consistently had the highest odds of HPV vaccine uptake, including Rhode Island (adjusted odds ratio [OR], 3.05), Massachusetts (OR, 2.19), and New Hampshire (OR, 1.72). States in the South—including Mississippi (OR, 0.41), Georgia (OR, 0.45), and Oklahoma (OR, 0.46)—consistently had the lowest.
States in the Midwest and West were generally better performers compared with the reference, though Nevada (OR, 0.60), Idaho (OR, 0.66), and Alaska (OR, 0.68) were outliers. The authors said the existence of low-performing states within regions with high uptake, and vice-versa, underscores “the limitations of regional analyses alone.”
Insights could help identify barriers, effective interventions
Lead study author Chinenye Lynette Ejezie, PhD, MPH, an assistant professor in the department of health sciences at Towson University, told CIDRAP News that identifying low-performing states allows researchers and policymakers to “conduct a deeper investigation into the underlying reasons for low HPV vaccine uptake.”
“These may include barriers related to health care access, socioeconomic conditions, cultural beliefs, political factors, misinformation, provider practices, or state-level policies,” Ejezie said. “Understanding these contributing factors can help stakeholders develop more targeted and effective interventions tailored to the specific needs of each state.”
Understanding these contributing factors can help stakeholders develop more targeted and effective interventions tailored to the specific needs of each state.
At the same time, she added, highlighting high-performing states could help researchers and policymakers identify factors and strategies that have driven higher uptake and adapt them to improve vaccination rates in low-performing states.
“This, in turn, can improve equitable access to the HPV vaccine and contribute to lower rates of HPV infection and HPV-related cancers nationwide,” she said.
Study highlights state-level differences in HPV vaccine uptake
Chris Dall, MA
51 minutes ago.
Human Papillomavirus (HPV)
Childhood Vaccines
Adult (non-flu) Vaccines
A new study shows wide state-level variation in the uptake of the human papillomavirus (HPV) vaccine.
The study, which analyzed data from the 2023 National Immunization Survey-Teen (NIS-Teen), found that states in the Northeast census region had significantly higher odds of HPV vaccine uptake, while states in the South had significantly lower odds. But even within regions, there was wide variability.
In the Northeast, for example, adolescents aged 13 to 17 in states like Massachusetts and Rhode Island were two to three times more likely than the reference state (Alabama) to receive at least one dose of the HPV vaccine. But teens in New Jersey had 52% lower odds of receiving the vaccine. And while most of the South underperformed, teens in Virginia were 75% more likely to get the vaccine.
“The coexistence of high and low HPV vaccination rates within regions underscores the need for further research to understand the underlying factors driving these disparities,” the study authors wrote.
Nationwide uptake has been suboptimal
The benefits of HPV vaccines have become abundantly clear since the first licensed vaccine, Gardasil, was approved in 2006. According to a new evidence review conducted by the Vaccine Integrity Project, an initiative of the University of Minnesota’s Center for Infectious Disease Research and Policy (publisher of CIDRAP News), HPV vaccines have reduced the risk of cervical cancer by 80% in women vaccinated by age 16 and by 66% in those vaccinated after 16. The review also found no association with severe side effects.
HPV is the most common sexually transmitted infection globally, and it’s the primary cause of cervical cancer and cancers of the vagina, vulva, penis, anus, and oropharynx (middle part of the throat). At least 79 million Americans are infected with at least one type of HPV.
The Centers for Disease Control and Prevention (CDC) in 2006 recommended the HPV vaccine for girls aged 11 to 12 and extended that recommendation to boys in 2011. But uptake in the United States has been lower than what public health officials would like to see. According to a previous analysis of the 2023 NIS-Teen survey by CDC researchers, only 61.4% US teens aged 13 to 17 were up to date with the full schedule of the HPV vaccine, below the 80% national target set by the Department of Health and Human Services, which oversees the CDC.
The coexistence of high and low HPV vaccination rates within regions underscores the need for further research to understand the underlying factors driving these disparities.
Uptake in the South has long been lower than in other parts of the country. In the new analysis, published earlier this week in JAMA Pediatrics, researchers wanted to get a better understanding of state-level uptake. To assess the probability of HPV vaccine uptake across states, they analyzed 2023 NIS-Teen responses from the parents of 16,057 adolescents.
After adjusting for age, sex, race and ethnicity, insurance status, and household poverty level, they found that states in the Northeast consistently had the highest odds of HPV vaccine uptake, including Rhode Island (adjusted odds ratio [OR], 3.05), Massachusetts (OR, 2.19), and New Hampshire (OR, 1.72). States in the South—including Mississippi (OR, 0.41), Georgia (OR, 0.45), and Oklahoma (OR, 0.46)—consistently had the lowest.
States in the Midwest and West were generally better performers compared with the reference, though Nevada (OR, 0.60), Idaho (OR, 0.66), and Alaska (OR, 0.68) were outliers. The authors said the existence of low-performing states within regions with high uptake, and vice-versa, underscores “the limitations of regional analyses alone.”
Insights could help identify barriers, effective interventions
Lead study author Chinenye Lynette Ejezie, PhD, MPH, an assistant professor in the department of health sciences at Towson University, told CIDRAP News that identifying low-performing states allows researchers and policymakers to “conduct a deeper investigation into the underlying reasons for low HPV vaccine uptake.”
“These may include barriers related to health care access, socioeconomic conditions, cultural beliefs, political factors, misinformation, provider practices, or state-level policies,” Ejezie said. “Understanding these contributing factors can help stakeholders develop more targeted and effective interventions tailored to the specific needs of each state.”
Understanding these contributing factors can help stakeholders develop more targeted and effective interventions tailored to the specific needs of each state.
At the same time, she added, highlighting high-performing states could help researchers and policymakers identify factors and strategies that have driven higher uptake and adapt them to improve vaccination rates in low-performing states.
“This, in turn, can improve equitable access to the HPV vaccine and contribute to lower rates of HPV infection and HPV-related cancers nationwide,” she said.