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US Adolescent Vaccine Rates Show Modest Improvement

August 30, 2019

By Reuters Staff

NEW YORK (Reuters Health) - Adolescent vaccine rates improved modestly in the U.S. during 2017-2018, but only about half of adolescents are fully up to date with the human papillomavirus (HPV) vaccine series, according to an analysis from the Centers for Disease Control and Prevention (CDC).

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of individuals aged 11-12 years to protect against HPV-associated cancers, meningococcal disease and pertussis and a booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) at age 16 years.

The CDC's Tanja Y. Walker and colleagues analyzed data from the 2018 National Immunization Survey-Teen to estimate vaccination coverage among adolescents in the United States.

Between 2017 and 2018, coverage with tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap) remain stable at about 89%, whereas coverage with at least one dose of MenACWY increased from 85.1% to 86.6% and coverage with at least two doses increased from 44.3% to 50.8%.

The proportion of adolescents that had received at least one dose of HPV vaccine increased from 65.5% to 68.1%, but only 48% of adolescents in 2017 and 51.1% in 2018 were up to date on the HPV vaccine series, the researchers report in the August 23 Morbidity and Mortality Weekly Report.

HPV up-to-date coverage increased among adolescent boys (from 44.3% in 2017 to 48.7% in 2018) but changed little among adolescent girls (from 53.1% to 53.7%).

The proportion of parents who reported receiving a provider recommendation for adolescent HPV vaccination ranged from 59.5% in Mississippi to 90.7% in Massachusetts. And adolescent HPV vaccine coverage (at least one dose) rates were higher among adolescents whose parents reported receiving such a recommendation.

No state met the Healthy People 2020 objective for HPV vaccination (receipt of two or three doses of HPV vaccine by 80% of adolescents aged 13-15 years).

"Although HPV vaccination has resulted in large declines in the prevalence of vaccine type HPV infections among adolescent girls and young adults, as well as decreases in cervical precancers, continuing to improve HPV vaccination coverage for all adolescents, male and female, will ensure they are protected from HPV infection and diseases caused by HPV, including cancers," the authors conclude.

In a related study, Dr. Virginia Senkomago and colleagues at the CDC used data from the U.S. Cancer Statistics to assess the incidence of HPV-associated cancers and to estimate the annual number of cancers caused by HPV during 2012-2016.

During this interval, HPV-associated cancers averaged 43,999 (an incidence of 12.2 per 100,000 persons), with an estimated 79% attributable to HPV.

Of the 34,800 cancers attributable to HPV, 92% (32,100) were attributable to HPV types targeted by the nine-valent HPV vaccine.

"Human papillomavirus causes nearly all cervical cancers and some cancers of the vagina, vulva, penis, anus, and oropharynx," the authors note. "Cervical cancer screening and HPV vaccination can prevent many of these cancers."

"Ongoing surveillance for HPV-associated cancers can inform state-level and national-level HPV vaccination and cervical cancer screening efforts and monitor their long-term impact," they add.

Neither Dr. Senkomago nor Ms. Walker responded to a request for comments.


MMWR 2019

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