HPV Vaccine Underused Despite ACA Access

The Centers for Disease Control and Prevention (CDC) announced on July 24, 2014 that the number of teenagers and preteens who are vaccinated against human papilloma virus (HPV) remains unacceptably low, even though the vaccine is covered as a preventive service and its value has been established. The CDC urges health care practitioners to make strong recommendations to parents that both boys and girls be vaccinated against HPV when they discuss meningococcal and tetanus, diphtheria and pertussis (TDAP) vaccines, which also are administered to adolescents and preadolescents. The CDC estimates that 57 percent of adolescent girls and 35 percent of adolescent boys have received at least one dose of the vaccine. About 38 percent of adolescent girls have received all three doses, up from one-third in 2012.

What is HPV?

HPV is the most common sexually transmitted virus. About 14 million people in the United States are infected with HPV each year. According to the CDC, 80 percent of women have been infected with HPV by age 50. HPV often has no symptoms. In addition to causing genital warts in both males and females, HPV infection causes cervical, vaginal, and vulvar cancers in women, penile cancer in men, and cancers of the anus and the oropharynx, which includes the back of the throat, base of the tongue and tonsils, in both sexes. About 20,000 women and 12,000 men develop HPV-related cancer each year.

The HPV Vaccines

There are two vaccines that offer protection against HPV-related cancers. Each must be given in three doses, the second two months after the first and the third four months later (six months after the first). According to the CDC, both HPV vaccines have been studied extensively and found to be safe. After the administration of 67 million doses, the CDC has received about 25,000 reports of adverse events—health occurrences that may or may not be related to the vaccination—and 8 percent were considered serious. There may be an increased risk of fainting, according to one study. Other commonly reported side effects include headache, fever, dizziness, nausea, and redness or swelling in the area of the vaccination.

Practitioners’ Recommendations

The CDC’s 2013 national survey found that preteens and teens were much more likely to receive the HPV vaccine when their health care practitioners recommended it to the parents. Among parents who had their daughters vaccinated, 74 percent said their daughters’ physicians had recommended it. In contrast, 52 percent of parents who did not have their daughters vaccinated said the physicians had recommended it. The physician recommendations may be even more effective for boys; 72 percent of parents whose sons were vaccinated against HPV received a doctor’s recommendation to do so, while only 26 percent of those who did not vaccinate their sons had been advised to do so.

Coverage Gap

Adolescents between the ages of 13 and 17 years were most likely to have received the TDAP vaccination (86 percent) and were very likely to have received at least the first of two doses of meningococcal vaccine (77.8 percent). 2013 was the first year that the number of teens who received the second dose of meningococcal vaccine was tracked; the CDC found that 29.6 percent of teens who received the first dose by age 16 received the second dose in 2013.

The CDC notes that the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) has increased access to preventive services, including HPV vaccination, making it easier and less expensive than ever for parents to have their children vaccinated.