Uptake of human papillomavirus vaccine stalls in the US

BMJ 2013; 347 doi: (Published 29 July 2013) Cite this as: BMJ 2013;347:f4798
  1. Michael McCarthy
  1. 1Seattle

The proportion of teenage girls in the United States receiving the vaccine against human papillomavirus (HPV) appears to have stalled at a little over 50%, the US Centers for Disease Control and Prevention has reported.1

The report, which appears in the current issue of the CDC’s Morbidity and Mortality Weekly Report, said that from 2007 to 2011 the percentage of girls in the US, aged 13-17 years, who had received at least one of the three recommended doses of the vaccine doubled from 25.1% to 53%, but, then, uptake appeared to stall, increasing to just 53.8% in 2012.

At a press conference to announce the results, CDC director Tom Frieden said, “These national data show no progress, zero, with HPV vaccine coverage in 2012,”

Currently there are two HPV vaccines available in the US, a bivalent vaccine that protects against HPV types 16 and 18, which cause 70% of cervical cancers and the majority of other HPV-associated cancers, and a quadrivalent vaccine that also protects against types 6 and 11, which cause 90% of genital warts. The quadrivalent vaccine accounts for 99% of the vaccine distributed in the US.

The CDC estimated that by increasing the percentage of girls aged 12 years and under receiving all three doses of the vaccine to 80%, an additional 53 000 cases of cervical cancer could be prevented over their lifetimes. But for every year that increases in coverage are delayed, another 4400 women will go on to develop cervical cancer, the CDC said. Currently, only 33.4% of this age group had received all three doses of the vaccine.

Frieden said that the study found that the problem did not appear to be access to healthcare, because most of the teenagers surveyed had gone to see a healthcare provider and had received other vaccines.

In fact, he said, if the HPV vaccine were being administered to unvaccinated girls at the same time they are visiting their healthcare provider to receive another vaccine, the percentage who would have received at least one dose would top 90%.

“We’re dropping the ball. We’re missing opportunities to give HPV vaccines, and that needs to change to protect girls from cervical cancer,” Frieden said.

The CDC found that many parents either did not see the vaccine as necessary or were reluctant to have it administered to their daughters, with one quarter saying they did not intend to have their daughters vaccinated in the coming year.

The top five reasons parents gave for not intending to have their daughters vaccinated were: that the vaccine was not needed (19%); the vaccine had not been recommended (14%); concerns about the vaccine’s safety (13%); lack of knowledge about the vaccine or the disease (12%); and having a daughter who is not sexually active (10%).

Frieden said that it was critical that healthcare providers do a better job educating parents about the need for the vaccine. “Research consistently showed that a provider’s recommendation to vaccinate is the single most influential factor in determining whether a parent gets their kid vaccinated. So we need to step up our efforts by talking to parents about the importance of this vaccine,” he added.


Cite this as: BMJ 2013;347:f4798