Reaching 80% human papillomavirus vaccination prevalence by 2026: How many adolescents need to be vaccinated and what are their characteristics?

Abstract

Background Human papillomavirus vaccination (HPVV) prevents several types of cancer. The American Cancer Society recently established a goal that by 2026, 80% of adolescents will be up to date (UTD) before their 13th birthday. However, the number in need of vaccination to reach this goal is unknown. This study estimated the number of additional adolescents (11‐12 years old) who need HPVV for 80% prevalence to be reached by 2026. Methods The study used de‐identified and publicly available data and exempt from institutional review board approval and informed consent. The 2016 National Immunization Survey for Teens was used to estimate the baseline HPVV prevalence. Linear growth to 80% HPVV prevalence by 2026 was applied to set intermediate targets. US Census Bureau data were used for population projections. This study estimated the cumulative number of additional adolescents 11 to 12 years old who would need to become UTD (ie, receive 2 doses) by first subtracting the number who would need to be vaccinated to achieve an intermediate target prevalence from the estimated number currently compliant and then summing these numbers between 2018 and 2026. Results Nationwide, an additional 7.62 million males (95% confidence interval [CI], 6.78 million to 8.40 million) and an additional 6.77 million females (95% CI, 5.95 million to 7.55 million), aged 11 to 12 years, would need to receive 2 doses of the vaccine between 2018 and 2026 for 80% prevalence to be achieved. Most adolescents not UTD (80%) also needed to initiate vaccination, and more than 90% recently visited a health care provider. Conclusions It is estimated that at least 14.39 million additional adolescents aged 11 to 12 years in the United States will need to receive 2 doses of HPVV for a UTD HPVV prevalence of 80% to be achieved by 2026. To reach this goal, improvements in facilitators of HPVV initiation, including physician recommendations and parental acceptability, are needed.

Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity

“…Furthermore, improving the availability of affordable healthy food and beverages, especially in neighborhoods with lower SES, is one of several unmet recommendations (47). Additionally, barriers to accessing healthcare hinders a variety of preventive services, including receipt of provider recommendations for smoking cessation in current smokers, weight loss in obese adults, as well as vaccination and screening (12,42,(126)(127)(128). The most recent policy to address barriers to healthcare is the 2010 Affordable Care Act (ACA), which has led to gains in health insurance and the use of some preventive services by expanding dependent insurance coverage, subsidizing insurance through the federal marketplace for individuals with low and medium incomes (100%-400% of the federal poverty levels), expanding Medicaid eligibility to low-income adults in some states, and removing the cost of some preventive services for privately and Medicare insured adults (129)(130)(131)(132)(133).…”

“…The 2015-2016 NHANES data were used to estimate the prevalence of overweight and obesity among adults 20 years based on physical examination data, with a response rate of 54.8% (6). Published data on human papillomavirus (HPV) and hepatitis B virus (HBV) vaccination were obtained from the 2017 NIS-Teen (11); HPV initiation rates were computed using methods described elsewhere (12).…”

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“…A recent study estimated that at least 14.39 million additional adolescents aged 11-12 years would need to receive two doses of the HPV vaccine to reach this goal. 22 Continued efforts are needed to find innovative ways to improve HPV vaccination rates for adolescents in the United States. The ED is often, for a variety of reasons used by parents for non-urgent care of their children 23,24 and an ED presentation may represent an opportunity for HPV vaccination.…”