HPV Vaccination Among Young Adults in the US

Abstract

The human papillomavirus (HPV) vaccine was approved for females in 2006 and males in 2009 for the prevention of anogenital cancer and warts. The indications were expanded in 2020 to include the prevention of oropharyngeal cancer, which is more common in males. 1 The Advisory Committee on Immunization Practices recommends routine vaccination with 2 doses at age 11 to 12 years, with catch-up vaccination at age 13 to 26 years (limited to age 13-21 years from 2011 to 2019 for males). 2 If the first dose occurs after age 15 years, a 3-dose series is recommended. 2 HPV vaccination rates are closely tracked and monitored for adolescents (aged 13-17 years). 3 However, little is known about vaccination rates in young adults, who are more likely to make health care decisions for themselves but less likely to access preventive services or be insured. 4 Our objective was to assess HPV vaccination among young adults in the US.

Effects of Religious Practice and Teachings about Sexual Behavior on Intent to Vaccinate against Human Papillomavirus

“…These findings clarify some of the earlier work on religiosity and HPV [ 12 , 13 , 14 , 15 , 21 ] by taking a two-step approach to how religiosity affects vaccination intent. We explored how religiosity impacts other factors that lead to vaccination decision making, specifically in the context of Christianity in America.…”

“…Despite HPV vaccines having proven effectiveness and an acceptable safety profile, the vaccination rate in the United States is low. Recent estimates of adolescent (ages [11][12][13][14][15][16][17] vaccination coverage show that 41.9% of females and 28.1% of males have completed a vaccination series [10]. The reported vaccination rates for young adults are even lower than adolescents.…”

“…The study also found that 4% of females and 3% of males initiated vaccination between ages 18 and 21. In comparison, 68.1% of adolescents have received one or more doses [ 12 ]. Young adults have more control over health decisions than adolescents but may have less access to health care services, be unaware they did not receive the vaccine, or not actively seek medical care because they believe themselves to be healthy.…”

“…Young adults have more control over health decisions than adolescents but may have less access to health care services, be unaware they did not receive the vaccine, or not actively seek medical care because they believe themselves to be healthy. If the HPV vaccination series is not initiated as an adolescent, the series is less likely to be completed [ 12 ]. There are many factors that could impact HPV vaccine uptake, including access to vaccination, health care provider recommendations, parental attitudes, religiosity, risk of infection, vaccine mandates, or sexual activity.…”

Predictors of Anal High-Risk HPV Infection Across Time in a Cohort of Young Adult Sexual Minority Men and Transgender Women in New York City, 2015–2020

“…Although we did not detect an association between vaccination and hrHPV infection, the lack of vaccine initiation and completion continues to create a risk state for SMM and TW across their sexual lifespans. Low rates of vaccination among SMM and TW may be attributed to population-specific factors such as limited knowledge within the community; limited communication from health care providers about sexual behaviors, sexual orientation, and HPV vaccination; and low perceived threat of HPV, including gendered misconceptions about HPV risk ( Gerend et al, 2019 ; Jaiswal et al., 2020 ; Meites et al., 2022 ; Nadarzynski et al, 2014 ; Wheldon et al, 2018 ), alongside overall lagging rates of vaccination among people assigned male at birth ( Chen et al, 2021 ; Preston & Darrow, 2019 ). Efforts to vaccinate members of this population must be ongoing, especially in light of the upper age range being expanded to 45 (with shared clinical decision-making) and findings that a two-dose series of the nonavalent HPV vaccine can confer sufficient protection if initiated at an early age, prior to 15 ( Meites et al, 2019 ).…”