HPV Vaccine School Entry Requirement in Puerto Rico: Historical Context, Challenges, and Opportunities

Effect of Hurricane Maria on HPV, Tdap, and meningococcal conjugate vaccination rates in Puerto Rico, 2015–2019

“…This fast catch-up in vaccination might be attributed in part to the efforts conducted before the disaster. In June 2017, the Secretary of Health announced that the vaccine was going to be required for school entry for children aged 11–12 years for the fall of 2018; the official requirement was implemented in August 2018 7 . The establishment of this public policy could have lessened the effect.…”

“…The HPV vaccine is an important adolescent’s vaccines to monitor. In the last decade, the HPV vaccine has led to an outstanding partnership among academic, clinical, and community-based organizations, 7 intending to promote vaccine uptake due to the disparate burden of cervical and other HPV-related cancers in the island. 8 Since 2006, the Advisory Committee on Immunization Practices (ACIP) recommended as part of the routine vaccination for girls aged 11–12 years, later in 2009 included in guidelines the use of this vaccine in males.…”

Esfuerzos realizados en Puerto Rico hacia la consolidación de políticas públicas para la prevención de cánceres asociados al VPH

“…Por otro lado, a pesar de los eventos climáticos, renuencia hacia la vacuna y potenciales barreras socio políticas antes y durante la implementación de este requisito escolar, se observó un potencial aumento en la tasa de vacunación contra VPH. Un análisis preliminar utilizando los datos del Registro de Inmunización de Puerto Rico del 2017 y 2019, se observó un aumento de 54,0% en la tasa de iniciación de esta vacuna entre jóvenes de 11 a 12 años de edad ( 30 ). No obstante, el efecto de la pandemia en las tasas de iniciación y cumplimiento de la serie de vacunación contra VPH aún se desconoce.…”

The adoption of the HPV vaccine school-entry requirement in Puerto Rico: How practical lessons can inform future vaccine policies

“…The HPV vaccine has proven to be a safe and effective tool to prevent HPV-related cancers (e.g., cervical, vulvar, anal, penile, oropharyngeal); yet, in 2020, only about 59 % of adolescents were up-to-date in receiving their vaccination series ( Pingali et al, 2021 ). Factors such as vaccine hesitancy caused by myths and misinformation surrounding the HPV vaccine ( Rositch et al, 2022 ), lack of strong provider recommendation ( Healy et al, 2022 ), and an absence of political will ( Abiola et al, 2013 , Barraza et al, 2016 ) have resulted, in part, in a limited number of states/territories (i.e., Virginia, Rhode Island, Washington DC, Puerto Rico, and Hawaii) adopting HPV vaccine school-entry requirements ( Barraza et al, 2016 , Colón-López et al, 2021b , State of Hawaii Department of Health, 2020 , Vázquez-Otero et al, 2021a ).…”

“…In part due to Puerto Rico (PR) having high HPV vaccination rates, in June 2017, PR’s Department of Health (DOH) announced that the HPV vaccine would be added to the list of school-entry required vaccines for fall 2018 ( Colón-López et al, 2021b , Vázquez-Otero et al, 2021a ). Subsequently, in May 2018, the DOH formally announced that the HPV vaccine would be required for 11 to 12-year-old children starting during the 2018–2019 academic year ( Colón-López et al, 2021b , Vázquez-Otero et al, 2021a ). As established by PR’s Immunization Law of 1983, only medical or religious exemptions are permitted.…”