Implementing interventions to start HPV vaccination at age 9: Using the evidence we have

Brandt, Heather M.; Footman, Alison; Adsul, Prajakta; Ramanadhan, Shoba; Kepka, Deanna

doi:10.1080/21645515.2023.2180250

Cited by 8 publications

(4 citation statements)

References 77 publications

(66 reference statements)

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“…Vaccination rate change for ages 9–10 exceeded those of ages 11–12 and age 13 in 2020 and 2021 and were comparable to older ages in 2022. Initiation rates for ages 9–10 have been lower than 11–12-year-old rates, 6 , 9 , 30 , 31 highlighting the vast opportunity for QI initiatives in primary and pediatric settings. The HEDIS Immunization Measure for Adolescents (IMA) is the industry benchmark for vaccination by age 13 with 2020 HPV completion rates ranging from 29.2% to 39.9% depending on insurance type.…”

Section: Discussionmentioning

confidence: 99%

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Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

Isher-Witt,

Foley,

Hassan

et al. 2023

Human Vaccines & Immunotherapeutics

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The American Cancer Society collaborated with a range of healthcare partners in 2020–2022 to implement quality improvement clinical interventions with the goal of improving HPV vaccination rates among adolescents’ ages 9–13. 2020 was the first cohort for which partners had been asked to submit HPV rate data for patients’ ages 9–12. At least 80% of the partners across all reported project years were able and willing to report HPV rates for these ages. Partners submitted HPV initiation rates at the beginning and end of the 12-month project year along with project activities, including evidence-based interventions (EBIs) implemented. Mean initiation rates for ages 9–10 significantly increased 4.1% during 2020 compared to non-significant rate increases of 2.6% and 2.0% for ages 11–12 and age 13, respectively. In 2021, ages 9–10 initiation saw a non-significant increase of 2.2%, whereas ages 11–12 and age 13 decreased non-significantly by 0.3% and 0.1%, respectively. The 2022 cohort saw significant initiation rate increases of at least 4% across all ages, potentially a promising result of the myriad back on track HPV vaccination campaigns designed to reverse the damage of the COVID-19 pandemic on adolescent immunizations. These findings demonstrate an effective adaptation of quality improvement in increasing HPV vaccination coverage among younger ages even during a national pandemic.

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Section: Discussionmentioning

confidence: 99%

“…5 Growing evidence suggests myriad benefits to beginning the HPV vaccination series at age 9, ranging from an increased likelihood of on-time completion 6–8 to less stigma around the association with sexual activity and a greater focus on cancer prevention. 9 …”

Section: Introductionmentioning

confidence: 99%

Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

Isher-Witt,

Foley,

Hassan

et al. 2023

Human Vaccines & Immunotherapeutics

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“…Additional trials are underway focusing on the impact of changing only the age at which HPV vaccines are recommended. More comprehensive intervention research, including a focus on drivers of successful implementation, 41 is needed to expand our evidence base for appropriate methodology and systems to improve delivery of HPV vaccination at the first opportunity.…”

Section: Next Steps For Hpv Vaccination At the First Opportunity – Da...mentioning

confidence: 99%

Human papillomavirus vaccination at the first opportunity: An overview

Bednarczyk

Brewer

Gilkey

et al. 2023

Human Vaccines & Immunotherapeutics

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The Advisory Committee on Immunization Practices (ACIP) has recommended human papillomavirus (HPV) vaccination for adolescents in the United States since 2006. Though recommended at a similar time to the routine recommendations for adolescent tetanus, diphtheria, and acellular pertussis vaccination (Tdap) and quadrivalent meningococcal vaccination (MCV4), HPV vaccine uptake has consistently lagged behind these other adolescent vaccines. The ACIP recommends HPV vaccination at 11–12 y, with vaccination starting at 9 y of age included as an option that is routinely encouraged by the American Academy of Pediatrics and American Cancer Society. To support efforts to increase HPV vaccination at the first opportunity, this commentary summarizes the current HPV vaccination recommendations and available evidence regarding HPV vaccination starting at 9 y – including recent studies and trials documenting the effectiveness of HPV vaccination at 9 in supporting vaccine series completion, while providing future directions for research and implementation to improve HPV vaccination.

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“…When HPV vaccination is initiated at 9 to 10 years of age, there is a significant increase in up-to-date (UTD) status by age 13 [ 18 ]. Additional benefits include the consequential spacing of recommended vaccines and an increased emphasis on cancer prevention messaging [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding Barriers to Human Papillomavirus Vaccination among Parents of 9–10-Year-Old Adolescents: A Qualitative Analysis

Agana-Norman,

Martinez Martinez,

Shanmugasundaram

et al. 2024

Vaccines

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HPV vaccination rates remain low among US adolescents, with only 54% completing the series in 2019. The vaccine is recommended at age 11–12 but can be given as early as age 9. Although it has been found that offering the vaccine earlier improves completion rates by age 13, parents remain reluctant to allow their younger children to initiate this vaccine. The purpose of this study was to better understand parental beliefs regarding receipt of the HPV vaccine among their children at ages 9–10. A 40 min phone interview was completed with 21 participants who were asked about their vaccine viewpoints. Even after receiving one-on-one education from a patient navigator, many caretakers expressed inadequate knowledge of the HPV vaccine and limited exposure to both positive and negative influences. The biggest concern was vaccine side effects, often resulting from a lack of medical understanding. Most parents were reluctant to vaccinate their children at a school-based clinic or pharmacy and believed that the government should not mandate HPV vaccination for public school attendance. Our study provides insight into parental beliefs and attitudes about HPV vaccination at age 9–10 years and barriers that need to be addressed.

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Implementing interventions to start HPV vaccination at age 9: Using the evidence we have

Cited by 8 publications

References 77 publications

Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

Age nine is possible: Improving age 9 HPV initiation through a national quality improvement initiative during the COVID-19 pandemic

Human papillomavirus vaccination at the first opportunity: An overview

Understanding Barriers to Human Papillomavirus Vaccination among Parents of 9–10-Year-Old Adolescents: A Qualitative Analysis

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