Overcoming Barriers to Low HPV Vaccine Uptake in the United States: Recommendations from the National Vaccine Advisory Committee: Approved by the National Vaccine Advisory Committee on June 9, 2015

Abstract

National Vaccine Advisory Committee An average of 25,900 cases of human papillomavirus (HPV)-associated cancers are newly diagnosed in the United States each year. 1,2 An estimated 14 million people are newly infected with HPV each year, and nearly half of these infections occur in people aged 14-25 years. 3 Although most infections resolve over time, persistent infection with oncogenic HPV types is associated with a variety of cancers. Virtually all cervical cancers are caused by HPV, along with 90% of anal, 69% of vaginal, 60% of oropharyngeal, 51% of vulvar, and 40% of penile cancers. 1 Furthermore, 87% of anal, 76% of cervical, 60% of oropharyngeal, 55% of vaginal, 44% of vulva, and 29% of penile cancers are caused by oncogenic HPV type 16 or 18. 4 Of the 35,000 HPV cancers reported in 2009 in the United States, 39% occurred in males. 1 Three HPV vaccines are currently available in the United States. One is a bivalent vaccine (designated as HPV2) designed to protect against HPV types 16 and 18, which are responsible for the most HPV-associated cancers. One is a quadrivalent vaccine (HPV4), which protects against HPV types 16 and 18 and two additional types, 6 and 11, that are the most common causes of genital warts. One is a nonavalent vaccine (HPV9) that protects against HPV types 6, 11, 16, and 18, and offers additional protection against five oncogenic HPV types, 31, 33, 45, 52, and 58. To prevent cancers associated with HPV infections, the Advisory Committee on Immunization Practices (ACIP) recommends HPV immunization for all children aged 11 or 12 years with the licensed three-doses series. The ACIP has recommended routine HPV immunization for girls since 2006 and for boys since 2011. 2 Despite ACIP's recommendations, rates of vaccination have remained low. In 2013, initiation rates for the HPV vaccine series were just 57.3% for girls and Public Members

Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy

“…In this way, our findings support the recommendations of the President’s Cancer Panel (2014) and the National Vaccine Advisory Committee (2016), which have endorsed expanding HPV vaccine provision in pharmacies. Extending HPV vaccine delivery to alternative settings is needed because fewer adolescents, compared to younger children, access the medical system for getting preventive care services (National Vaccine Advisory Committee, 2008).…”

“…To address this barrier, the President’s Cancer Panel and the National Vaccine Advisory Committee (NVAC) recommended promoting and facilitating HPV vaccination in pharmacies (President’s Cancer Panel, 2014; National Vaccine Advisory Committee, 2016). Understanding parents’ perspectives on HPV vaccination in pharmacies is an important component of this agenda.…”

A multi-site case study of community-clinical linkages for promoting HPV vaccination

“…11,12 Despite previous HPV vaccination interventions, uptake, and completion of the HPV vaccine series remains a public health challenge. [13][14][15] Innovative and coordinated partnerships between vested stakeholders and implementation of evidence-based prevention strategies in clinical and community settings offers a way to connect these settings. 16 Community-clinical linkages (CCLs), which are "…collaborations between health care practitioners in clinical settings and programs in the communityboth working to improve the health of people and the communities in which they live", 17 build upon this concept by linking community programs and clinical practice settings together, thereby capitalizing on the synergy of these two settings and their collective resources.…”

Correlates of human papillomavirus (HPV) vaccination initiation and completion among 18–26 year olds in the United States

“…4 The oncogenic strains are responsible for 99.7% of cervical cancers and precancerous lesions, as well as 90% of anal cancers, 69% of vaginal, 60% of oropharyngeal, 51% of vulvar, and 40% of penile cancers. 4,5 The Advisory Committee on Immunization Practices (ACIP) recommends routine HPV vaccination for adolescents between 11 and 12 years of age. 6 Catch-up vaccination is also recommended for females aged 13-26 years, for males aged 13-21 years who may have missed the initial vaccine window, and up to 26 years for males immunocompromised or men who have sex with men.…”