Sexual Activity–Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Concerns persist about sexual disinhibition after human papillomavirus (HPV) vaccination of preteenage girls. Self-reported surveys have indicated few anticipated behavior changes after HPV vaccination. Little is known about sexual activity-related clinical outcomes after HPV vaccination. WHAT THIS STUDY ADDS:Utilizing managed care organization electronic data, we evaluated the incidence of adverse outcomes of sexual activity among vaccinated preteenage girls and found little difference between those who received HPV vaccine and those who did not. abstract OBJECTIVE: Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to selfresponse biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity-related clinical outcomes after adolescent vaccination. METHODS:We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care-seeking behavior and demographic characteristics. RESULTS:The cohort included 1398 girls (493 HPV vaccine-exposed; 905 HPV vaccine-unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccineexposed girls relative to HPV vaccine-unexposed girls (adjusted incidence rate ratio:

Correlation of HPV Vaccination Status and Sexual Behavior: A Study of Adolescent and Young Women in Greece

“…Both answers reflect a more responsible attitude to sex and indicate that the motive to be vaccinated was not promiscuity but rather an act of caution. Bednarczyk et al [29] have shown that vaccinated girls 11-12 have not any increased risk of pregnancy, STD or contraceptive counselling a finding that is supported by other studies [30]. In our study the vaccinated population started sex earlier after having discussed it with their mothers and doctors significantly more common than non-vaccinated.…”

Countering Vaccine Hesitancy

“…49 Reassuring parents that the vaccine is safe and that there is no evidence that HPV vaccine increases sexual activity may dispel their concerns. 50 Some parents are concerned primarily about the pain associated with immunizations. Strategies to reduce pain include administering vaccines quickly without aspirating, holding the child upright, administering the most painful vaccine last, and e5…”

Parents’ perceptions of the HPV vaccine: a key target for improving immunization rates

“…This found no clinically meaningful difference between the vaccine exposed group compared to the vaccine unexposed group [13]. Liddon et al also examined this issue in a nationally representative survey and found no association between receipt of the HPV vaccine and being sexually active or having more sexual partners [14].…”