Poor and Minority Teens Less Likely to Finish HPV Vaccine Series

Increases in vaccination rates for human papillomavirus (HPV) are trailing increases in rates for two other vaccines recommended for teens and preteens, according to data from the Centers for Disease Control and Prevention.

Coverage rates for the other two vaccines —Tdap, which protects against tetanus, diphtheria and pertussis, and MenACWY, which protects against meningococcal meningitis—are continuing to increase, but vaccination rates for HPV vaccine remain low, the study found. HPV infection can lead to cervical cancer, but vaccination dramatically reduces this risk.

The study in CDC’s Morbidity and Mortality Weekly Report drew on data from the 2010 National Immunization Survey-Teen.

“More U.S. teens are being protected against these serious, and sometimes deadly, diseases,” said Anne Schuchat, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases.  “However, the HPV results are very concerning.  Our progress is stagnating, and if we don’t make major changes, far too many girls in this generation will remain vulnerable to cervical cancer later in life.  Now that we have the tools to prevent most cervical cancers, it is critical that we use them.”

About 6 million people become infected with HPV each year, and the CDC reports that every year, about 12,000 women will be diagnosed with cervical cancer. CDC recommends HPV vaccine for 11- or 12-year-old girls to protect against the types of HPV that cause cervical cancer and also recommends teenage girls who have not yet been vaccinated with HPV vaccine complete the vaccination series. HPV vaccines are given in three doses (as shots) over six months. To ensure the highest level of protection, girls must complete all three shots.

The CDC NIS-Teen survey found:

• Coverage for the three routine teen vaccines was 49 percent for one dose of HPV vaccine; 63 percent for MenACWY; and 69 percent for Tdap vaccine.
• For girls who received the recommended three doses of HPV vaccine, coverage increased 5.3 points to 32 percent over the previous year.
• Hispanics had higher coverage for one dose of MenACWY and HPV, but third-dose HPV coverage lagged for blacks and Hispanics compared with whites.  Girls living in poverty were also less likely to complete the HPV series.
• Coverage increases for HPV were less than half of the increases seen for Tdap (13.3 points) and meningitis (9.1 points) vaccines.

Continued improvements in MenACWY and Tdap are important. With 27,550 cases of pertussis reported in 2010 – 4,858  in 11- to 18-year-olds – it is critical that preteens get their Tdap vaccine. “This one-time dose of Tdap can prevent pertussis infection,” said Dr. Schuchat.  “Also, preteens and teens who get vaccinated with MenACWY are protecting themselves from an infection that can lead to lifelong disability – or, in some cases, death in 48 hours or less. Let’s make sure all teens are protected.”

Dr. Schuchat stressed that any visit to the doctor—such as annual health checkup or physicals for sports, camp, or college—can be a good time for preteens and teens to get the recommended vaccinations.  By making sure all recommended vaccines are given at every opportunity, coverage for all the teen vaccines could increase substantially.

Families who may need help paying for vaccines should ask their health care provider about the Vaccines for Children program, which provides vaccines at no cost to uninsured children younger than 19 years. For help in finding a local health care provider who participates in the program, parents can call 800-CDC-INFO or go to www.cdc.gov/vaccines.

The CDC has conducted the National Immunization Survey-Teen since 2006. This survey of more than 19,000 teens aged 13-17, is similar to the standard NIS which began collecting immunization information in 1994 among children 19 through 35 months old.  The NIS-Teen is a random telephone survey of parents or caregivers, followed by verification of records with health care providers. The survey estimates the proportion of teens aged 13 through 17 years who have received the three recommended adolescent vaccines, as well as three of the recommended childhood vaccines, by the time they are surveyed.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES