Very Few States Require HPV Vaccine

Only 2 US states require the human papillomavirus (HPV) vaccine for adolescents. As a result, HPV vaccination coverage is well below the Healthy People 2020 goal of 80%.

The HPV vaccine is currently required in only Virginia and Washington, DC, with Rhode Island joining the duo this August. This contrasts greatly with the varicella vaccine, which is required in all states; the hepatitis B vaccine, which is required in 47 states and DC; and the meningococcal vaccine, which is required in 29 states and DC.

Consequently, US Centers for Disease Control and Prevention (CDC) data reveal that only 37.6% of girls and 13.9% of boys received the 3-dose HPV series in 2013. But in an exclusive interview with Pharmacy Times, study author Jason L. Schwartz, PhD, MBE, of Princeton University said pharmacists can help improve these lacking vaccination rates.

“Pharmacists can play an important role in the success of HPV vaccination efforts by reminding parents or guardians of adolescents to learn more about the vaccine and its benefits,” Dr Schwartz said.

“If all health care professionals communicate a common, clear message in support of routine, on-time HPV vaccination, the disappointing rates observed thus far are likely to improve substantially in the years ahead.”

Dr. Schwartz and his co-authors maintained that school requirements have traditionally helped promote high vaccination rates for other immunizations. When the first HPV vaccine was approved back in 2006, however, proponents decided it would be a better move to focus on “supply, safety, financing, and education” before pushing for requirements.

The researchers examined 3 other vaccines for adolescents—hepatitis B, varicella, and meningococcal conjugate—and identified when a requirement took effect in each state, plus DC. The time frame of the requirements ranged from 1990 to March 15, 2015, and included those with later effective dates.

In particular, the researchers studied how long it took states to enact requirements after a recommendation from the CDC Advisory Committee on Immunization Practices was published in the Morbidity and Mortality Weekly Report. Those publication dates were 1991 for hepatitis B, 1996 for varicella, 2005 for meningococcal, and 2007 for HPV.

The average time it took a state to enact a requirement was 6 years and 7 months for hepatitis B, 6 years and 1 month for varicella, and 4 years and 10 months for meningococcal conjugate. While very few states require the HPV vaccine, those that do took an average of 4 years and 2 months to adopt their requirement.

The researchers posited that the 3 doses required for the HPV vaccine could pose challenges for vaccination uptake.

With the recent FDA approval of the 9-valent HPV vaccine, the researchers suggested further discussion is needed about strategies to promote higher vaccination rates and encourage more states to adopt requirements.