Coadministering Recommended Vaccines at 11-to-12-Year Visit Could Improve HPV Vaccination Rates

August 15, 2017

Coadministering Recommended Vaccines at 11-to-12-Year Visit Could Improve HPV Vaccination Rates

  1. Alain Joffe, MD, MPH, FAAP

Only one fourth of eligible 11-year-olds received Tdap, human papillomavirus, and quadrivalent meningococcal vaccinations at the same visit.

  1. Alain Joffe, MD, MPH, FAAP

Although the Centers for Disease Control and Prevention recommends administration of tetanus–diphtheria–acellular pertussis (Tdap), human papillomavirus (HPV), and quadrivalent meningococcal (MenACWY) vaccines at age 11 to 12 years, HPV vaccination rates lag behind those of the other two.

Investigators used data from a large U.S. commercial medical claims database to study vaccination patterns among more than 1.5 million adolescents who turned age 11 between 2009 and 2014, had not had a previous Tdap/HPV/MenACWY vaccine, and had at least 1 year of follow-up data.

During a median follow-up of 16 months, 56% of adolescents received at least one vaccination; 18% received HPV, 52% Tdap, and 46% MenACWY. Coadministration occurred in nearly all adolescents (92%) receiving only Tdap and MenACWY but in only one fourth of those receiving all three vaccines. On average, adolescents were older when they received HPV vaccine (age, 11.8 years) compared with either Tdap or MenACWY (age, 11.2 years). Those who had a primary care visit in the prior year had approximately 45% higher rates of Tdap and MenACWY vaccination but only a 20% higher rate of HPV vaccination.

Comment

These data suggest that significant opportunity exists for increasing timely adolescent HPV vaccination rates by concurrently administering all three vaccines at the 11-to-12-year well-adolescent visit. As a cancer prevention vaccine, HPV vaccine is not qualitatively different from the Tdap and MenACWY vaccines and so should not be deferred. The message to parents is straightforward: “Your child needs three important vaccines today.” Providers can also point out that starting the HPV vaccine series at age 11 will eliminate the need, cost, and discomfort of a third dose.

Editor Disclosures at Time of Publication

  • Disclosures for Alain Joffe, MD, MPH, FAAP at time of publication Editorial boards JAMA Pediatrics

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