Studies Find Interventions Increase HPV Vaccine Coverage

Three recent studies have found that interventions increase the rates of human papillomavirus (HPV) vaccination among teens and young women. The HPV vaccine series is recommended for routine use in girls and boys aged 11 to 12 years, in young women up to age 26, in young men up to age 21, and in men up to age 26 who have sex with other men and those with compromised immune systems. However, the HPV vaccine series has the lowest completion rates of any other vaccine.

In one study, researchers reviewed the literature on the effectiveness of practice and community-based interventions to increase HPV vaccine rates in the U.S. Intervention approaches included reminder and recall, physician-focused interventions (e.g., audit and feedback), school-based programs and social marketing (using multiple approaches). Seven studies used a randomized design, and eight used quasiexperimental approaches (one used both). Thirteen studies included girls, and two studies included boys. The studies were conducted in a variety of populations and geographic locations. Twelve studies reported significant increases in at least one HPV vaccination outcome, one reported a nonsignificant increase, and one reported mixed effects. The researchers concluded that future efforts to increase HPV vaccination rates in the U.S. should focus on programs that can be implemented within healthcare settings such as reminder and recall strategies and physician-focused efforts, as well as the use of alternative community-based locations such as schools.¹

In another study, researchers found that patients aged 9 years to 18 years were almost three times more likely to start the HPV vaccine series and 10 times more likely to complete it if their health providers received prompts during an appointment alerting them the patient was due for a shot during an appointment. Patients aged 19 years to 26 years were six times more likely to start the vaccine and eight times more likely to complete the series. And, rates were significantly higher for young African-American women.²

Finally, in a third study, researchers examined how the Affordable Care Act provisions implemented in 2010 that require insurance plans to offer dependent coverage to people aged 19 to 25 years and to provide targeted preventive services with zero cost-sharing affected the use of the HPV vaccine, which is among the most expensive of recommended vaccines, among young women. Using data from 2008 through 2012 from the National Health Interview Survey, they estimated that the 2010 policy implementation increased the likelihood of HPV vaccine initiation and completion by 7.7 percent and 5.8 percent, respectively, for women aged 19 years to 25 years relative to a control group of women aged 18 years to 26 years. The estimates translate to approximately 1.1 million young women initiating and 854,000 young women completing the vaccine series.³