Why is the HPV vaccine completion rate so low?

hpv vaccine papilloma virus low completion rate (laboratory of tumor virus biology)

The completion rate for the human papillomavirus (HPV) vaccine series remains alarmingly low 7 years after its introduction in the US, say researchers at the University of Texas Medical Branch (UTMB). A series of three studies, published in Cancer, Human Vaccines & Immunotherapeutics and Vaccine used data from the 2010 National Health Interview Survey to show that more than 75% of nearly 2,000 women aged 18-26 in the US did not receive the HPV vaccine, 10% were incompletely vaccinated, and about two-thirds said they didn't want the vaccine. On top of this, just 2% of nearly 3,000 males aged 9-17 started the vaccine, and only 0.5% completed the three dose-series during 2010.

One study, published in Cancer, examined health insurance company records of 271,976 female patients aged nine and older. The study showed that of the females who received the first dose of the HPV vaccine between 2006 and 2009, just 38.2% received all 3 doses within 365 days. In most age groups, especially the 9-12 and 13-18 age groups, this represented a marked drop in the proportion of females completing the vaccine series in 2009 compared to 2006.

These results might be a bit of a shock to some – they certainly surprised me.

Why is the HPV vaccine uptake in the US so low, and possibly dropping?

Well, cost will certainly be a barrier, especially for those who are not insured or have a low income. The researchers, however, cite a lack of awareness and understanding about the vaccine to be the biggest obstacles. Another study, by the Mayo Clinic and recently published in Paediatrics, showed that more than 2 in 5 parents in a survey believed the HPV vaccine was unnecessary. 5 years ago, 40% of parents surveyed said they wouldn't vaccinate their daughter against HPV. In 2010, that figure rose to 44%.

Parents are also becoming increasingly concerned about potential side effects, reports the study. The parents surveyed were more concerned about HPV vaccine safety than other vaccines in the survey, with 16% of parents concerned about the safety of the HPV vaccine but only 1% concerned about the safety of Tdap and MCV4.

How do we improve these figures for the years to come? Improved educational interventions are necessary, say researchers. They suggest that new physician-patient communication methods, increased physician recommendations, and public vaccine financing programs might help increase uptake and completion rates for the HPV vaccine. Perhaps parents need to be better educated that all three shots are required for protection

You can read more about approaching risk perception, vaccine hesistancy and behaviour by downloading a free presentation by Mary Appleton, presented at the World Vaccine Congress Lyon 2012. Download the presentation here >

Why do you think the HPV vaccine uptake in the US is low? What do you suggest to improve the initiation and completion rates?

You can join our discussion on LinkedIn or leave a comment below, I'd love to hear what you think.

If you'd like to know more about strategy and innovation in vaccines, you might like to consider attending the World Vaccine Congress and Expo 2013 on the 16-18 April 2013, Gaylord National Hotel and Convention Center, Washington DC. You can download the brochure here.

Comments 2

  1. Glen

    There are at least three major reasons for the low uptake – one, while there’s high recognition of cervical cancer, this isn’t a highly visible or urgency health issue for adolescents for whom vaccination is recommended; two, the recommended for adolescent males isn’t perceived by most parents as necessary or important (e.g., it helps prevent relatively rare diseases or protect future sex partners); and three, the vaccine brings high costs, both financial and in terms of commitment (i.e., three vaccination visits). The result is an overall perception by most parents and guardians that the costs and risks (however small) aren’t worth the benefit.

  2. Tony Rush

    I think there’s a strong streak of anti-intellectualism in our country that keeps a lot of otherwise-intelligent people from doing smart things.

    We see it every day when people rail about “the dangers of vaccines” or believe the urban legends about how MMR vaccines cause autism (they don’t).

    In other words, if these same people (and Facebook) had existed 100 years ago, we’d see people refusing to take the smallpox vaccine because of something they read on Facebook….

    …and we’d see millions of people dying from that preventable disease.

Leave a Reply

Your email address will not be published. Required fields are marked *