Study: Moving HPV vaccine initiation to age 9 or 10 could improve ... - Healio

February 28, 2023

2 min read

Source/Disclosures

Disclosures: Goodman is employed by Merck. Please see the study for all other authors' relevant financial disclosures.

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Routine HPV vaccination rates could be improved if children were vaccinated earlier, according to a new study.

The CDC recommends routine HPV vaccination in the U.S. at ages 11 or 12 years but says the vaccine can be given as early as age 9 years.

Elizabeth Goodman, MD, MBA, a researcher at Merck's Center for Observational and Real-World Evidence, told Healio that she and her colleagues studied whether or not initiating HPV vaccination at ages 9 to 10 years had a positive impact on the HPV series completion when compared with initiation at ages 11 to 12 years.

"Completion rates among young people in the U.S. have remained stubbornly suboptimal — 61.7% among 13- to 17-year-olds in 2021, well below the Healthy People 2020 target of 80%," Goodman said. "Any action resulting in higher completion rates before HPV exposure and infection has the potential to increase the public health benefits of vaccination. Since the likelihood of HPV exposure increases as adolescents age, the goal is to vaccinate children prior to HPV exposure."

Goodman and colleagues assessed data from the National Immunization Survey-Teen 2017-2020, comprising 19,575 15- to 17-year-olds who initiated HPV vaccination between the ages of 9 to 12 years.

Ultimately, early initiators were more likely to complete the vaccination series by ages 13 (74% vs. 31.1%, P < .001) and 15 (91.7% vs. 82.7%, P < .001) years but less likely to complete within 3 years (82.3% v.s 84.9%, P = .007).

According to Goodman, although the researchers did not have "specific expectations" for what the study would show, they hypothesized that earlier age of initiation would lead to stronger series completion rates in early and mid-adolescence.

"The findings suggest this is because of increased time between initiation and the target completion age, what we called the 'time pathway' in the paper," Goodman said. "We had thought that, in addition to the time pathway, changing the developmental stage by moving initiation from early adolescence, or ages 11 to 12 years, to late childhood, or ages 9 to 10 years, what we called the 'development pathway,' would be one way that earlier initiation could impact completion, but the data did not support that mechanism of action."

The researchers ultimately concluded that moving HPV vaccination recommendations to age 9 and 10 could improve coverage rates.

"While more research is needed in this area, this study provides physicians with helpful information as they consider when to begin discussing HPV vaccination," Goodman said. "We are always interested in additional research that might help inform the scientific community on the potential impact of HPV vaccination to both individual and public health."

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