TRENDS AND ANNUALIZED CHANGES IN HUMAN PAPILLOMAVIRUS (HPV) VACCINATION AMONG ADOLESCENTS IN THE UNITED STATES, 2013-2023
Author(s)
R. Constance Wiener, DMD, PhD1, Hao Wang, MD2, Chan Shen, PhD3, Usha Sambamoorthi, MA, PhD4;
1West Virginia University, Morgantown, WV, USA, 2JPS Healthcare, Dallas, TX, USA, 3Penn State University, Hershey, PA, USA, 4Temple University, Professor, Associate Dean of Health Outcomes Research and AI Innovation, Philadelphia, PA, USA
1West Virginia University, Morgantown, WV, USA, 2JPS Healthcare, Dallas, TX, USA, 3Penn State University, Hershey, PA, USA, 4Temple University, Professor, Associate Dean of Health Outcomes Research and AI Innovation, Philadelphia, PA, USA
OBJECTIVES: HPV vaccination can prevent HPV-related cancers, yet vaccination coverage among U.S. adolescents remains lower than recommended. In addition, uptake has not followed a consistent pattern over time. This study assessed trends and annualized changes in HPV vaccination among U.S. adolescents aged 9-17 years between 2013 and 2023.
METHODS: We conducted a pooled cross-sectional analysis of adolescents aged 9-17 years from National Health and Nutrition Examination Survey (NHANES) data from four cycles: 2013-2014 (n = 1,636), 2015-2016 (n = 1,534), 2017-2018 (n = 1,361), and 2021-2023 (n = 1,695). The analytic sample included 6,226 adolescents with complete HPV vaccination information. All analyses accounted for the complex survey design. Weighted vaccination prevalence was estimated by survey cycle, and trends were analyzed using Rao-Scott chi-square tests and survey-weighted unadjusted and adjusted logistic regressions.
RESULTS: Weighted HPV vaccination prevalence increased from 28.2% in 2013-2014 to 35.1% in 2015-2016, showed little change in 2017-2018 (34.5%), and increased again to 44.1% in 2021-2023 (p < 0.001). Annualized changes varied across periods, with an increase of 3.45% from 2013-2015, minimal change from 2015-2017 (−0.33%), and a subsequent increase of 2.14% from 2017-2022. Overall, vaccination increased at an annualized rate of 1.87% between 2013 and 2023. Relative to 2013-2014, the odds of HPV vaccination were higher in 2015-2016 (OR = 1.38; 95% CI: 1.06-1.78), 2017-2018 (OR = 1.34; 95% CI: 1.03-1.73), and 2021-2023 (OR = 2.01; 95% CI: 1.59-2.53). However, increases were not observed among non-Hispanic Black adolescents, adolescents living in poverty, or those without health insurance.
CONCLUSIONS: HPV vaccination receipt over the past decade followed an uneven pattern, with periods of growth and relative stagnation. Disparities by race/ethnicity, income, and insurance status suggest that targeted public health may be required.
METHODS: We conducted a pooled cross-sectional analysis of adolescents aged 9-17 years from National Health and Nutrition Examination Survey (NHANES) data from four cycles: 2013-2014 (n = 1,636), 2015-2016 (n = 1,534), 2017-2018 (n = 1,361), and 2021-2023 (n = 1,695). The analytic sample included 6,226 adolescents with complete HPV vaccination information. All analyses accounted for the complex survey design. Weighted vaccination prevalence was estimated by survey cycle, and trends were analyzed using Rao-Scott chi-square tests and survey-weighted unadjusted and adjusted logistic regressions.
RESULTS: Weighted HPV vaccination prevalence increased from 28.2% in 2013-2014 to 35.1% in 2015-2016, showed little change in 2017-2018 (34.5%), and increased again to 44.1% in 2021-2023 (p < 0.001). Annualized changes varied across periods, with an increase of 3.45% from 2013-2015, minimal change from 2015-2017 (−0.33%), and a subsequent increase of 2.14% from 2017-2022. Overall, vaccination increased at an annualized rate of 1.87% between 2013 and 2023. Relative to 2013-2014, the odds of HPV vaccination were higher in 2015-2016 (OR = 1.38; 95% CI: 1.06-1.78), 2017-2018 (OR = 1.34; 95% CI: 1.03-1.73), and 2021-2023 (OR = 2.01; 95% CI: 1.59-2.53). However, increases were not observed among non-Hispanic Black adolescents, adolescents living in poverty, or those without health insurance.
CONCLUSIONS: HPV vaccination receipt over the past decade followed an uneven pattern, with periods of growth and relative stagnation. Disparities by race/ethnicity, income, and insurance status suggest that targeted public health may be required.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH40
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Pediatrics, STA: Vaccines