Presentation (CTI)

OBJECTIVES: Vaccination against human papillomavirus (HPV) is the key to reducing HPV-related diseases and cancers. This study’s objective was to (1) estimate initiation of the HPV vaccine among Kentucky Medicaid beneficiaries who had not received HPV vaccination in previous years and (2) assess vaccination rate differences by age, sex, and ethnicity and inform policy strategies to improve equitable vaccine uptake.
METHODS: A retrospective cohort study was conducted using Kentucky Medicaid administrative data from 2011 to 2022. For each measurement period (calendar year), beneficiaries were included if they were enrolled in Medicaid and had no record of HPV vaccination in the look-back period (the previous year). HPV vaccine initiation was defined as receipt of a first HPV vaccine dose during the measurement period. Annual counts and percentages of first-dose initiation were calculated overall and stratified by age group (9-26 and ≥27 years), sex, and ethnicity (Hispanic, Non-Hispanic). All percentages reflect initiation among individuals eligible for first-time HPV vaccination.
RESULTS: Between 2011 and 2022, 216102 Medicaid beneficiaries who were not HPV vaccinated in previous years received their first HPV vaccine dose (0.76%). Initiation occurred predominantly among beneficiaries aged 9-26 years (210393; 2.42%), while initiation among those aged ≥27 years was lower (3054; 0.02%). Among females who were not vaccinated previously, 113639 initiated vaccination (0.77%), compared with 104,206 males (0.75%). Hispanic beneficiaries who were not vaccinated in earlier years had higher initiation (14,020; 1.44%) than Non-Hispanic beneficiaries (202082; 0.73%). Across demographic groups, initiation increased over time.
CONCLUSIONS: Among Kentucky Medicaid beneficiaries vaccine initiation was concentrated in the recommended age range of 9-26 years and remained rare at older ages. Differences by sex and ethnicity persisted. These findings highlight the importance of targeted, age-appropriate, and culturally informed interventions to promote HPV vaccine initiation and reduce disparities.