Presentation (CTI)

OBJECTIVES: The incidence of HPV-associated oropharyngeal cancer has surged globally, and the United States (US) has updated its HPV vaccination guidelines to include age-expanded recommendations, particularly shared clinical decision-making. The study assessed HPV vaccine initiation and completion among US young and older adults aged 45 and older and examined Behavioral Risk Factor Surveillance System (BRFSS) data from 2017-2022.
METHODS: A multivariable logistic regression was used to estimate the odds of HPV vaccination and completion, with 95% confidence intervals. The Andersen’s Behavioral Model of health services was incorporated to categorize the socio-demographic variables.
RESULTS: A predominantly lower proportion of vaccinated adults were above 45 years old, with lower odds of HPV vaccination declining with aging. Prior to the pandemic era, more than half of individuals who were either unvaccinated or initiated but never completed the vaccine series were White Non-Hispanics, individuals employed, insured, or in the South region, and adults who never binge drink. Specifically, a higher percentage of these unvaccinated adults were males, adults aged 35 years and above, married, and had no HIV testing. Adults with lower odds of HPV vaccination were found across all age groups, Non-Hispanic Blacks, and other Non-Hispanics, those living outside the center city within a Metropolitan Statistical Area, and those in the South or Midwest, and those who had last medical routine checkups within 5 years or more during and after the pandemic era.
CONCLUSIONS: The findings suggest inclusion of individuals above 45 years in age-expanded initiatives aimed at utilizing health services and access to promote HPV vaccination uptake and coverage among other adults, men, individuals of Non-Hispanic ethnicity, adults in South and Mid-West, are crucial to reducing the burden of HPV-related diseases in US population.