In the Journals

Recommendation for routine HPV4 vaccination leads to increased uptake

Advisory Committee on Immunization Practices recommendations for routine quadrivalent HPV vaccination appears to have increased uptake among boys in the eligible age group, according to recently published data.

“There is a general awareness regarding women and HPV, but many people don’t know that men are also susceptible to the cancers tied to HPV,” Rulin C. Hechter, MD, PhD, of the Kaiser Permanente Southern California department of research and evaluation, told Infectious Disease News. “It’s important to track HPV4 vaccine uptake among boys and ensure they receive the vaccine, particularly since research has shown that the HPV4 vaccine produces the highest immune response at ages 11 to 12 and is most effective if given before exposure to the virus.”

Using electronic medical records, Hechter and colleagues examined boys aged 9 to 17 years who were enrolled in Kaiser Permanente Southern California health plans during new ACIP routine HPV4 recommendations in 2011. Participants were categorized into age groups indicating those who were of HPV4 (Gardasil, Merck) vaccination age during permissive use recommendation for genital warts (cohort one; Oct. 21, 2009 to Dec. 21, 2010), recommendation for anal cancer (cohort two; Dec. 22, 2010 to Oct. 24, 2011) and recommendation for routine use (cohort three; Oct. 25, 2011 to May 31, 2013). Sociodemographic information, health care utilization and HPV4 uptake data were analyzed, and associations between these variables were identified using Poisson regression.

There were 297,703 boys included in cohort one, 357,384 boys in cohort two and 345,348 boys in cohort three. Cohorts were similar in age and race, more than 70% had a pediatrician as their primary care provider, and roughly 25% were ever enrolled in a Medicaid program.

Although HPV4 series initiation increased over time, the greatest increase was observed with implementation of the routine use recommendation in cohort three. Uptake rates were highest among boys within the targeted age range of 11 years to 12 years after implementation, and those with a pediatrician as their assigned PCP had higher uptake across all cohorts. Initiation was associated with the receipt of influenza vaccination during the previous year among all cohorts, as well as with nonwhite race after the recommendation for routine vaccination.

“It is essential that primary care providers begin to educate young boys and their parents about the risks associated with HPV and the preventive measures that are available,” Hechter said. “Although our study did not explore the types of conversations PCPs are having with boys and their parents, it is important to ensure PCPs are armed with the appropriate information and resources to be able to talk about the HPV4 vaccine and its benefits.” – by Dave Muoio

Disclosure: The researchers report no relevant financial disclosures.

Advisory Committee on Immunization Practices recommendations for routine quadrivalent HPV vaccination appears to have increased uptake among boys in the eligible age group, according to recently published data.

“There is a general awareness regarding women and HPV, but many people don’t know that men are also susceptible to the cancers tied to HPV,” Rulin C. Hechter, MD, PhD, of the Kaiser Permanente Southern California department of research and evaluation, told Infectious Disease News. “It’s important to track HPV4 vaccine uptake among boys and ensure they receive the vaccine, particularly since research has shown that the HPV4 vaccine produces the highest immune response at ages 11 to 12 and is most effective if given before exposure to the virus.”

Using electronic medical records, Hechter and colleagues examined boys aged 9 to 17 years who were enrolled in Kaiser Permanente Southern California health plans during new ACIP routine HPV4 recommendations in 2011. Participants were categorized into age groups indicating those who were of HPV4 (Gardasil, Merck) vaccination age during permissive use recommendation for genital warts (cohort one; Oct. 21, 2009 to Dec. 21, 2010), recommendation for anal cancer (cohort two; Dec. 22, 2010 to Oct. 24, 2011) and recommendation for routine use (cohort three; Oct. 25, 2011 to May 31, 2013). Sociodemographic information, health care utilization and HPV4 uptake data were analyzed, and associations between these variables were identified using Poisson regression.

There were 297,703 boys included in cohort one, 357,384 boys in cohort two and 345,348 boys in cohort three. Cohorts were similar in age and race, more than 70% had a pediatrician as their primary care provider, and roughly 25% were ever enrolled in a Medicaid program.

Although HPV4 series initiation increased over time, the greatest increase was observed with implementation of the routine use recommendation in cohort three. Uptake rates were highest among boys within the targeted age range of 11 years to 12 years after implementation, and those with a pediatrician as their assigned PCP had higher uptake across all cohorts. Initiation was associated with the receipt of influenza vaccination during the previous year among all cohorts, as well as with nonwhite race after the recommendation for routine vaccination.

“It is essential that primary care providers begin to educate young boys and their parents about the risks associated with HPV and the preventive measures that are available,” Hechter said. “Although our study did not explore the types of conversations PCPs are having with boys and their parents, it is important to ensure PCPs are armed with the appropriate information and resources to be able to talk about the HPV4 vaccine and its benefits.” – by Dave Muoio

Disclosure: The researchers report no relevant financial disclosures.