In the newest issue of JAMA, a recently study has come out showing that only two states in the United States require the human papillomavirus vaccination. This is significantly lower than other vaccines that are associated with sexual transmission, such as hepatitis B.
It has been eight years since the human papillomavirus vaccine was recommended for adolescents in the United States, with coverage well below the Healthy People 2020 target, which was 80 percent. The Center for Disease Control and Prevention showed that just 38 percent of girls and 14 percent of boys, who were all adolescents, had completed the three-dose series in 2013. There have been a lot of efforts recently to emphasize just how important the human papillomavirus vaccine is, and that it should not be treated any differently than other recommended vaccinations.
The lead authors of the study were Jason L. Schwartz, Ph.D., M.B.E., and Laurel A. Easterling, both from Princeton University. They examined the timing and presence of state requirements for vaccinations, with relevance to adolescent health, and then compared that to the implementation of the human papillomavirus vaccine. The vaccines in the study were the same ones used by the Center for Disease Control and Prevention to evaluate the adolescent vaccination that were added since 1990. The new vaccines protected against hepatitis B, varicella meningococcal conjugate, and human papillomavirus. The researchers noted the earliest dates of a requirement, if applicable, for each vaccine in every state, and included D.C. These vaccinations would be for any child, adolescent or college-aged person. 47 states and Washington D.C mandated a hepatitis B vaccine, with all 50 states and D.C requiring the varicella vaccine, and 29 states and D.C required the meningococcal vaccine. The HPV vaccination was only required in 2 states and D.C. Virginia and D.C required the HPV vaccination by March 2015, with Rhode Island joining in August 2015.
When you compare this to the hepatitis B vaccination, eight years after the recommendation, 36 states and D.C had required the vaccination. The varicella vaccine was required in 38 states plus D.C and the meningococcal conjugate vaccine was required in 21 states plus D.C. The HPV vaccine is sitting at 1 state plus D.C in the same time frame after the recommendation. It is not clear why there has not been a more widely implemented policy regarding the HPV vaccine, unless it has to do with the contentious climate surrounding required vaccines for children and adolescents, which has been a hot topic for the past several years.
The bigger issue is that HPV is such a common sexually transmitted disease that if you are not given the vaccine by age 27, most doctors think you already have it, which means it’s almost impossible to get at that age. HPV can be silent, which means you might have the disease and not actually show the warts, and then you can transmit that your partner and never know it. This is why it’s so important for adolescents to get the HPV vaccine before they become sexually active, since it’s estimated that 80 percent of adults over 30 have the disease. HPV itself is not a huge deal for men, except for the genital warts, but for women, certain strains of the virus can cause cervical cancer, and can also lead to fertility issues. It is not yet known if other states will be requiring the vaccination, but the authors of the study hope more states begin talking about the need for the vaccination.