A Head Start for HPV Vaccine: Better Series Completion

By Meghan Knoedler

The Human Papillomavirus (HPV) is the most common sexually transmitted disease (STD), with about 14 million new cases each year.

Surprisingly, this STD is largely asymptomatic but can carry quite a punch. HPV affects both men and women and can cause cervical cancer and other cancers of the genitals, anus, mouth, and throat, all of which can lead to severe disease, disability, infertility or death.

There are currently three different licensed vaccine options for use in girls and boys that protect against and prevent HPV, and using these vaccines routinely could potentially prevent 70% - 90% of cervical cancers. However, for the vaccine to be most effective, the series of 3 vaccines should be completed prior to any sexual activity.

The Centers for Disease Control and Prevention have a target completion rate of 80% for girls aged 13-15 years old. Currently, not even half of girls (40%) aged 13-17 completed the vaccine series, and less than a quarter (22%) of boys complete the series by the same age. Current guidelines recommend beginning the series of three vaccines at 11 to 12 years of age, but give permission to begin the series as early as nine years of age.

A population health study by Jennifer St. Sauver, Ph.D., Associate Professor in Epidemiology in collaboration with Lila Rutten, Ph.D. and Robert Jacobson, M.D. Scientific and Medical Directors, respectively, of the Population Health Science Program within the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery decided to study beginning the vaccination series earlier and the effect of on-time vaccine completion.

They found results that, “Initiating the HPV vaccine series at 9 to 10 years of age was associated with higher rates of on-time vaccination completion — 97 percent — compared to initiating at 11 to 12 years of age — 78 percent…These data suggest that immunization programs that begin vaccination against HPV in children 9 to 10 years could improve the likelihood of on-time HPV series completion.”

Ultimately, with an earlier start of the vaccine, more children have an on-time completion of the HPV vaccine series prior to sexual activity, which results in a greater number of cancers prevented.

The research team will not stop here. They plan to continue to study HPV vaccines to determine if younger age at vaccination alone accounts for improved rates of completion, or if age is a marker for other factors that should be targeted to improve on-time completion. Additionally, the team is looking at different location options for vaccination to see if other non-clinical places (such as schools) to administer vaccines may contribute to higher on-time completion rates.

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Robert Jacobson, M.D.

Lila Finney Rutten, Ph.D.

Robert Jacobson, M.D., and Lila Finney Rutten, Ph.D., lead the Population Health Science Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

Jennifer St. Sauver, Ph.D., is a Health Sciences Researcher, study lead author, and the scientific manager of the Rochester Epidemiology Project. The Rochester Epidemiology Project, through which this research was made possible, is celebrating 50 years in 2016.