Durham, NC—Have there been racial and ethnic disparities in the update of the HPV vaccine in adults?
In 2018, the FDA expanded the age of eligibility for the HPV vaccine to 27 to 45 years. “However, it is unclear if there are racial/ethnic disparities in HPV vaccine uptake for this age-group following this expanded recommendation,” wrote the Duke University–led researchers. “We aimed to identify any disparities in HPV vaccine in 27- to 45-year-olds based on sociodemographic factors.”
The study team analyzed nationally representative, cross-sectional data from the 2019 National Health Interview Survey using 9,440 responses. The results were published in the journal Human Vaccines & Immunotherapeutics.
The participants were mostly non-Hispanic whites (60.7%) and females (50.9%), according to the report.
“In adjusted models, females had over three times greater odds of vaccine uptake compared to males (aOR [adjusted odds ratio] = 3.58; 95% CI 3.03, 4.23). Also, compared to non-Hispanic whites, Non-Hispanic blacks were 36% more likely (aOR = 1.36; 95% CI 1.09, 1.70), and Hispanics were 27% less likely (aOR = 0.73; 95% CI 0.58, 0.92) to receive the vaccine,” the authors wrote. “Additionally, individuals without a usual place of care had lower odds of vaccine uptake (aOR = 0.72; 95% CI 0.57, 0.93), as were those with lower educational levels (aORhigh school = 0.62; 95% CI 0.50, 0.78; aORsome college = 0.83; 95% CI 0.70, 0.98).”
The study concluded that disparities exist in HPV vaccine uptake among 27- to 45-year-olds, with adult Hispanics having lower odds of receiving the vaccine. “Given the vaccine’s importance in cancer prevention, it is critical that these disparities are addressed and mitigated,” the researchers pointed out.
Background information in the article noted that HPV is the leading sexually transmitted infection in the United States and that 85% of sexually active individuals will be infected at some point in their lifetime.
“There are over 100 subtypes of HPV, and at least 40 of these can spread through direct contact via vaginal, anal, or oral sex and cause infection,” according to the study. “Nine out 10 of these infections clear within 2 years, but lingering HPV infections can lead to precancers, anogenital cancers, oropharyngeal cancers, and genital warts.”
The researchers also advised that at least 44,000 new cases of HPV-associated cancers are diagnosed in the U.S. each year, adding, “Furthermore, rates of HPV-associated oropharyngeal cancers have been increasing for the past 40 years, and currently there are no screening tests for early detection. Hence, primary prevention through vaccination is critical.”
The nonavalent vaccine was initially approved for individuals aged 9 to 26 years, but the FDA expanded the age range for eligibility to individuals aged 27 to 45 years, and the Advisory Committee on Immunization Practices followed in 2019 by recommending the vaccine for this age group based on shared clinical decision-making with a provider. “Although it is likely that most individuals in this age group have been exposed to some HPV subtypes, many may remain protected against some HPV subtypes covered by the nonavalent vaccine, thereby mitigating risk for developing some HPV-associated malignancies,” the authors wrote.
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