Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, affecting about 50% of sexually active individuals. HPV encompasses over 200 related viruses, which are classified into low-risk and high-risk categories. In approximately 90% of cases, the immune system clears the infection on its own. Low-risk HPV typically causes warts around the genitals, anus, mouth, or throat. High-risk HPV infections, if not managed effectively, can lead to cancers of the cervix, oropharynx, vagina, vulva, penis, or anus. Each year in the United States, HPV is responsible for approximately 36,000 cancer cases.
The HPV vaccine (Gardasil) was first introduced in 2006 to protect against four strains of the virus. Since 2014, it has been updated to protect against nine strains. The vaccine can prevent up to 90% of cancers caused by HPV. The Centers for Disease Control and Prevention (CDC) recommends starting vaccination at age 11-12, though it can be administered as early as 9 years old. The complete vaccination series includes two doses given six to 12 months apart. Vaccination is recommended up to age 26. For individuals aged 27 to 45, the decision to vaccinate should be made in consultation with a physician to assess potential benefits. For sexually active adults in a long-term monogamous relationship, the likelihood of a new HPV infection is lower.
Girls are more likely to be vaccinated as compared to boys.
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Despite the ongoing recommendation and proven cancer prevention benefits of the HPV vaccine, there are significant disparities in vaccination rates. According to CDC data from 2022, only 38.6% of children aged 9-17 received at least one dose of the vaccine. Girls were more likely to be vaccinated (42.9%) compared to boys (34.6%). Vaccination rates were lowest among children without insurance (20%), with higher rates observed among those with Medicaid (37%) or private insurance (41.5%). Additionally, vaccination rates increased with higher parental education levels and family income. Notably, Hispanic children had significantly lower vaccination rates compared to non-Hispanic white children.
Similar studies have explored vaccination disparities among adults. Analysis of the 2019 National Health Interview Survey, which included adults aged 27 to 45, revealed that female adults had over three times higher odds of being vaccinated compared to males. Hispanic adults were 27% less likely to receive the vaccine compared to non-Hispanic white and non-Hispanic black individuals. Additionally, lower educational levels were associated with reduced odds of receiving the vaccine. For adults without a primary place of care, there was also a lower vaccination rate.
In both the pediatric and adult populations, there are significant disparities in HPV vaccination rates. Factors such as education level, socioeconomic status, and healthcare access highlight broader systematic barriers contributing to vaccine hesitancy. Addressing these gaps in care requires multifaceted strategies. Since HPV-related cancers are largely preventable with the vaccine, it is crucial to overcome these barriers to raise awareness and improve access.
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