JAMA Pediatrics: Northeast tops HPV uptake, South lowest

JAMA Pediatrics published a cross-sectional study on May 11 finding that HPV vaccine uptake among U.S. adolescents varied sharply by state, even after adjusting for sociodemographic factors. The analysis used 2023 National Immunization Survey-Teen responses from more than 16,000 adolescents ages 13 to 17, according to CIDRAP’s summary of the paper. Several Northeastern states showed higher odds of vaccination than the reference state, Alabama, while multiple Southern states showed lower odds. The paper adds state-level detail to a national picture that has been largely flat. CDC reported that 76.8% of U.S. adolescents ages 13 to 17 had received at least one HPV vaccine dose in 2023, and 61.4% were up to date with the series. CIDRAP said the new JAMA Pediatrics analysis was designed to examine how that national shortfall was distributed across states. (eurekalert.org) ### Which states stood out most in the new analysis? Rhode Island, Massachusetts and New Hampshire were among the states with significantly higher odds of HPV vaccination compared with Alabama, according to the JAMA Pediatrics study summary distributed through EurekAlert. Mississippi, Georgia and Oklahoma were among the states with significantly lower odds, with Kentucky and West Virginia also listed on the low-uptake side. (cdc.gov) Rhode Island had the lowest proportion of unvaccinated adolescents at 8%, while Mississippi had the highest at 39%, according to a report summarizing the study’s state estimates. Oklahoma followed at 36% and Georgia at 35%. CIDRAP separately reported that Massachusetts and Rhode Island adolescents were two to three times as likely as those in Alabama to have received at least one HPV vaccine dose. (eurekalert.org) ### Did the regional pattern hold across every state? New Jersey was a notable exception inside the Northeast, according to CIDRAP’s account of the study. Adolescents there had 52% lower odds of receiving the vaccine despite the region’s broader high-uptake pattern. Virginia was an exception in the South, where adolescents were 75% more likely to get the vaccine than those in Alabama. (conexiant.com) The authors said the mix of high- and low-performing states within the same region pointed to factors beyond geography alone. “The coexistence of high and low HPV vaccination rates within regions underscores the need for further research to understand the underlying factors driving these disparities,” CIDRAP quoted the study authors as writing. (cidrap.umn.edu) ### What exactly does HPV vaccine uptake mean here? The study examined uptake among adolescents ages 13 to 17 using 2023 NIS-Teen data, a CDC survey that collects parent responses and verified provider vaccination records. EurekAlert described the paper as a cross-sectional study of state-level differences in HPV vaccine uptake after adjustment for key sociodemographic factors. (cidrap.umn.edu) CDC recommends HPV vaccination at ages 11 or 12, with vaccination allowed to start at age 9. CDC also recommends vaccination through age 26 for people who were not vaccinated earlier, and says some adults ages 27 through 45 may choose vaccination after discussion with a clinician. ### How does this fit with the broader U.S. vaccination picture? The CDC’s 2023 adolescent coverage report showed HPV vaccination still trailing other routine teen vaccines. (eurekalert.org) In 2023, 89.0% of adolescents had received at least one Tdap dose and 88.4% had received at least one meningococcal conjugate dose, compared with 76.8% for at least one HPV dose. CDC’s 2024 follow-up report showed little movement nationally. (cdc.gov) In 2024, 78.2% of adolescents had received at least one HPV dose and 62.9% were up to date, while the agency said HPV coverage had remained stable for a third consecutive year. ### Why do public health officials track this vaccine so closely? CDC says HPV vaccination can prevent more than 90% of cancers caused by HPV from ever developing. (cdc.gov) The agency recommends vaccinating children before exposure to the virus, which is why the routine schedule centers on ages 11 and 12. The next national benchmark will come with CDC’s future NIS-Teen releases, while the JAMA Pediatrics paper identified state-level gaps that researchers said warrant further study. (cdc.gov) CIDRAP’s May 13 report and the JAMA Pediatrics article provide the named states and comparative estimates at the center of the new analysis. (cidrap.umn.edu) (cdc.gov)