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In the News: HPV vaccine has slow entry into public health policy

Photo: CC, Art Writ, VCU CNS, https://flic.kr/p/bmfYzd

It’s been nearly a decade since the human papillomavirus (HPV) vaccination was introduced, yet vaccination rates are still very low. A recent JAMA report showed the HPV vaccine has had a more difficult time making its way into public health policy than other vaccinations.

According to recent data from the CDC, only 37.6 percent of American teenage girls have received the series of HPV vaccinations, and only 13.9 percent of teenage boys. Only two states, Virginia and, as of next month, Rhode Island, require the vaccination for middle school enrollment.

The JAMA report showed the vaccine for chickenpox was required in 21 states and the meningococcal virus vaccine was required in 38 states at the eight-year mark of their releases. Even the hepatitis B vaccine, which similar to HPV, prevents a sexually transmitted infection that causes cancer, was required in 36 states.

So why is the HPV vaccination not more widely accepted?

At the time of its release in 2006, the vaccination was only approved for girls, targeting 11 and 12-year-olds as a way to prevent the sexually transmitted infection that causes cervical cancer. Lacking a vaccine for boys, the HPV vaccine became associated with female sexuality.

The initial language used in policy discussions surrounding the HPV vaccination led people to believe the vaccine would increase sexual activity among young women, says Sarah Gollust, Ph.D., assistant professor in the School of Public Health, in a recent NPR article.

Gollust, along with her colleague Erika Franklin Fowler at Wesleyan University, conducted a comprehensive analysis of news media coverage of the vaccine.“Our research found the news media commonly emphasized political controversy in the first two years following FDA approval of the vaccine in 2006,” said Gollust. “This controversy frame for the HPV vaccine could have effects on how the public, or even health care providers, think about the vaccine.”

Approval for the vaccination for teenage boys came three years after the approval for girls and was not added to the list of recommendations until 2011.

“If they had waited until it was recommended for both boys and girls, perhaps that would have made a big difference,” Gollust said. “No other vaccine is required for just one gender, so it felt like there was something different about this one.”

Gollust says the previous controversy over the vaccination is still lingering, possibly contributing to hesitation among pediatricians to recommend a HPV vaccine involving adolescent sexuality. The recommendation from a doctor is a significant factor in the decision to vaccinate.

“I think the biggest place to push here now is on the provider conversation, having providers discuss the vaccine with their patients as they would discuss any other vaccine,” Gollust said.

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