Abstract P018: Differences in guideline-recommended age of human papillomavirus (HPV) vaccine initiation and completion in the United States
Authors: Casimir Trinity , Talip Marian F. , Abouelella Dina K. , Nair Mrudula , Rocke Daniel J. , Watts Tammara L. , Osazuwa-Peters Nosayaba , Boakye Eric Adjei 
Published: January 2023

Abstract
Background: While there has been increase in the uptake of the human papillomavirus (HPV) vaccine, current vaccine rate fell short of the Healthy People 2020 target. The Centers for Disease Control and Prevention (CDC) recommends that the vaccine be routinely administered to children between 11 and 12 years and could begin as early as 9 years of age. However, it is unclear to what extent the CDC’s guideline-recommended age of HPV vaccine uptake is followed. Objective: To test the hypothesis that HPV vaccine uptake is more likely at an older age in the United States rather than the CDC recommended age of 11-12 years. Methods: We analyzed the 2017-2020 nationally representative, cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for respondents between 9 and 17 years of age, grouped as 9-10 years, 11-12 years, and 13-17 years. Outcome of interest was age of HPV vaccine uptake (initiation and completion), based on the above age groups. We estimated odds of vaccine uptake by age, using logistic regression models, and adjusted for covariates, including sex, race/ethnicity, income, and healthcare access. Results: There were 2,584 participants in our study. However, while 22% were aged 9-10, only 5.7% in this age group had initiated the vaccine. In crude analysis, there was a significant difference in in age of vaccine uptake (both initiation and completion) across age groups (p &lt; .0001). After adjusting for covariates, we found significant associations between age and HPV vaccine uptake. Compared to participants aged 11-12 years, adolescents aged 13-17 years had over double the odds of initiating (aOR = 2.57; 95% CI 1.88, 3.51) or completing (aOR = 2.67; 95% CI 1.76, 4.06) the HPV vaccine series. However, younger individuals between 9-10 years were less likely to initiate (aOR = 0.14; 95% CI 0.09, 0.22) or complete the vaccine series (aOR = 0.19; 95% CI 0.09, 0.37). Conclusions: While the CDC recommends HPV vaccine uptake between 11-12 years of age and as early as 9 years, individuals are significantly more likely to receive the vaccine as adolescents, and less likely to receive the vaccine between 9-10 years of age. Future studies will determine patients vs. provider factors driving this difference in recommended age of vaccine uptake compared to reported age of uptake.
Citation Format: Trinity Casimir, Marian F. Talip, Dina K. Abouelella, Mrudula Nair, Daniel J. Rocke, Tammara L. Watts, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Differences in guideline-recommended age of human papillomavirus (HPV) vaccine initiation and completion in the United States. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P018.