Examining Low HPV Vaccination Rates

Examining Low HPV Vaccination Rates

Human papillomavirus (HPV) vaccination among adolescents aged 11 or 12 has been shown to be effective and is recommended as a routine primary prevention strategy to reduce many HPV-related cancers. However, data indicate that HPV vaccination coverage is low for adolescents. Examining Coverage To better understand HPV vaccination coverage rates in the United States, the CDC partnered with the National Committee on Quality Assurance (NCQA) to evaluate the rate of vaccination among more than 626,000 girls at age 13 who were enrolled in commercial health insurance plans or Medicaid in. “NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) houses data on performance measures for important healthcare issues that are reported by health insurance plans,” explains Shannon Stokley, MPH. “The HEDIS HPV Vaccine for Female Adolescents performance measure evaluates how many members of a given health plan have received the complete, three-dose HPV vaccination series by the age of 13.” Stokley and colleagues found that although health plan performance on HPV coverage varied by plan type, overall performance was low. Commercial plans provided all three doses of the HPV vaccine to a median of 12% of adolescent girls by age 13, with rates ranging from 0% to 34%. The authors observed little difference in performance by plan size, and the highest-performing plans were health maintenance organizations. Although Medicaid plans reported a significantly higher rate of coverage, these plans provide all three doses of the vaccine to only 19% of girls by age 13, with coverage ranging from 5% to 52% among the various plans. Next Steps “Other reports have shown that vaccination coverage rates for the tetanus, diphtheria, and pertussis...

Recommendations for Cervical Cancer Screening

In 2012, the United States Preventive Services Task Force (USPSTF) updated screening recommendations for cervical cancer. According to the update, an annual Pap smear is not necessary to prevent deaths from cervical cancer. Screening for cervical cancer is recommended in women aged 21 to 65 with cytology every 3 years. Screening every 3 years starting at age 21 saves the same number of lives as annual screening, but with half the number of colposcopies and fewer false-positive tests. For women aged 30 to 65 who want to lengthen the screening interval, screening with a combination of cytology and HPV testing every 5 years is recommended.  “It’s important to balance benefits and potential risks associated with screening.” The USPSTF recommends against screening for cervical cancer in women younger than age 21 and in women older than age 65 who have had adequate prior screening and are not otherwise at high risk for cervical cancer. It also recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion or cervical cancer. Screening for cervical cancer with HPV testing, alone or in combination with cytology, is not recommended in women younger than 30. Women who have been vaccinated against HPV infection should be screened in accordance with age-specific recommendations for unvaccinated women. Women who have an abnormal Pap test but negative HPV test can have a Pap test alone in 3 years or co-testing in 5 years. If a Pap test is negative but HPV is positive, women can be screened again with...