To assess the timing of HPV vaccination in relation to sexual debut among adolescents.
Key Findings:
79% of adolescents completed the HPV vaccination series prior to sexual debut.
12% of adolescents remained unvaccinated prior to sexual activity.
70% of those unvaccinated prior to sexual debut remained unvaccinated later.
Missed opportunities were more common among non-Hispanic White and commercially insured adolescents.
Clinics that initiated HPV vaccination at age 9 had lower rates of missed opportunities.
Interpretation:
Missed vaccination opportunities may be linked to physician recommendation practices, family decision-making, and clinic processes rather than access to healthcare.
Limitations:
Cross-sectional design limits causal inference.
Reliance on self-reported sexual activity may affect accuracy.
Data derived from a single region may limit generalizability.
Conclusion:
Earlier initiation of HPV vaccination and improved clinical workflows are essential to reduce missed opportunities and enhance cancer prevention among adolescents.
