Objective:

To assess the timing of HPV vaccination in relation to sexual debut among adolescents.

Approach:

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.

Sources:

• JAMA Pediatrics
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