Despite a slight increase in the number girls and boys ages 13–17 receiving a human papillomavirus (HPV) vaccine since 2012, approximately one third of parents of girls and over half of parents of boys reported that their child’s clinician had failed to recommended the HPV vaccination during office visits. These results from the 2013 National Immunization Survey-Teen (NIS-Teen) were published in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

Currently the quadrivalent (HPV4) and bivalent (HPV2) vaccines are approved in the United States to protect against HPV types 16 and 18 that cause 70% of cervical cancers. In addition, the HPV4 vaccine also protects against HPV types 6 and 11 that cause 90% of genital warts. The Advisory Committee on Immunization Practices (ACIP) has recommended HPV vaccination in adolescent girls at ages 11 or 12 years since 2007, one year after the availability of the vaccine, and the HPV4 vaccine for adolescent boys at 11 or 12 years of age. In this study, an analysis of vaccination records revealed that the percentage of adolescents receiving ≥1 dose of HPV vaccine rose 3.5% in 2013 compared to the previous year for girls and 13.8% for boys. Fifty-seven percent of the adolescent girls surveyed had received ≥1 dose of the vaccine and 34.6% for adolescent boys. The study also evaluated missed opportunities for HPV vaccination, in which the adolescent received at least one vaccine but not the first dose of the HPV vaccine. At age 13 years the percentage of unvaccinated girls with at least one missed opportunity for HPV vaccination ranged from 9.3% (CI=8.1–10.8%) for the 1994 birth cohort to 83.7% (CI=77.8–88.2%) for the 2000 birth cohort. Vaccine coverage with ≥1 dose of HPV vaccine could have reached 91.3% (CI=87.9–93.8%) by age 13 years for the 2000 birth cohort if all missed opportunities had been eliminated, a 44.5 percentage-point difference from the actual coverage level.

Parental reports of a recommendation for the HPV vaccine from their clinician increased for parents of both girls and boys compared to the previous year (64.4% vs. 61.0 and 41.6% vs. 28.0%, respectively). Parents of vaccinated adolescents were more likely to have received a recommendation compared to parents of unvaccinated adolescents (girls 73.7% vs. 52.0%, boys 71.7% vs. 25.7%). The most commonly cited reasons by parents for not vaccinating their child included lack of knowledge and the belief that the vaccine was unnecessary; 22.8% of parents of adolescent boys and 13% of parents of adolescent girls said that the lack of recommendation from their clinician was the main reason for no HPV vaccination.

The CDC plans to continue its efforts to educate both parents and clinicians on the importance of the HPV vaccine, particularly to protect against vaccine-preventable, HPV-associated cancers.

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