HPV Vaccine Uptake in Males: An Assessment of Vaccination Coverage from Immunization Information System (IIS) Sentinel Sites

BACKGROUND:  In 2009, the Advisory Committee on Immunization Practices (ACIP) issued guidance that the Quadrivalent HPV vaccine may be given to males aged 9-26.  In October 2011, ACIP recommended routine HPV vaccination of males aged 11 or 12 years and of males 13-21 years who were not previously vaccinated.  IIS are a tool that can be used to provide timely estimates of adolescent vaccination coverage. IIS Sentinel Site project grantees provide quarterly vaccination coverage data from their Sentinel jurisdictions. Data from 8 sites participating in the IIS Sentinel Site Project were used to provide HPV coverage estimates for males aged 11-18 from October 2009-September 2012.

METHODS:  Calculations of HPV vaccination coverage estimates (≥1 dose) for Quarter 4 of 2009 (October-December 2009), Quarter 4 of 2011 (October-December 2011) and for 2012 (January- September 2012) were calculated using aggregate data from 11-18 year olds residing in all areas of Michigan, Minnesota, New York City, and North Dakota and geographic subsets of adolescents in Arizona, Colorado, Oregon, and Wisconsin. Coverage estimates for 3 doses were also calculated for 2012 (January-September 2012).  Additional measures include weekly doses administered, observation of changes in weekly dose distribution, and age of first vaccination for males post ACIP recommendation change.

RESULTS:  

Aggregate data from approximately 1.5 million adolescent males per quarter were included for analysis.  Coverage in males increased gradually since the 2009 ACIP guidance that vaccine may be used in males. By December 2009 0.3% percent of males age 11-18 received ≥1 doses of HPV vaccination. Coverage increased to 5.8% by December 2011 (at the time of the routine recommendation).  By September 2012, 12.3% of males aged 11-18 years received ≥1 dose of HPV and  2.7% received 3 doses. Among vaccinated males aged 13-15, 27.2% received their first dose between 11-12 years of age.  The number of doses administered to males surpassed the number of doses administered to females for 13-15 year olds in 5 of 8 sites and for 16-18 year olds in 6 of 8 sites by September 2012.

CONCLUSIONS:  

HPV vaccination coverage in males has increased since the ACIP recommendation for routine use but is far below target levels.  Continued efforts to increase provider participation and maintain adolescent participation in the IIS will allow for the continued use of the IIS in the monitoring of HPV vaccination coverage.