Conclusions
HPV infections cause nearly 26,000 cases of cancer in the U.S. and more than 600,000 cases worldwide each year. Two safe, effective vaccines can prevent infections with HPV types most commonly associated with cancer. In the United States, these vaccines have been recommended by ACIP for adolescent girls since 2006 and for adolescent boys since 2011.* However, HPV vaccine uptake lags behind that of other adolescent vaccines, leaving millions of young people vulnerable to infection with this cancer-causing virus.
Increasing HPV vaccine uptake in the United States should be a public health priority. Successes in other countries and in parts of the United States indicate that this goal is achievable. Targeted interventions are needed to ensure timely progress. In this report, the Panel outlined a multipronged strategy for accelerating U.S. HPV vaccine uptake. All stakeholders in the National Cancer Program should work together and with stakeholders focused on vaccines to promote and facilitate HPV vaccination as an urgent national priority.
Key to increasing HPV vaccination in the U.S. is reducing missed clinical opportunities. If all providers strongly recommend HPV vaccines to age-eligible patients, including those receiving other vaccines, uptake of HPV vaccines should increase dramatically. Systems changes should be made, as necessary, to support this recommendation. Also, parents and adolescents should be provided with information about HPV-associated diseases and vaccines so they can make informed decisions. In addition, they should be able to obtain vaccines at convenient locations and from a wider range of providers, including pharmacists.
Although the Panel's charge is focused on the U.S. National Cancer Program, the Panel recognizes the role of the United States in supporting cancer control efforts in other parts of the world, particularly low- and middle-income countries. Moreover, especially in the case of infectious diseases, what happens in one country may influence the health of another. HPV vaccines have the potential to reduce the significant burden of cervical cancer and other HPV-associated cancers in these countries. The United States should continue to collaborate with global partners and find ways to support development of HPV vaccine programs around the world.
Continued research on HPV-associated cancers and HPV vaccines is needed to ensure that messages regarding vaccination are effective and that current vaccines are used optimally. Evidence that one or two doses are effective likely would result in major increases in HPV vaccine uptake. Next-generation vaccines that offer broader protection and/or logistical advantages should be pursued. Research is needed to determine how best to integrate HPV vaccination and cervical cancer screening.
The Panel is committed to achieving the vision of increased HPV vaccine uptake. In that spirit, the Panel suggests that a credible organization, such as NVAC, be given responsibility for monitoring the status of uptake and implementation of these recommendations. That accountability, in combination with the Panel's commitment to monitor implementation of recommendations outlined in this report, will increase the likelihood that the report and its recommendations will become agents for change. The ultimate goal is reduction, or even elimination, of preventable HPV-associated cancers in the United States and around the world. This is a goal around which all major cancer and vaccine-related organizations should rally. It is achievable and within our reach.
Footnotes
* The ACIP recommendation for males is for Gardasil® only.
