Human papillomavirus (HPV) vaccination coverage was low among male adolescents in the US, leaving a large population susceptible to HPV infection maturing into adulthood, according to an analysis of the 2013 National Immunization Survey-Teen data to assess HPV vaccine uptake (≥1 dose) and series completion (≥3 doses) among the study’s 9,554 male participants aged 13 to 17 years. Researchers found:

• HPV vaccination coverage with ≥1 dose was 34.6% and series completion was 13.9%.

• Coverage was significantly higher among non-Hispanic blacks and Hispanics compared with non-Hispanic white male adolescents.

• Having mothers who were widowed, divorced, or separated; having 1 to 3 physician contacts in the past year; a well-child visit at age 11 to 12 years; having 1 or 2 vaccination providers; and living in urban or suburban areas were all associated with a higher likelihood of HPV vaccination.

• Having mothers with some college or college education, a higher family income to poverty ratio, and receiving vaccinations from all sexually transmitted diseases/school/teen clinics or other facilities were associated with a lower likelihood of HPV vaccination.

Citation: Lu PJ, Yankey D, Jeyarajah J, et al. HPV vaccination coverage of male adolescents in the United States. [Published online ahead of print October 26, 2015]. Pediatrics. doi: 10.1542/peds.2015-1631.

Commentary: Clearly we in medicine have not done a great job informing parents about the benefits of this vaccine. In data from the CDC, there were 33,200 cases of HPV-related cancers in the US from 2006-2010. Of these, 20,600 were in females but surprisingly, 12,600 were in males. Cervical cancers were most common in females with oropharyngeal cancers in males. This virus is so ubiquitous that we are not going to be able to keep our teens and young adults away indefinitely. We should not discuss this vaccine as a referendum on teenage sex but instead as a cancer-protecting vaccine. Studies have shown teens that receive this vaccine are no more sexually active than unvaccinated peer controls. We certainly do not discuss sexual transmission in recommending Hepatitis B vaccine for newborns. We should look at barriers in our own offices and clinics that prevent the vaccine to be as easy to get as a flu shot. Our nurses and staff should ask at every teenage/ young adult visit about getting the vaccine. — John Russell, MD