Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;13(5):730-738.
doi: 10.1007/s11764-019-00791-9. Epub 2019 Jul 24.

Suboptimal uptake of human papillomavirus (HPV) vaccine in survivors of childhood and adolescent and young adult (AYA) cancer

Sharon M Castellino  1   2 , Kristen E Allen  3 , Katherine Pleasant  4 , Graham Keyes  5 , Katherine A Poehling  5   4 , Janet A Tooze  4   6
Affiliations

Suboptimal uptake of human papillomavirus (HPV) vaccine in survivors of childhood and adolescent and young adult (AYA) cancer

Sharon M Castellino et al. J Cancer Surviv. 2019 Oct.

Abstract

Purpose: To estimate the population-based incidence of HPV vaccination after childhood cancer.

Methods: Pediatric and young adult cancer survivors identified in the institutional Comprehensive Cancer Center registry were linked to the North Carolina Immunization Registry (NCIR). Initiation and completion of any HPV vaccine was evaluated in survivors born between 1984 and 2002 with an NCIR record by December 2014. Descriptive statistics and Kaplan-Meier estimates of cumulative incidence were stratified by sex and age at eligibility for vaccine. Cox proportional hazards were conducted and stratified by sex.

Results: Among 879 (n = 428 female; n = 451 male) study-eligible cancer survivors without prior HPV vaccination (n = 501 < 18 years, n = 378 ≥ 18 years at the time of eligibility), the cumulative incidence of HPV vaccine initiation following cancer therapy was 48.1% among females at 8.2 years and 29.2% among males at 5.0 years after vaccine eligibility among those < 18 years, and 6.2% among females at 8.1 years and 2.0% among males at 4.2 years after vaccine eligibility among those ≥ 18 years. Among those who initiated vaccination, 53% of females and 43% of males completed a 3-dose series. Younger age at cancer diagnosis (≤ 10 and 11-14 years vs. ≥ 15 years) and shorter interval from diagnosis to vaccine eligibility were more likely to initiate vaccination in models adjusted for age at eligibility, race/ethnicity, cancer type, relapse, and transplant.

Conclusions: Despite the benefit of a cancer prevention strategy, cancer survivors are sub-optimally vaccinated against HPV.

Implications for cancer survivors: Immunization registries can help oncologists and primary care providers identify gaps in vaccination and target HPV vaccine delivery in survivors.

Keywords: Adolescent and young adult (AYA) cancer survivor; Childhood cancer; Human papilloma virus (HPV) vaccine; Immunization registry; Vaccine-preventable disease.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest Dr. Castellino receives research funding from Bristol Meyers Squibb for an observational study not relevant to this work. Dr. Poehling received research funding for observational studies from the National Institutes of Health and MedImmune for an observational study not relevant to this work. The remaining authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Cumulative incidence of human papillomavirus (HPV) vaccine initiation among childhood and adolescent and young adult (AYA) cancer survivors, stratified by sex and age at vaccine eligibility. Time 0 (zero) represents the date the cancer survivor became eligible to receive the HPV vaccination based on age and completion of cancer treatment
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination - updated recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2016;65:1405–8. - PubMed
    1. Petrosky E, Bocchini JA, Hariri S, Chesson H, Curtis CR, Saraiya M, et al. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2015;64:300–4. - PMC - PubMed
    1. Garland SM, Brotherton JML, Moscicki AB, Kaufmann AM, Stanley M, Bhatla N, et al. HPV vaccination of immunocompromised hosts. Papillomavirus Res. 2017. [cited 2018 May 10];4:35–8. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2405852117300253. - PMC - PubMed
    1. Stobbe M Vaccine panel gives nod to HPV shots for men up to age 26. Associated Press; 2019. Available from: https://www.apnews.com/e341072cbfa040369fd157bd255ed40a.
    1. Walker TY, Elam-Evans LD, Singleton JA, Yankey D, Markowitz LE, Fredua B, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years - United States, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:874–82. - PMC - PubMed

Substances