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• Posted May 1, 2024

School Entry Rules Boost Kids' HPV Vaccination Rates

Getting the HPV shot in adolescence can spare kids a lifetime of risk for cervical and other cancers related to the virus, but only half of American kids are up-to-date on these shots.

Now, a new review suggests that if schools mandate HPV shots as an entry requirement for students, immunization rates rise.

"A majority of studies evaluating HPV vaccine school-entry requirements found positive associations between school-entry requirements and HPV vaccination coverage," said a team at Wake Forest University in Winston-Salem, N.C.

Even mandating other vaccines (for example, the meningitis or the Tdap vaccines) had a "spillover" effect, encouraging more parents to vaccinate their kids against HPV.

HPV (human papillomavirus) is easily transmitted via sex; that's why the U.S. Centers for Disease Control and Prevention advises that kids of both genders receive the vaccine at 11 or 12 years of age. The vaccine is given in two doses, spaced 6 months apart.

Unfortunately, CDC data for 2022 showed that just 50% of 13-year-olds were up-to-date on HPV vaccination.

Could requiring children to be vaccinated against HPV before school entry help boost that number?

Currently, only Hawaii, Puerto Rico, Rhode Island, Virginia and Washington, D.C., have such requirements in place.

In the new study, the Wake Forest team, plus researchers at Duke University and University of North Carolina at Chapel Hill, looked at 2009-2022 data from 36 different studies comparing HPV vaccination rates against local school entry policies.

“We found consistent evidence that school-entry requirements work in places that require parents who don’t vaccinate to submit an exemption,” said study senior author Brigid Grabert, an assistant professor of implementation science at Wake Forest University's School of Medicine, in Winston-Salem, N.C. “We also found that school-entry requirements for other vaccines resulted in positive spillover effects for HPV vaccinations.”

For example, one study looking at uptake of the HPV vaccine among girls from middle-income households found a 30 percentage point jump in vaccine initiation (at least one dose) in a state that required it for school entry, compared to seven surrounding states where it was not required.

One study from Philadelphia found that school entry mandates for the Tdap and meningitis shots (but not HPV) were also "associated with increased HPV vaccine initiation among 12 to 13-year-olds," raising uptake by nine percentage points.

The findings were published recently in Pediatrics.

“Policymakers should be aware that HPV-related cancers and disease can be reduced,” Grabert said in a Wake Forest news release. “But not all policies are effective. Policymakers should carefully consider the best strategy to increase the administration of HPV vaccines.” 

More information

Find out more about HPV vaccination at the CDC.

SOURCES: Wake Forest University School of Medicine, news release, April 29, 2024; Pediatrics, April 16, 2024