An Ecological Analysis of HPV Vaccination in the United States Before and During the COVID-19 Pandemic by Age, Sex, and Urbanicity Using Private Insurance Claims Data.

Milkie Vu, Jingjing Li, Kai Hong, Jennifer W Kaminski, Bo-Hyun Cho, Yoonjae Kang
Author Information
  1. Milkie Vu: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. ORCID
  2. Jingjing Li: Department of Behavior, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
  3. Kai Hong: Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  4. Jennifer W Kaminski: Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  5. Bo-Hyun Cho: The National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  6. Yoonjae Kang: The National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Abstract

INTRODUCTION: We aim to assess HPV vaccine administration among privately insured populations before and during the COVID-19 pandemic in the United States and stratify the assessments by demographic and geographic characteristics.
METHODS: Using the Merative MarketScan Commercial Claims and Encounters Database, we estimated monthly and yearly HPV vaccine administration among people aged 9-26 from 2019 to 2022, measured as the proportion of the enrolled population who received ������1 dose of HPV vaccine during that month or year, and their relative percent change from 2020 to 2022, compared to the same period in 2019, overall and stratified by age group, sex, and urbanicity.
RESULTS: HPV vaccine administration in 2020, 2021, and 2022 was lower than in 2019 and continued to decline for all age groups. The relative percent change in rate in 2022 relative to 2019 was -6.0% among children, -38.3% among adolescents, and -42.5% among young adults. The patterns were similar across subgroups, with certain disparities in magnitude. By subpopulations, the highest percent declines in 2022 relative to 2019 in each age group were observed among children in rural areas (-13.5%), male adolescents (-39.8%), and young adults in rural areas (-46.0%).
CONCLUSION: During the COVID-19 pandemic, HPV vaccine administration dropped substantially and had not exceeded the pre-pandemic levels by the end of 2022, with larger declines seen among male adolescents and young adults in rural areas. Our results highlight the need for continuing monitoring and targeted intervention strategies to improve HPV vaccine administration.

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Grants

  1. K12TR005104/NCATS NIH HHS
  2. KL2TR001424/NCATS NIH HHS
  3. K01CA296781/NCI NIH HHS
  4. T32CA193193/NCI NIH HHS

MeSH Term

Humans
COVID-19
Adolescent
Papillomavirus Vaccines
United States
Male
Child
Female
Adult
Young Adult
Papillomavirus Infections
Vaccination
Age Factors
Urban Population
SARS-CoV-2
Sex Factors
Insurance, Health
Pandemics

Chemicals

Papillomavirus Vaccines

Word Cloud

Created with Highcharts 10.0.0HPVamongvaccine2022administration2019relativeCOVID-19percentageadolescentsyoungadultsruralareaspandemicUnitedStatesUsingClaimschange2020group0%children5%declinesmaleINTRODUCTION:aimassessprivatelyinsuredpopulationsstratifyassessmentsdemographicgeographiccharacteristicsMETHODS:MerativeMarketScanCommercialEncountersDatabaseestimatedmonthlyyearlypeopleaged9-26measuredproportionenrolledpopulationreceived������1dosemonthyearcomparedperiodoverallstratifiedsexurbanicityRESULTS:2021lowercontinueddeclinegroupsrate-6-383%-42patternssimilaracrosssubgroupscertaindisparitiesmagnitudesubpopulationshighestobserved-13-398%-46CONCLUSION:droppedsubstantiallyexceededpre-pandemiclevelsendlargerseenresultshighlightneedcontinuingmonitoringtargetedinterventionstrategiesimproveEcologicalAnalysisVaccinationPandemicAgeSexUrbanicityPrivateInsuranceData

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