Human papillomavirus vaccination in commercially-insured vaccine-eligible males and females, United States, 2007–2014

In the United States, the Advisory Committee on Immunization Practices (ACIP) has recommended routine human papillomavirus (HPV) vaccination at age 11–12 years since 2006 for girls and since 2011 for boys. ACIP also recommends vaccination through age 26 for females and through age 21 for males; males may be vaccinated through age 26. We describe vaccine uptake in adolescents and young adults using data from MarketScan Commercial Claims and Encounters. We analyzed data on persons aged 11–26 years on December 31, 2014 who were continuously enrolled in a MarketScan health plan from age 11 through year 2014, or from 2006 to 2014 if aged ≥11 years in 2006 (916,513 females, 951,082 males). Individuals were grouped based on their age (years) in 2014: 11–12 (born 2002–03), 13–14 (2000–01), 15–16 (1998–99), 17–18 (1996–97), 19–21 (1993–95), and 22–26 (1988–1992). We calculated cumulative coverage with ≥1 HPV vaccine dose by sex, birth cohort, and calendar year. In females, the proportion initiating vaccination at age 11–12 years was low in 2008 and 2010 (12.6% and 11.1%) and higher in 2012 (15.7%) and 2014 (19.5%); in males, initiation at age 11–12 was 0.9% in 2010, 8.3% in 2012, and 15.1% in 2014. In females who aged into vaccine eligibility, cumulative coverage by 2014 was higher in older cohorts (17–18: 53%; 15–16: 47%; 13–14: 39%; 11–12: 19.5%). For males, cumulative coverage by 2014 was similar in those aged 13–14, 15–16, and 17–18 years (28.9%, 32.5%, 30.3%), and lower in those aged 11–12 (15.1%), 19–21 (18.4%), and 22–26 years (4.5%). The proportion of males and females initiating vaccination at the recommended ages was low. Although more females than males were vaccinated in all cohorts, the male–female differences were smaller in younger than older cohorts. The trajectory of male vaccination uptake could signal higher acceptability in males.