McKeithen MC, Gilkey MB, Kong WY, Oh NL, Heisler-MacKinnon J, Carlson R, James G, Grabert BK. Policy Approaches for Increasing Adolescent HPV Vaccination Coverage: A Systematic Review.
Pediatrics 2024;
153:e2023064692. [PMID:
38623635 PMCID:
PMC11035154 DOI:
10.1542/peds.2023-064692]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
CONTEXT
US jurisdictions have enacted a wide range of policies to address low human papillomavirus (HPV) vaccination coverage among adolescents, but it is unclear which policies are effective.
OBJECTIVE
To systematically review the impact of governmental policies on adolescent HPV vaccination coverage.
DATA SOURCES
PubMed, Embase, and Scopus databases.
STUDY SELECTION
Eligible studies, published from 2009 to 2022, evaluated the impact of governmental policies on HPV vaccination coverage among adolescents ages 9 to 18.
DATA EXTRACTION
Two investigators independently extracted data on study sample, study design and quality, policy characteristics, and HPV vaccination outcomes. We summarized findings by policy type: school-entry requirements (SERs), federally-funded policies related to the Vaccines for Children program and Medicaid, educational requirements, and others.
RESULTS
Our search yielded 36 eligible studies. A majority of studies evaluating HPV vaccine SERs found positive associations between SERs and HPV vaccination coverage (8 of 14), particularly for SERs in Rhode Island and Washington, DC. All studies evaluating SERs for other adolescent vaccines observed positive spillover effects for HPV vaccination (7 of 7). Federally-funded policies related to Vaccines for Children and Medicaid were consistently associated with higher HPV vaccination coverage (7 of 9). Relatively few studies found associations between educational requirements and HPV vaccination coverage (2 of 8).
LIMITATIONS
Studies used limited vaccination data sources and non- or quasi-experimental designs. Some studies had no or poorly matched comparison groups.
CONCLUSIONS
Our findings suggest promise for SERs and federally-funded policies, but not educational requirements, for increasing HPV vaccination coverage among adolescents.
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