"Whatever ya say doc": A legislative approach to HPV vaccine acceptance among adolescents using the National Immunization Survey - Teen, 2010 - 2012

In March 2007, The Advisory Committee on Immunization Practices (ACIP) recommended female adolescents receive the Human Papillomavirus vaccine. Males received recommendation approximately 2 years later. Subsequently, over 25 states introduced legislation to encourage HPV vaccination initiation for all adolescents.

Objective: Estimate state legislation’s effect on HPV vaccine initiation and patient care provider (PCP) recommendations by gender.

HPV vaccine legislation acquired from the National Conference on State Legislatures was classified into four groups based on status: none, introduced or active in committee (Active), passed either or both Houses (Passed), died in committee (Died). Gender differences in PCP recommendations and HPV vaccine initiation among adolescents were estimated using NIS – Teen 2010 to 2012 data. Multivariable logistic modeling in progress explores the effect of legislation status on these estimates.

Over half the respondents represent states that produced legislation between 2007 and 2012 of which 70% are active, 20% have passed and 10% have died. Residents in states with no history of legislation responded with 28% initiation and 37.6% PCP recommendation for the HPV vaccine. States with active, passed and died legislation had similar initiation (range: 24-28%; p <.001) and PCP recommendation (range: 33-36%; p < .05). PCP recommendations to parents with daughters (OR: 35.8; 95%CI: 30.9-41.4) had higher odds of vaccine initiation than those received by parents with sons (OR: 7.2; 95%CI: 6.6-7.7).

The effect of current health policy has little influence on HPV vaccine initiation. Future legislation efforts should encourage PCP recommendation of the HPV vaccine to parents of all adolescents.