Policy analysis of legislative activity related to the human papillomavirus (HPV) vaccine in the United States, 2006-2014

Background:  The development of the HPV vaccine was touted as one of the largest public health achievements in the prevention of cervical, oral, and anal cancers.  The vaccination was added to the immunization schedule by the Centers for Disease Control and Prevention for adolescent girls aged 11-12 in 2006 and extended to males aged 11-12 in 2010.  State-based policies to mandate HPV vaccination are politically challenging since the vaccine protects against a sexually transmitted infection. Many of the states who were early adopters of mandatory vaccination for girls have faced repeals, criticism for broad opt-outs and have not yet passed legislation requiring the HPV vaccine for young males.

Objective:  The objective of this policy analysis is to analyze state legislation focused on voluntary or mandatory HPV vaccination from 2006-2014.

Methods:  A content analysis was conducted among primary sources of data from HPV vaccine-related bills, including using the National Conference of State Legislatures (NCSL) as a search-source.   Secondary data sources were also consulted including: white papers, commentaries from medical journals, newspaper articles, and textual data on blog sites for lay health consumers.

Results:  Preliminary findings reveal that much of the legislative activity occurred early after the HPV vaccination was introduced, and focused on increased information for parents, public financing, awareness campaigns, etc.  Far fewer states focused on voluntary or mandatory vaccination.

Conclusion:  Understanding the barriers to achieving mandatory vaccination policy and implementation of such policies for HPV vaccines continues to remain a public health priority, with implications for providers and public health professionals.