Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination at 11–12 years; the series can begin at age 9. U.S. HPV vaccination coverage is lower than other adolescent vaccinations. One proposed strategy to increase coverage is initiation at 9–10 years....

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Main Authors: Sarah K. Brewer, Ruth Stefanos, Neil C. Murthy, Amimah F. Asif, Shannon Stokley, Lauri E. Markowitz
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2025.2480870
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author Sarah K. Brewer
Ruth Stefanos
Neil C. Murthy
Amimah F. Asif
Shannon Stokley
Lauri E. Markowitz
author_facet Sarah K. Brewer
Ruth Stefanos
Neil C. Murthy
Amimah F. Asif
Shannon Stokley
Lauri E. Markowitz
author_sort Sarah K. Brewer
collection DOAJ
description The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination at 11–12 years; the series can begin at age 9. U.S. HPV vaccination coverage is lower than other adolescent vaccinations. One proposed strategy to increase coverage is initiation at 9–10 years. We systematically reviewed studies addressing vaccination at age 9 to identify and evaluate evidence regarding potential programmatic advantages. Among 30 publications from 2014 to 2024 there were retrospective cohort studies (N = 11), intervention studies with a component focused on vaccination at 9–10 (N = 12), and studies of feasibility or acceptability by providers or caregivers (N = 7). While retrospective analyses found earlier initiation associated with completion, limitations in methodology preclude a cause-and-effect interpretation. Impact of age 9 vaccination is difficult to isolate in intervention studies that had multiple components. While initiating vaccination at age 9 is feasible, questions remain regarding the benefit of this approach to increase coverage.
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spelling doaj-art-d26dc6d7ab204b79bc3ebab2f3da4e042025-08-20T02:24:59ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2480870Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024Sarah K. Brewer0Ruth Stefanos1Neil C. Murthy2Amimah F. Asif3Shannon Stokley4Lauri E. Markowitz5Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USADivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USAImmunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USAImmunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USAImmunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USADivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USAThe Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination at 11–12 years; the series can begin at age 9. U.S. HPV vaccination coverage is lower than other adolescent vaccinations. One proposed strategy to increase coverage is initiation at 9–10 years. We systematically reviewed studies addressing vaccination at age 9 to identify and evaluate evidence regarding potential programmatic advantages. Among 30 publications from 2014 to 2024 there were retrospective cohort studies (N = 11), intervention studies with a component focused on vaccination at 9–10 (N = 12), and studies of feasibility or acceptability by providers or caregivers (N = 7). While retrospective analyses found earlier initiation associated with completion, limitations in methodology preclude a cause-and-effect interpretation. Impact of age 9 vaccination is difficult to isolate in intervention studies that had multiple components. While initiating vaccination at age 9 is feasible, questions remain regarding the benefit of this approach to increase coverage.https://www.tandfonline.com/doi/10.1080/21645515.2025.2480870Human papillomavirusvaccinationpolicyvaccination at age 9immunization schedulesystematic review
spellingShingle Sarah K. Brewer
Ruth Stefanos
Neil C. Murthy
Amimah F. Asif
Shannon Stokley
Lauri E. Markowitz
Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
Human Vaccines & Immunotherapeutics
Human papillomavirus
vaccination
policy
vaccination at age 9
immunization schedule
systematic review
title Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
title_full Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
title_fullStr Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
title_full_unstemmed Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
title_short Human papillomavirus vaccination at age 9 or 10 years to increase coverage – a narrative review of the literature, United States 2014–2024
title_sort human papillomavirus vaccination at age 9 or 10 years to increase coverage a narrative review of the literature united states 2014 2024
topic Human papillomavirus
vaccination
policy
vaccination at age 9
immunization schedule
systematic review
url https://www.tandfonline.com/doi/10.1080/21645515.2025.2480870
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