Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

HPV Vaccination & Disparities in HPV Prevalence

Vaccine; ePub 2018 Oct 28; Hirth, McGrath, et al

In a retrospective analysis of 6 cycles of the National Health and Nutrition Examination Survey (NHANES) data from 2003‒2014, human papillomavirus (HPV) vaccination was low among black and Mexican American females aged 14‒26 years, which contributed to disparities in HPV prevalence. Results on HPV status from vaginal samples of females aged 14‒26 years who responded about HPV vaccination were used to determine HPV prevalence. Racial/ethnic comparisons were made across time, and models were developed to examine the role of HPV vaccination in observed variations for vaccine-type HPV prevalence. Researchers found:

  • Among 4,080 females, 29.7% were black, 25.6% were Mexican American, 8.9% were Hispanic, and 35.8% were white.
  • Compared to prevaccine years (2003‒2006), vaccine-type HPV did not decrease until late post-licensure years (2011‒2014).
  • Lower vaccination in black females contributed to disparities in vaccine-type HPV.
  • Most of the decrease in vaccine-type HPV occurred among white females.
  • HPV vaccination resulted in the observed national decrease in vaccine-type HPV.


Hirth J, McGrath CJ, Kuo YF, Rupp RE, Starkey JM, Berenson AB. Impact of human papillomavirus vaccination on racial/ethnic disparities in vaccine-type human papillomavirus prevalence among 14‒26 year old females in the U.S. [Published online ahead of print October 28, 2018]. Vaccine. doi:10.1016/j.vaccine.2018.10.075.


This study is both encouraging and discouraging. It seems that the HPV vaccine has had an impact on HPV rates. These lower rates will hopefully lead to a decrease in the 27,000 HPV–related cancers seen in the US each year. The bad news is that this vaccine is not reaching every segment of the US population. Clinicians should offer this vaccine in both males and females and present it to parents as a vaccine that will “help prevent cancers.” —John Russell, MD

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