Should Kids Start Getting The HPV Vaccine Before Age 11?

teen gets injection in arm

Giving children the human papillomavirus vaccine before age 11 could help promote on-time vaccination, report researchers.

Approximately 45,300 cancers related to human papillomavirus (HPV) occur in the US every year. HPV vaccination has the potential to prevent up to 80% of these cancers. While raising HPV vaccination rates has been a public health priority since 2014, improving these numbers has been slow and uneven.

Understanding ways to increase and sustain HPV vaccination levels has taken on additional importance in light of the COVID-19 pandemic. National pediatric and adolescent vaccinations during the pandemic, including HPV vaccination, declined initially by more than 70% and have remained below pre-pandemic levels.

In an effort to identify ways to improve vaccination rates, researchers developed a program called Development of Systems and Education to improve HPV vaccination (DOSE HPV), which began at Boston Medical Center (BMC) and four practices in affiliated community health centers between 2016 and 2018.

The intervention demonstrated double-digit improvements in HPV vaccine initiation. While this was encouraging, the researchers wanted to see if the improvements were sustained after the intervention was completed.


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The researchers looked at monthly HPV vaccination coverage among the adolescents aged 9-18 who received primary care at the two practices from March 2016 (before the intervention) to October 2020.

They examined how many adolescents in different age groups started and completed the vaccine series over time. Both practices chose to start the HPV vaccine series at age 10 to give adolescents more chances to complete the series before their 13th birthdays.

“The data showed that the improvements were sustained for four years beyond the completion of the initial vaccination and the rates of adolescents completing the HPV vaccine series by their 13th birthday (the CDC definition of on time completion) increased from 62% to 88%—nearly double the national rate of series completion among 13 year-olds (45.6%),” says corresponding author Rebecca Perkins, associate professor of obstetrics & gynecology and a gynecologist at Boston University Medical Center.

This is believed to be the first study to examine the sustainability of interventions four years after implementation, Perkins says.

“The sustained improvement over time indicates that these types of programs may be a good public health investment. It also indicates that starting the HPV vaccines series before age 11 can improve on-time completion of the series by giving more chances for kids to be vaccinated.”

The study appears in the Journal of Lower Genital Tract Disease.

Source: Boston University

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Boston University

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