Written by Hannah Harp
Spoon Feed
Clinicians reported that acceptability and feasibility of starting HPV vaccination at age 9 was not significantly lower than starting the series at age 11.
Hit me with your best shot!
ACIP recommends initiating the HPV vaccine series at age 11-12 years, though the vaccine has been approved for children as young as nine years old. The benefits of initiating the series at age nine include more time to complete the series, decreasing shot burden at the 11-year-old visit, having more time to discuss the vaccine, and having the vaccine conversation when sexuality is less salient. But will parents accept giving the most frequently declined vaccine (outside of seasonal vaccines) at an even younger age?
This mixed-methods study evaluated the feasibility and acceptability of initiating routine HPV vaccination at ages 9-10 rather than 11-12 years in 33 pediatric practices across Colorado and California. One month post-intervention, 90% of clinicians in Colorado and 77% in California reported routinely recommending HPV vaccination at an earlier age. Most clinicians noted no increase in parental concerns (CO 73%, CA 57%) or pushback (CO 66%, CA 50%), and interviews revealed that conversations were often easier and shorter due to reduced focus on sexual activity. This study did not include completion rates of the full HPV series by age thirteen, but it looks like the research team has that project in the pipeline.
How does this change my practice?
My experiences completely line up with the experiences described by the participating clinicians. I get very little pushback when I offer HPV vaccine at age nine. Frequently, the parents will leave the decision up to the patient, and it’s pretty easy to convince a nine-year-old that they want one shot now and two later instead of three all at once. My HPV vaccination rate is 88%, though I don’t know how much earlier vaccination contributes to that.
Source
Feasibility and Acceptability of Recommending HPV Vaccine at Ages 9-10 Years. Pediatrics. 2025 Jul 1;156(1):e2024069625. doi: 10.1542/peds.2024-069625. PMID: 40451241
