The rates of human papillomavirus (HPV) vaccine initiation among young cancer survivors are low, according to a study published in the Journal of Clinical Oncology.1

Despite the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices’ (ACIP) recommendations to initiate HPV vaccines in pediatric patients, HPV remains a very common sexually transmitted infection, especially among adolescents and young adults. Cancer survivors particularly are at high risk for HPV-related morbidities, but there is a scarcity of data regarding rates and barriers to HPV vaccine initiation among this patient population.

For this study ( Identifier: NCT01492582), researchers collected survey responses from 1046 young cancer survivors in remission.

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The results of the study showed that the rate of vaccine initiation was significantly lower in cancer survivors (23.8%; 95% CI, 20.6%-27.0%) compared with population peers (40.5%; 95% CI, 40.2%-40.7%) (P < .001), and only 13.5% of patients completed the 3-dose series. Patients were also more likely to be HPV vaccine-naive than the general population (odds ratio [OR], 1.72; 95% CI, 1.41-2.09; P < .001).

Vaccine initiation in adolescent survivors of cancer, ages 13 to 17 years, was 22.0% (95% CI, 17.3%-26.7%) vs 42.5% (95% CI, 42.2%-42.8%) in population peers (P < .001).

Vaccine initiation in young adult survivors, aged 18 to 26 years, was 25.3% (95% CI, 20.9%-29.7%) compared with 24.2% (95% CI, 23.6%-24.9%) in population peers. 

Factors that may prevent initiation include provider neglect to recommend (OR, 10.8; 95% CI, 6.5-18.0; P < .001), survivors’ perceived lack of HPV vaccine insurance coverage (OR, 6.6; 95% CI, 3.9-11.0; P < .001), male gender (OR, 2.9; 95% CI, 1.7-4.8; P < .001), endorsement of vaccine-related barriers (OR, 2.7; 95% CI, 1.6-4.6; P < .001), and younger age (9 to 12 years; OR, 3.7; 95% CI, 1.8-7.6; P < .001).

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The authors concluded by saying that “additional research is needed to delineate specific barriers that may be unique to the survivor population and that may inform future interventions to promote HPV vaccine uptake among young cancer survivors.”


  1. Klosky JL, Hudson MM, Chen Y, et al. Human papillomavirus vaccination rates in young cancer survivors. J Clin Oncol. 2017 Aug 24. [Epub ahead of print] doi: 10.1200/JCO.2017.74.1843