High impact of quadrivalent human papillomavirus vaccine across racial/ethnic groups: National Health and Nutrition Examination Survey, 2003–2006 and 2015–2018

ABSTRACT

Human papillomavirus (HPV) causes cervical as well as other cancers. Racial and ethnic disparities in cervical cancer incidence and mortality in the United States are well documented. HPV vaccination has been recommended in the United States since 2006 and is expected to prevent HPV-attributable cancers in all racial/ethnic groups. Quadrivalent HPV vaccine-type (HPV6/11/16/18) and nonvaccine-type cervicovaginal HPV prevalences were estimated from National Health and Nutrition Examination Surveys in 2015–2018 (vaccine era) and 2003–2006 (prevaccine era) data. Prevalence ratios comparing 2015–2018 to 2003–2006 were calculated among sexually experienced Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Mexican American (MA) females aged 14–24 years. Quadrivalent HPV vaccine-type prevalence declined 82% (CI: 60%–92%) among NHW, 86% (CI: 64%–95%) among NHB, and 100% among MA females, forecasting future reductions in cervical cancer across racial/ethnic groups.

KEYWORDS:

• HPV vaccine
• cervical cancer
• race/ethnicity
• National Health and Nutrition Examination Survey
• adolescents and young adult females

Acknowledgments

Juanita M. Onyekwuluje, Sonya Patel, Krystle L. Love, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Carolyn Neal, National Center for Health Statistics, Research Data Center, CDC.

Author contributions

Conception and design: J.G., L.M., E.U., R.S., R.L.

Acquisition of data: R.L., T.Q., E.U., L.M.

Data analysis: R.L.

Interpretation of data: R.S., R.L., J.G., L.M.

Drafting of manuscript: R.S., R.L., J.G., L.M.

Revision of manuscript: all authors

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are a combination of publicly available and restricted data. Please see the NHANES website for more information: https://www.cdc.gov/nchs/nhanes/index.htm.

Disclaimer

The findings in this article are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.

Prior presentations

This work was included in a poster at EUROGIN (February 2023, Spain, Abstract # 4836) and presented at CDC’s Epidemic Intelligence Service (EIS) Conference (April 2023, Atlanta, GA).

Additional information

Funding

This work was supported by the Centers for Disease Control and Prevention.