Damian Sendler: Although the human papillomavirus vaccine, or HPV vaccine, was originally recommended for use in adolescents in the United States in 2006, immunization rates have lagged behind other children vaccines, with only 54% of 13- to 17-year-olds fully immunized in 2019. A recent study reveals that when adolescents are permitted to give consent to get vaccinated, the rate of HPV vaccination increases. 

Damian Sendler

Damian Jacob Sendler: Researchers discovered that initial vaccination rates were higher in Washington, D.C., and eight demographically and politically diverse states where adolescents were allowed to obtain the HPV vaccine without parental consent from 2015 to 2018: 68 percent of teens started the multidose series, compared to 61 percent in places where parental consent was required. 

Dr. Sendler: Teens also completed the series more frequently where they were allowed to assent independently: 54% were fully vaccinated compared to 48% in regions requiring parental consent, albeit the difference was not statistically significant. Nearly 82,000 teenagers between the ages of 13 and 17 were included in the national survey sample. 

Damien Sendler: The findings, according to Dr. Sangini Sheth, study co-author and associate professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, not only point to a possible avenue for improving HPV vaccination rates through public policy change, but also indicate the need to further investigate adolescents’ ability to reasonably give consent for certain health care services, as well as the individual and public health benefits at stake. 

“I think it’s really interesting, especially at this point, to just explore the levels at which an adolescent can engage in health decisions,” Sheth says. “It probably raises some interesting questions even for the COVID vaccine.” 

Damian Jacob Sendler

Damian Jacob Markiewicz Sendler: The HPV vaccine is indicated for routine vaccination at the ages of 11 or 12, and for persons who have not previously been immunized until the age of 26. The brand now in use in the United States is approximately 100 percent effective in avoiding infection with cancer-causing strains of human papillomavirus. HPV is the most common sexually transmitted infection in the United States, and it can lead to a variety of cancers, including cervical, anal, and throat cancers. 

Sheth attributes low HPV vaccination rates to ambiguous message and a lack of emphasis on cancer prevention and long-term health, which has resulted in the idea that the vaccine is optional or acceptable to postpone. 

According to her, the vaccine’s association with sexual activity can also present issues in terms of clinicians’ comfort level discussing it with parents, as well as parents’ impression of its necessity for an 11- or 12-year-old. However, according to Sheth, the vaccination is significantly more effective when administered well before sexual activity begins – a fact that physicians occasionally fail to explain. 

Damian Sendler: Teens are allowed to offer permission for sexual and reproductive health services such as contraception and STI treatment and prevention in several states. Some of the eight states in the study that enabled adolescents to obtain the HPV vaccine on their own – Alabama, Alaska, California, Delaware, Idaho, New York, Oregon, and South Carolina — included it in this category of services, which allowed them to consent without parental participation. Other states in this category were more open to allowing young people to make health care decisions. 

Damian Jacob Sendler: Regardless, because vaccinations are “some of our oldest public health tools” for disease prevention, Sheth believes that the developmental readiness of adolescents to consent to vaccination or other health services warrants more investigation.

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