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\nAfter this article was published, CDC recommended that 11- to 12-year-olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses.
\nAbout 14 million people are infected with human papillomavirus (HPV) each year. HPV can cause cervical, vulvar, and vaginal cancers in women and penile cancer in men. It can also cause anal cancer, throat cancer, and genital warts in both men and women. One study estimated that in the United States, about 26,000 cancers per year were attributable to HPV during 2004 to 2008; see the most recent estimates.
\nHPV vaccines are given as a series of three shots over six months. CDC recommends the HPV vaccine for preteen boys and girls aged 11 or 12 years, so they are protected before being exposed to the virus. Two vaccines (Cervarix and Gardasil) protect against cervical cancers in women. Gardasil also protects against genital warts and cancers of the anus, vagina, and vulva. Both vaccines are available for females; only Gardasil is available for males.
\nUnfortunately, in the United States, HPV vaccination rates are low compared with other recommended vaccines. We reviewed studies published between 2009 and 2012 to better understand why preteens and teens aren\u2019t vaccinated against HPV at all, or don\u2019t finish the series of three shots. This is the first literature review to include male as well as female adolescents, and to identify the barriers faced by health care providers, parents, and traditionally underserved groups.
\nBy addressing the barriers found in this report, we can increase HPV vaccine use and protect children\u2019s health. For example, doctors should check teens\u2019 and preteens\u2019 vaccination status at every visit, including acute care visits, to make sure they are up-to-date. Doctors and parents need to be educated about the importance of vaccinating adolescents before they become sexually active. Health care professionals may benefit from guidance on how to explain HPV vaccine recommendations to patients and parents. To be most effective, efforts to increase HPV vaccine use need to consider the different concerns of certain groups within the population.
\nHolman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among U.S. adolescents: A systematic review of the literature.External \n JAMA Pediatrics 2014;168(1):76\u201382.
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