Texas Ranks 47th in Cancer-Preventing HPV Vaccination Coverage

AUSTIN—In 2016, less than a third of Texas adolescents were up-to-date on human papillomavirus (HPV) vaccinations, according to a new report from researchers at The University of Texas System and UT Health Northeast. Only Wyoming, Mississippi, South Carolina and Utah had HPV vaccination coverage levels lower than Texas. The report utilizes recently released data from the Centers for Disease Control and Prevention. 

The vaccines offer protection from the HPV strains most closely linked to cancer. If given in two doses at ages 11 and 12 (or three doses when older), the vaccines can help prevent HPV-associated cancers in males and females. The vaccines are most effective when given at younger ages and prior to exposure to HPV.

HPV is associated with 99 percent of cervical cancers, 95 percent of anal cancers, 70 percent of throat and neck cancers, 65 percent of vaginal cancers, 50 percent of vulvar cancers, and 35 percent of penile cancers. HPV-associated cancers make up approximately 3 percent of all cancer cases among women and 2 percent of all cancer cases among men in the United States.

“These are preventable cancers,” said David Lakey, M.D., the UT System’s Vice Chancellor for Health Affairs and Chief Medical Officer. “That means thousands of lives can be improved, or saved, if we can bring our vaccination rates up to where they are for other adolescent vaccines.”

The data comes from the National Immunization Survey (NIS) of teens ages 13-17. The same survey data found that rates for the tetanus, diphtheria, and acellular pertussis vaccine (Tdap), and for the meningococcal conjugate vaccine (MenACWY), were 85 percent and 85.5 percent, respectively. These coverage estimates were similar to those in the U.S. overall.

Although adolescent HPV vaccination coverage in Texas has been increasing over the past decade, it has not kept pace with the U.S. overall. As recently as 2013, rates for the vaccine were on par with the U.S. average. By last year, the percentage of Texas adolescents who had received at least one dose of the HPV vaccine was 10.6 percentage points lower for females and 11.7 percentage points lower for males than the national average.

Texas ranks 47th in terms of up-to-date HPV vaccination out of the 50 states and the District of Columbia, though there is dramatic variation within the state. The 2016 estimate for up-to-date vaccination for El Paso County was 66 percent, which was higher than every state in the nation except Rhode Island. Only 23.9 percent of teens in Dallas County, on the other hand, had up-to-date coverage in 2016, which was worse than every other state and the District of Columbia.

“Every year since the teen survey began in 2008, estimates for adolescent HPV vaccination coverage in El Paso has been substantially higher than anywhere else in Texas,” says Eileen Nehme, Ph.D., Assistant Professor for Population Health at UT Health Northeast. “Years ago, El Paso’s health advocates made a concerted effort to get their teens vaccinated, and the data show their efforts paid off. We should learn from El Paso’s experience, and bring those lessons to benefit the rest of the state.”

In both the U.S. and Texas, males were less likely than females to be up-to-date on HPV vaccines. Nationally, teens living in an urban area were the most likely to be up-to-date in HPV vaccina­tions, while those living in more rural areas were the least likely. This variation is evident in the Texas numbers, although the difference is not statistically significant.

“The huge vaccination gap in Texas, between HPV and other adolescent vaccines, suggests that the best opportunity to increase coverage lies in providing the HPV vaccine at the same visit when other adolescent vaccines are given,” says Divya Patel, Ph.D., Assistant Professor for Population Health at UT Health Northeast. “If we can change attitudes and behaviors around the HPV vaccine, and increase awareness that it is a cancer prevention vaccine, we can make a huge difference in people’s lives.”

Background Materials

About The University of Texas System

Educating students, providing care for patients, conducting groundbreaking basic, applied and clinical research, and serving the needs of Texans and the nation for more than 130 years, The University of Texas System is one of the largest public university systems in the United States. With 14 institutions and a projected enrollment of more than 234,000 students, the UT System confers more than one-third of the state’s undergraduate degrees, educates approximately two-thirds of the state’s health care professionals annually and accounts for almost 70 percent of all research funds awarded to public institutions in Texas. The UT System’s operating budget for FY 2018 is $18.3 billion, funded in part by $3.6 billion in sponsored programs from federal, state, local and private sources. With more than 20,000 faculty – including Nobel laureates and many members of the National Academies – and nearly 80,000 health care professionals, researchers, student advisors and support staff, the UT System is one of the largest employers in the state.

About UT Health Northeast

For 70 years, UT Health Northeast has provided excellent patient care to the citizens of Texas and beyond. Signature programs include cancer, chest diseases, primary care, behavioral health, and public and community health, along with over 25 additional medical specialties. As the only university medical center in Northeast Texas, its mission also includes education and research. Graduate medical education residencies are in family medicine, rural family medicine, internal medicine, occupational medicine, and psychiatry with many newly trained physicians electing to stay in Northeast Texas, a medically underserved region of the state. Graduate degrees include biotechnology and public health. In addition, scientists in the Center for Biomedical Research have been awarded more than $137 million in competitive funding since 2004. With an annual operating budget of over $200 million, UT Health Northeast is a major economic engine for the region.


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