Human papillomavirus (HPV) vaccination remains underused in
the United States, and few population-level studies on effectiveness exist.
We examined trends in rates of genital warts diagnoses and
HPV vaccination rates (defined as receipt of 1 or more vaccine doses) among
low-income and minority adolescents between 2004 and 2013. Data were obtained
from a database containing de-identified medical record information including
all outpatient visits to an urban medical center and 6 affiliated community
health centers. International Classification of Diseases, Ninth Revision codes
were used to determine genital warts diagnoses. We estimated annual rates of
genital warts for each period for females and males using an interrupted
time-series Poisson regression model.
As HPV vaccination rates in low-income, minority adolescents
rose from 0% to 59% (females) and 0 to 41% (males) between 2004 and 2013,
genital warts rates decreased from 3.5% (females) and 3.6% (males) to 1.5%
(females) and 2.9% (males). Rates of genital warts decreased significantly for
both females and males from the prevaccination to the postvaccination periods
(P < 0.05 for both comparisons). Genital warts rates for males began to
decrease after the introduction of female vaccination and continued to decrease
after male vaccination was introduced.
Introduction of HPV vaccination correlated with lower rates
of genital warts among a cohort of low-income and minority adolescents. Rates
of genital warts began to decrease in females and males following the
introduction of female vaccination and continued to fall after the introduction
of male vaccination, indicating that male vaccination may confer additional
benefit to both males and females over herd immunity alone, especially when
vaccination rates are suboptimal.
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By:
- 1From the *Boston University School of Medicine/Boston Medical Center, Boston MA; †Veterans Affairs Boston Healthcare System, Boston MA; and ‡Veterans Affairs Boston Healthcare System/Boston University School of Medicine, Boston MA.
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