Despite recommendations from the Centers for Disease Control and Prevention (CDC), very few states require human papillomavirus (HPV) vaccination for adolescents and that the vaccination rates are far below those of other recommended vaccines.

In 2007, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommended a three-dose HPV vaccination series, with the second and third doses administered two and six months after the first dose, for females aged 9–26 years. This recommendation was expanded to include males in 2011. 

In a research letter published in the Journal of the American Medical Association, Jason L. Schwartz, PhD, MBE, and Laurel A. Easterling, both from Princeton University, reviewed the presence and timing of state requirements for vaccines (particularly requirements for adolescents) and compared them to the implementation of HPV vaccines. 

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They noted the earliest date that a requirement took effect for each vaccine in every state and the District of Columbia (D.C.) for any childhood, adolescent, or college-aged population.

Vaccine requirements were more common for hepatitis B vaccination (47 states and Washington, D.C.), varicella vaccination (50 states and Washington, D.C.), and meningococcal conjugate vaccination (29 states and Washington, D.C.) HPV vaccination was only required in Virginia and Washington, D.C. through March 2015; Rhode Island’s requirement will go into effect in August 2015. In comparison, the hepatitis B vaccine was required in 36 states and D.C. eight years after being recommended by the ACIP, varicella vaccine in 38 states and D.C., and meningococcal conjugate vaccine in 21 states and D.C.

Vaccination coverage is “substantially below” the Healthy People 2020 target of 80%, as only 38% of adolescent girls and 14% of adolescent boys had completed the three-dose series in 2013, according to data in the report.

HPV vaccines should not be viewed or treated differently than other routinely recommended vaccines to increase these rates, the authors concluded.


1. Schwartz JL, et al. JAMA. 2015; 314(2):185-186. 

This article originally appeared on MPR