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Clin Pediatr (Phila). 2017 Apr;56(4):363-370. doi: 10.1177/0009922816660541. Epub 2016 Oct 1.

Human Papillomavirus Vaccination and Age at First Sexual Activity, National Health and Nutrition Examination Survey.

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1 National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.


The National Health and Nutrition Examination Survey (NHANES) collects information on human papillomavirus (HPV) vaccination history as well as sexual activity. We evaluated data from NHANES to assess report of HPV vaccination with ≥1 dose and 3 doses among females and males aged 11 to 26 years during 2007-2014. We also examined age at first vaccine dose and age at first sexual activity among females aged 14 to 26 years. Vaccination significantly increased in females aged 13 to 26 years, but not among 11- to 12-year-old girls, and remained low for both females and males. In NHANES 2011-2014, among females with known age at first vaccine dose, 43.1% reported having had sex before or in the same year they received their first HPV vaccine, and this varied by race/ethnicity. Clinicians should provide strong recommendations consistent with guidelines, including routine vaccination of girls and boys at age 11 or 12 years.


HPV vaccine; National Health and Nutrition Examination Survey; human papillomavirus (HPV); sexual activity; vaccine initiation

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