HPV Vaccination Uptake Among Vaccine-Eligible U.S. Adults with and Without a Cancer History: A National Health and Nutrition Examination Survey Analysis, 2011–2023

Abstract

Background: Human papillomavirus includes more than 200 types, classified by cancer risk. Since 2006, the vaccine has effectively prevented human papillomavirus infection and associated cancers; however, coverage among adults remains low. Furthermore, research examining human papillomavirus vaccination among adults with a cancer history is limited. Objective: To estimate vaccination uptake for human papillomavirus among U.S. adults aged 20–47 and compare uptake by cancer history. Methods: This study used data from the National Health and Nutrition Examination Survey from 2011 to 2023. The final analytic sample included 13,511 adults aged 20–47 with self-reported vaccination status and cancer history. The data were weighted to account for the complex survey design and produce nationally representative estimates. Results: Among eligible adults, 84.7% were unvaccinated, 2.9% were under-vaccinated, and 12.4% had completed the vaccine series. Among eligible adults with a self-reported cancer history, the majority were unvaccinated. Vaccination completion differed by sociodemographic and healthcare-related factors. Conclusions: Human papillomavirus vaccination remained low among eligible U.S. adults, including those with a self-reported cancer history. These findings support efforts to improve adult vaccination coverage and prevent human papillomavirus infections and associated cancers.