The relatively low HPV vaccine uptake in the US has been attributed in part to fears that vaccinating against the sexually transmitted virus would encourage early or risky sexual behavior in adolescents. To look at the potential impact of pro-vaccine legislation on behaviors, researchers compared CDC surveillance data on teen sexual activity in states in the US with policies promoting or mandating HPV vaccination among adolescents to states without any specific vaccination policies in a study published in Pediatrics this month. They found no difference in reported sexual activity or risk behavior in states with vaccine legislation. These results support a prior study in which researchers looked at diagnosis of sexually transmitted infection as a marker for sexual activity or increased risk behavior, and found that there was no difference between vaccinated and unvaccinated adolescents over the five year study period. Despite this consistent, reassuring evidence that vaccinating for HPV will not increase sexual activity among adolescents, the US has not met their Healthy People targets for HPV vaccine coverage, and lags behind many other countries. Australia recently announced that they may be the first country to eliminate cervical cancer due to their successful vaccination programs, suggesting that this may be an achievable target. What are the remaining hurdles for the US to meet their targets for this cost-effective and life-saving vaccine?

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