The case for catch‐up human papillomavirus vaccination in at‐risk populations: Rural communities and survivors of pediatric and young adult cancers

Abstract

We read with interest the recent updated human papillomavirus (HPV) vaccination guideline presented by Saslow et al on behalf of the American Cancer Society (ACS) Guideline Development Group.1 Although the recommendations offer sound guidance to promote vaccination, we disagree with the authors' decision to universally reject shared decision making for all unvaccinated individuals aged 27 through 45 years, a measure that both the Advisory Committee on Immunization Practices and the Children's Oncology Group recommend.2,3 Forgoing catch-up vaccination in adults aged older than 26 years is a missed opportunity to provide immunization for traditionally undervaccinated and at-risk groups, in particular those residing in rural communities and survivors of pediatric and young adult (PAYA) cancers. Unlike the ACS guidelines, current survivorship care guidelines from the Advisory Committee on Immunization Practices and Children's Oncology Group prevent such misjudgments by including the catch-up HPV vaccine recommendation. HPV vaccination initiatives; community education; awareness strategies; and a clear, consistent guideline recommendation can help to reduce cancer-related risks and prevent unnecessary morbidity and mortality for all populations.