title: Examining future adolescent human papillomavirus vaccine uptake, with and without a school mandate.
abstract: OBJECTIVE
  To develop a model of adolescent (HPV) human papillomavirus vaccine utilization that explored future HPV vaccination rates, with and without a school mandate, for the vaccine at middle school entry.
  
  
  METHODS
  A dynamic, population-based, compartmental model was developed that estimated over a 50-year time horizon HPV vaccine uptake among female adolescents living in the United States. The model incorporated data on parental attitudes about this vaccine and adolescent health care utilization levels.
  
  
  RESULTS
  Without a mandate, our model predicted that 70% coverage, a lower threshold value used in many previous modeling studies of HPV vaccination, would not be achieved until a mean of 23 years after vaccine availability. Maximal coverage of 79% was achieved after 50 years. With a school mandate in place, utilization increased substantially, with 70% vaccination coverage achieved by year 8 and maximal vaccination coverage, 90%, achieved by year 43.
  
  
  CONCLUSIONS
  Our results suggest that vaccine utilization is likely to be low for several years, though strong school mandates might improve HPV vaccine uptake. These results affect the interpretation of previous modeling studies that estimated the potential clinical effects of HPV vaccination under assumptions of very high vaccine utilization rates.
authors: Department of Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan 48109-5456, USA. adempsey@umich.edu
authors: Amanda F
authors: AF
authors: Dempsey
authors: David
authors: D
authors: Mendez
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D037141:Mandatory Programs / Q000706:statistics & numerical data* / Q000639:trends*; D015233:Models, Statistical; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D012572:School Health Services / Q000458:organization & administration*; D014481:United States
chemical_list: D053918:Papillomavirus Vaccines