Human Papillomavirus Vaccination Coverage among Adults Aged 27-45 Years in the U.S., 3 Years after the Recommendation for Shared Clinical Decision Making.

INTRODUCTION:In 2019, shared clinical decision making was recommended by the Advisory Committee on Immunization Practices for consideration of human papillomavirus vaccination of adults aged 27-45 years. This study aims to assess human papillomavirus vaccination among adults aged 27-45 years 3 years after shared clinical decision making recommendation. METHODS:Human papillomavirus vaccination (≥1 dose) among adults aged 27-45 years was assessed from the 2022 National Health Interview Survey and compared with results from 2019; vaccination from the 2021-2023 National Health and Nutrition Examination Survey was assessed and compared with results from 2017-2018. Analyses were conducted in 2025. RESULTS:Human papillomavirus vaccination coverage among adults aged 27-45 years was 21.8% in 2022, 6.3 percentage points higher than 2019 based on the National Health Interview Survey; coverage was 26.6% in 2021-2023, 16.7 percentage points higher than 2017-2018 based on the National Health and Nutrition Examination Survey. Among adults aged 27-45 years who were not vaccinated before age 27 years, coverage based on the National Health Interview Survey was 2.7%, an increase of 0.9 percentage points compared with 2019. Factors independently associated with higher human papillomavirus vaccination among those not vaccinated before age 27 years included older age, female sex, not being married, and having a regular physician for health care. CONCLUSIONS:Human papillomavirus vaccination among adults aged 27-45 years in 2022 was low despite an increase in coverage from 2019. Few adults were vaccinated at age 27-45 years. As persons vaccinated in routinely recommended and catch-up age groups progress into this population, coverage is likely to increase. Further surveys in this age group can inform overall coverage as well as use of shared clinical decision making in different population subgroups.