Legislative Changes in US States’ to Increase HPV Vaccination




Assistant Professor of Nursing

Project Summary

This summer I had the opportunity to study Human Papillomavirus (HPV) legislation under the mentorship of Dr. Melanie Kornides from Penn Nursing. My project’s focus is on the impact of legislative action on HPV vaccine uptake and interest. 

HPV is the most common sexually transmitted infection. It usually goes away on its own, but in some cases the infection can lead to different types of cancer in females as well as males. In 2006 the Center for Disease Control and Prevention (CDC) adopted the Advisory Committee on Immunization Practices’ (ACIP) recommended guidelines regarding a preventative vaccine against HPV. It is nationally recommended that all adolescents between ages 11 and 12 be vaccinated, yet uptake remains relatively low with only 49% of adolescents up to date on the vaccine. Legislation regarding the vaccine remains at the state level. 

My main task this summer was to conduct a qualitative content analysis on legislation introduced from 2006 to 2018 regarding the HPV vaccine. Over the course of the summer, I learned about the content analysis research tool. Using this method, I studied HPV vaccine-related legislation and determined the presence of various pre-established categories and codes. I adapted the categories and codes over time according to bill content. I originally sourced legislation from the National Conference of State Legislatures (NCSL) website. However, after an initial round of coding, I found that there was legislation missing from 15 states. I found additional bills by searching state legislature websites and archives using search terms “hpv”, “papillomavirus” and “papilloma virus”. The second round of coding consisted of these bills. 
Successfully implementing policies regarding the HPV vaccine proves to be a challenge according to the study’s preliminary results. In the 12 years following the FDA’s approval of the HPV vaccine, only 41.3% of bills introduced passed. The most effective method of increasing vaccine coverage is requiring it for school entry. Currently only three jurisdictions do. The two coding intervals yielded similar results: legislative action has predominantly focused on promoting awareness, vaccine cost, and vaccination based on age or grade. A limitation to this study is that the results are still preliminary. The study did not end at the conclusion of the summer. There are still existing bills that were not included on the NCSL website. I will be conducting a final round of sourcing and coding. Due to time constraints, I did not have time to conduct the Google Trends or National Immunization Survey data analyses. Analyses will take place following the final coding interval to measure effects of legislative action on vaccination interest and uptake.  

This summer, I had the chance to learn more about the content analysis research tool, HPV legislation, and qualitative research methods. My PURM experience allowed me to see firsthand what a career in research would look like. I look forward to seeing where the project will lead me as I continue to work with Dr. Kornides.