Human papillomavirus vaccination in girls and women has increased significantly since the implementation of the Affordable Care Act (ACA), according an analysis of federal survey data.

Overall, girls and women were 3.3 times more likely to receive the vaccine (95% confidence interval, 2.0, 5.5; P less than .0001) in the post–ACA implementation period, compared with the pre-ACA period. They were 5.8 times more likely to receive all three doses of the vaccine (95% CI, 2.5-13.6; P = .0001) post ACA, compared with one dose during that period, according to Rosemary Corriero of the University of Georgia, Athens, who is also a fellow at the Centers for Disease Control and Prevention, and her coauthors (J Pediatr Adolesc Gynecol. 2017 Jul 26. doi: 10.1016/j.jpag.2017.07.002).

The cross-sectional analysis included four waves of data from 2007-2008, 2009-2010, 2011-2012, and 2013-2014 – two waves before the ACA and two waves after. The data comes from the National Health and Nutrition Examination Survey (NHANES) questionnaire. In the pre-ACA surveys, 2,452 teenage girls and women were included, compared with 2,147 in the post-ACA years. The majority of participants were white, and analysis was limited to those aged 9-33 years.

The increase in vaccination could be due to the ACA’s provision requiring coverage of preventive health services without patient cost sharing in most health plans, but the investigators couldn’t say for sure.

Vaccination uptake was significantly higher for those with insurance coverage in both pre- and post-ACA groups (P = .0007 and P = .01, respectively).

Despite these increases, vaccination rates are still low. There has been progress, but “physicians and public health professionals could assist in the acceleration of HPV vaccination uptake by increasing communication of HPV vaccination importance and by utilizing campaigns and materials that are readily available,” the investigators wrote.

The study was limited by a lack of data for teenage boys and men before implementation of the ACA and by the overlap in pre- and post-ACA data in the 2009-2010 wave because of the timing of the provision. Additionally, the data was self-reported.

The investigators reported having no relevant financial disclosures.