Background HPV vaccines have been available in the US since 2006 and have the potential to prevent ≥90% of anogenital warts (AGW). Monitoring trends in AGW is important to assess progress of immunization programs.
Methods Two datasets for Connecticut (population 3.6 million) were used. Data for residents with private insurance were available for 2012–2017 from a multi-payer claims database (∼1 million covered individuals per year). Data for residents with Medicaid insurance were available for 2009–2013 (∼512,000 individuals per year).
Results Among privately insured women, the annual incidence rate (IR) of AGW declined from 104 to 68 per 100,000 during 2012–2017. Significant declines were observed for women aged 15–19 (p for trend=.03, average annual percent change (AAPC) -11%), 20–24 (p<0.001, AAPC -13%), 25–29 (p<0.001, AAPC -7%), and 30–34 (p<0.01, AAPC -2%). Similar patterns were observed among men, with an overall decline from 179 to 105 per 100,000, and p<0.001 for trends in each age group and AAPCs ranging from -16% to -3%. Among Medicaid-insured women, the overall IR of AGW declined from 175 to 145 per 100,000 during 2009–2013. Significant declines were observed for women up to age 29 years (p<0.05 and AAPCs from -13% to -3%). Rates in Medicaid-covered men did not decline in any age group.
Conclusion In Connecticut, significant and substantial declines in AGW have occurred in women during both periods (2009–2013 and 2012–2017). In men, declines occurred during 2012–2017 but not during 2009–2013, perhaps due in part to the later routine recommendation for males in 2011 compared to females in 2006. Greater declines in younger populations are consistent with HPV vaccine impact. These reductions have been achieved in a setting of moderate HPV vaccine uptake and could be further reduced with higher coverage.
Disclosure No significant relationships.
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