Abstract A123: Legislation by states and its impact on factors causing divergence in HPV vaccination coverage: Analysis of 2013-2017 National Immunization Survey - Teens (NIS-TEENS)

Abstract

Abstract Background: Human papilloma virus (HPV) is strongly associated with multiple cancer types, affecting women, men and children of all races, ethnicities and backgrounds. HPV causes more than 30,000 cases of cancer every year and more than 70% of U.S population will experience at-least one HPV infection at some point. School-entry mandates and public health education campaigns though being separate entities, have significantly increased vaccine uptake, reduced disease prevalence and decreased racial disparities in disease rates. Furthermore, improvements in immunization against HPV are not equally distributed across gender, age, demographic and socioeconomic divisions within the recommended group of vaccine recipients. Objectives: To analyze and report the association between state-level policies and HPV vaccination uptake. We further explore predictors of HPV vaccination uptake using Aday & Anderson’s behavioral theory of healthcare utilization. Methods: A repeated cross-sectional survey of NIS-Teens data from 2013-2017 was used for the analysis. Bivariable associations and multivariable ordered logistic regression models were statistically performed using STATA 15/IC & SAS v9.4. Results: HPV vaccination completion rates were 17% higher in teens who lived in states with a legislative mandate irrespective of policy enactment. Relative to males, females had 72% higher odds of uptake. Compared to whites, Non-Hispanic blacks had a 21% lower odds of vaccination uptake. Compared to western region of the US, the north-east region reported 1.47 times higher odds of HPV vaccination. Provider recommendation was also significantly associated with HPV vaccination coverage rates. Conclusion: State legislative mandates had a profound impact of vaccination uptake. Additionally, racial minorities were significantly less likely to receive vaccination. Analysis of statewide adaptation of policy related bills and federal funding on VFC (Vaccine For Children) program could further inform those policy initiatives with the greatest uptake of vaccination. Citation Format: Radhika Ranganathan, Peyin Hung, Swann Arp Adams, Nicole L Hair, Shiba Simon Bailey. Legislation by states and its impact on factors causing divergence in HPV vaccination coverage: Analysis of 2013-2017 National Immunization Survey - Teens (NIS-TEENS) [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A123.