Lower human papillomavirus vaccine initiation and completion among Asian American adolescents compared to their peers: National Health and Nutritional Examination Survey 2011-2018.

Abstract

To compare human papillomavirus (HPV) vaccination initiation and completion between Asian American adolescents and their peers. HPV vaccine initiation and completion of adolescents aged 9-17years old were analyzed using the National Health and Nutritional Examination Survey data from 2011 to 2018. The outcomes were HPV vaccine initiation percentage among all adolescents and completion percentage among initiators. Odds ratios for initiation or completion among Hispanics, Blacks, and Asians (referred to as racial/ethnic minorities) versus Whites were compared using logistic regression, adjusted for adolescent's age, annual family income, parent education, and insurance coverage. From 2011 to 2018, overall initiation was less than 40% among U.S. adolescents. The initiation increased among boys (from 10% in 2011-12 to over 30% in 2017-2018) but not among girls. Compared to White girls, Black and Hispanic girls were more likely, while Asian girls were less likely to initiate vaccination. Although not statistically significant, Asian girls had ORs ranging from 0.65 to 0.99 for initiation compared to White girls in each of the four survey cycles. Black and Hispanic boys were more likely to initiate vaccination compared to White boys. Initiation among Asian boys increased to 39% in the 2017-2018 survey cycle. Racial/ethnic minority girls were less likely to complete the series compared to White girls, while the opposite was seen in Black boys. HPV vaccination status varies among racial/ethnic groups. Future efforts should be made to achieve the Healthy People 2020 goal of 80% vaccination among U.S. adolescents and address the gap among Asian American girls.