Socioeconomic and Racial Trends in Human Papillomavirus Vaccination: A 10-Year Retrospective Review [ID: 1366482

Abstract

INTRODUCTION: Human papillomavirus (HPV) vaccination in the United States is low, and lack of vaccination disproportionately affects minority patients and those of a lower socioeconomic status. We sought to assess the effect of race and ethnicity and socioeconomic factors on HPV vaccine adoption over the last decade. METHODS: An analysis was conducted on data from the National Health Nutrition Examination Survey from 2009 to 2018 of individuals aged 12–26 years. Sociodemographic and vaccination history was gathered via self-report. Logistic regression models assessed relationships between HPV vaccination and variables of interest. RESULTS: Data from 8,120 individuals were included in the analysis. Vaccine initiation among females rose from 30.5% (95% CI 25.7–35.8) in 2009–2010 to 55.1% (95% CI 50.0–60.0) in 2017–2018 and from 8.3% (95% CI 6.2–10.9) in 2011–2012 to 36.4% (95% CI 31.2–41.9) in 2017–2018 for males. Individuals with insurance coverage were 2.0 times more likely to report being vaccinated (95% CI 1.8–2.6). Independent of insurance coverage, having a routine place to seek health care was associated with a 1.9 times increase (95% CI 1.5–2.3) in HPV vaccination. Independent of insurance and access to care, Mexican American and non-Hispanic Black individuals were 1.7 times (95% CI 1.3–2.2) and 1.4 times (95% CI 1.1–1.9) less likely to complete the vaccine series compared to non-Hispanic White individuals. CONCLUSION: Human papillomavirus vaccination initiation has increased in the United States over the past 10 years; however, vaccination has plateaued among women with only half of females vaccinated and nearly a fifth initiating but not completing the series. Access to care appears to be a significant predictor of HPV vaccination.