Abstract
BackgroundHuman Papillomavirus (HPV) vaccination coverage is below national goals in the United States. Research is needed to inform strategically designed interventions that target sociodemographic groups with underutilization of HPV vaccination.MethodsSecondary data analysis of the National Immunization Survey-Teen 2013 measured association of sociodemographic factors (e.g., ethnicity/race, insurance) with HPV vaccination among females and males ages 13–17 (N = 18,959). Chi-square and multivariable Poisson regressions were conducted using survey-weighted statistics.ResultsHaving a mother ≥35 years, a mother with some college, being of “Other” ethnicity/race, and having no providers who order vaccines from health departments was negatively associated with females initiating HPV vaccination. Having a mother with some college, being of Non-Hispanic White or “Other” ethnicity/race, and having some or no providers who order vaccines from health departments was negatively associated with males initiating HPV vaccination. These same factors were negatively associated with males completing HPV vaccination with the exception of “Other” ethnicity/race. In contrast, having an unmarried mother, being ages 15–17, having a hospital based provider, and receiving other adolescent vaccinations were positively associated with females initiating and completing HPV vaccination. Having an unmarried mother, health insurance that is not employer or union sponsored, and influenza and meningitis vaccinations was positively associated with male’s initiating HPV vaccination. For males, being 15 or 17 years old and having other adolescent vaccinations was positively associated with vaccine completion. All findings p ≤ 0.05.ConclusionsFuture HPV vaccination interventions may benefit from targeting certain sociodemographic groups that were negatively associated with HPV vaccination in this study.
Highlights
Human Papillomavirus (HPV) vaccination coverage is below national goals in the United States
Multiple systematic reviews have been completed on HPV vaccination and sociodemographic factors that are associated with HPV vaccination
One study analyzing NIS-Teen data spanning 2008–2011 found that HPV vaccination patterns differ from other adolescent vaccinations in that below-poverty adolescents and minority race/ethnicity adolescents had higher series initiation compared to above-poverty and white adolescents [6]
Summary
Human Papillomavirus (HPV) vaccination coverage is below national goals in the United States. Another review of the literature identified barriers to HPV vaccination among healthcare providers (e.g., providing only risk-based recommendations, financial challenges including cost to parents and lack of insurance reimbursement), parents and caregivers (e.g., lack of information or provider recommendation, concerns about cost and side effects), and underserved populations (e.g., limited information, being uninsured, low completion of series) [5]. These summaries of the literature provide context for studying and interpreting associations of sociodemographic factors with HPV vaccination using a national dataset of adolescent immunizations, the National Immunization Survey-Teen (NIS-Teen). In addition to poverty status and race/ethnicity, there are other social factors that have been associated with HPV vaccination including older adolescent age, being seen in public or hospital facilities, and having received other adolescent vaccinations [4, 10, 11]
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