Human Papillomavirus Vaccine Use Among Adolescent Girls and Young Adult Women: An Analysis of the 2007 California Health Interview Survey
ABSTRACT Administration of the human papillomavirus (HPV) vaccine is recommended for adolescent girls and young adult women. Little is known about the factors associated with vaccination. This study examined prevalence and correlates of HPV vaccine initiation (≥1 dose) among a statewide representative sample of adolescent and young adult females living in California.
HPV vaccination data on 3615 parents of adolescent girls aged 12-17 and 2068 young adult women aged 18-27 from the 2007 California Health Interview Survey (CHIS) were examined by sociodemographic, healthcare access, and health behavior factors using chi-square and multivariable logistic regression models.
Nineteen percent of adolescent girls and 11% of young adult women had initiated the HPV vaccine series. In both groups, lower educational attainment (parental/own) was associated with lack of vaccine initiation. For adolescents, vaccine initiation was also significantly lower among those whose parents had low incomes or no usual source of care. For young adults, initiation was lower among the older group and those who spent less time in the United States, had public insurance, had no recent provider visit, or had fewer sexual partners.
In a statewide representative sample, different correlates of early initiation of HPV vaccination emerged for Californian adolescent girls and young adult women. These different patterns may be due to differential access to programs that provide free or low-cost HPV vaccines. Because several of these factors are associated with disparities in use of Pap tests, disparities will persist or even worsen unless greater effort is placed on vaccinating populations at highest risk for cervical cancer.
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ABSTRACT: Australia commenced a publically-funded, National Human Papillomavirus (HPV) Vaccination Program in 2007 with a two year catch-up phase for females aged 12-26 years. To identify the factors associated with the uptake of the HPV vaccine (which has a recommended 3-dose schedule in Australia) by young adult women vaccinated by general practitioners and community-based programs within the catch-up phase. 1139 women who were eligible to receive the free HPV vaccine during the catch-up period were recruited in 2008-2009 (age 20-29 years at recruitment), in New South Wales, after having a normal (negative) cervical smear result recorded on the NSW Pap Test Register. Participants completed a self-administered questionnaire providing information on vaccination status, and sociodemographic and other factors. Overall, 880 (77%) women reported receiving ≥1 dose of the vaccine and 777 women (68%) reported receiving ≥2 doses. In multivariable analysis (adjusting for the period for which each woman was eligible for free HPV vaccination), uptake of ≥1 dose of the vaccine was significantly associated with being born in Australia (p<0.01), being single (p=0.02), being nulliparous (p<0.01), living in a higher socioeconomic status area (p-trend=0.03), living in more remote areas (p=0.03), drinking alcohol (p<0.01) and using hormonal contraceptives (p<0.01). Although vaccinated women were more likely to have fewer sexual partners than unvaccinated women (p-trend=0.02), they were also more likely to report a prior sexually transmitted infection (STI) (p=0.03). Similar factors were associated with receiving ≥2 doses. In this group, women living in higher socioeconomic status areas were more likely to be vaccinated against HPV in the catch-up phase of the national program. Although vaccinated women tended to have fewer sexual partners, they also reported prior STIs, which may be a marker of increased risk of prior exposure to HPV. The findings of this study reinforce the continuing need to prioritise equitable delivery of vaccination to various population subgroups. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.Vaccine 04/2015; 32. DOI:10.1016/j.vaccine.2015.01.024 · 3.49 Impact Factor
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ABSTRACT: Objective. To examine social variations in parental rationales for delaying or forgoing the HPV vaccination in their U.S. adolescent children. Methods. Using data from the 2011 National Immunization Survey-Teen, we estimated a series of binary logistic regression models to predict the odds of reporting (1) any vaccine delay (n = 25,229) and (2) specific rationales among parents who reported that they were “not likely at all” to vaccinate their teen (n = 9,964). Results. The odds of not receiving a recommendation to vaccinate were higher in parents of boys (OR = 2.57; CI = 2.20-3.01). The odds of reporting a lack of knowledge were higher in parents who identified as Hispanic (OR = 1.39; CI = 1.11-1.72), Black (OR = 1.49; CI = 1.19-1.85), and other races (OR = 1.43; CI = 1.13-1.80) than parents who identified as non-Hispanic White. Socioeconomic disparities in parental rationales for delaying HPV vaccination in their teen children were sporadic and inconsistent. Conclusion. Our results suggest that interventions should focus on increasing information about the benefits of the HPV vaccine among parents of minority youth. Our findings also suggest that interventions targeting health care providers may be a useful strategy for improving vaccine uptake among adolescent males.12/2014; 1(1):21-26. DOI:10.1016/j.pmedr.2014.09.003
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ABSTRACT: This study assessed HPV vaccination and its correlates among culturally diverse 18-26 year-old community college women in Los Angeles. Specific research questions were: (1) What proportion of respondents have initiated the HPV vaccine, and what proportion have completed the three-dose series? (2) What demographic (e.g., age, ethnicity), psychosocial (e.g., vaccine-related beliefs, perceived social norms), and health care-related variables (e.g., health insurance status, provider recommendation, health care trust and satisfaction) are associated with vaccine initiation for this sample? Participants were recruited from the campus of a community college in central Los Angeles. All female students between 18 and 26 were eligible to participate. An anonymous web-based survey assessed number of HPV vaccine doses received as well as demographic information, HPV- and HPV vaccine-related knowledge, attitudes, and behavior, perceived social norms, provider & health care system factors, sexual behavior, cervical health, and mother-daughter communication about sex. Analyses were conducted using 178 surveys. Multivariate logistic regression tested the relationships of statistically significant bivariate predictors to vaccine initiation. Those who initiated the vaccine were younger, more often had a health-related academic major, thought the vaccine to be safer, perceived HPV severity lower, and perceived higher social approval for HPV vaccination than those unvaccinated. All who had initiated the vaccine had a doctor's recommendation. To increase uptake among 18-26-year-old women, research should explore provider interventions to increase vaccine recommendation, and also identify individuals and groups who may have negative beliefs about vaccine safety and efficacy to provide support in vaccine decision-making.Journal of Community Health 06/2012; DOI:10.1007/s10900-012-9572-x · 1.28 Impact Factor