Health Care Provider Recommendation, Human Papillomavirus Vaccination, and Race/Ethnicity in the US National Immunization Survey.

Kelly R. Ylitalo is with the Department of Epidemiology, University of Michigan, Ann Arbor. Hedwig Lee is with the Department of Sociology, University of Washington, Seattle. Neil K. Mehta is with the Department of Global Health at the Rollins School of Public Health, Emory University, Atlanta, GA.
American Journal of Public Health (Impact Factor: 4.23). 06/2012; DOI: 10.2105/AJPH.2011.300600
Source: PubMed

ABSTRACT Objectives. Human papillomavirus (HPV) is a common sexually transmitted infection in the United States, yet HPV vaccination rates remain relatively low. We examined racial/ethnic differences in the prevalence of health care provider recommendations for HPV vaccination and the association between recommendation and vaccination. Methods. We used the 2009 National Immunization Survey-Teen, a nationally representative cross-section of female adolescents aged 13 to 17 years, to assess provider-verified HPV vaccination (≥ 1 dose) and participant-reported health care provider recommendation for the HPV vaccine. Results. More than half (56.9%) of female adolescents received a recommendation for the HPV vaccine, and adolescents with a recommendation were almost 5 times as likely to receive a vaccine (odds ratio = 4.81; 95% confidence interval = 4.01, 5.77) as those without a recommendation. Racial/ethnic minorities were less likely to receive a recommendation, but the association between recommendation and vaccination appeared strong for all racial/ethnic groups. Conclusions. Provider recommendations were strongly associated with HPV vaccination. Racial/ethnic minorities and non-Hispanic Whites were equally likely to obtain an HPV vaccine after receiving a recommendation. Vaccine education efforts should target health care providers to increase recommendations, particularly among racial/ethnic minority populations. (Am J Public Health. Published online ahead of print June 14, 2012: e1-e6. doi:10.2105/AJPH.2011.300600).

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