Article

Health Disparities in Human Papillomavirus Vaccine Coverage: Trends Analysis From the National Immunization Survey-Teen, 2008-2011

Rollins School of Public Health, Emory University, Atlanta GA.
Clinical Infectious Diseases (Impact Factor: 9.42). 10/2013; 58(2). DOI: 10.1093/cid/cit707
Source: PubMed

ABSTRACT Adolescent uptake of human papillomavirus (HPV) vaccine remains low. We evaluated HPV vaccine uptake patterns over 2008-2011 by race/ethnicity, poverty status, and the combination of race/ethnicity and poverty status, utilizing National Immunization Survey-Teen data. Minority and below poverty adolescents consistently had higher series initiaion than white and above poverty adolescents.

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    • "A trend analysis of NIS-Teen data for 2008 through 2011 reported that minority and below-poverty adolescents had consistently higher HPV vaccine series initiation than white and above-poverty adolescents. In this analysis, all race/ethnicity groups had completion percentages ranging from 32% to 40% [6]. Overall, these current HPV vaccination rates are well below the Healthy People 2020 goal of an 80% coverage level of 3 doses of HPV vaccine by age 13–15 years [7]. "
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    ABSTRACT: Objective: Minority populations in the United States are disproportionally affected by human papillomavirus (HPV) infection and HPV-related cancer. We sought to understand physician practices, knowledge and beliefs that affect utilization of the HPV vaccine in primary care settings serving large minority populations in areas with increased rates of HPV-related cancer. Study design: Cross-sectional survey of randomly selected primary care providers, including pediatricians, family practice physicians and internists, serving large minority populations in Brooklyn, N.Y. and in areas with higher than average cervical cancer rates. Results: Of 156 physicians randomly selected, 121 eligible providers responded to the survey; 64% were pediatricians, 19% were internists and 17% were family practitioners. Thirty-four percent of respondents reported that they routinely offered HPV vaccine to their eligible patients. Seventy percent of physicians reported that the lack of preventive care visits for patients in the eligible age group limited their ability to recommend the HPV vaccine and 70% of those who reported this barrier do not routinely recommend HPV vaccine. The lack of time to educate parents about the HPV vaccine and cost of the vaccine to their patients were two commonly reported barriers that affected whether providers offered the vaccine. Conclusions: Our study found that the majority of providers serving the highest risk populations for HPV infection and HPV-related cancers are not routinely recommending the HPV vaccine to their patients. Reasons for providers' failure to recommend the HPV vaccine routinely are identified and possible areas for targeted interventions to increase HPV vaccination rates are discussed.
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