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: 8.89). 10/2013; 58(2). DOI: 10.1093/cid/cit707
Source: PubMed


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.

1 Follower
13 Reads
  • Source
    • "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]. "
    [Show abstract] [Hide abstract]
    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.
    Vaccine 05/2014; 32(33). DOI:10.1016/j.vaccine.2014.05.058 · 3.62 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To identify factors associated with human papillomavirus (HPV) vaccination and to determine the geographic distribution of vaccine uptake while accounting for spatial autocorrelation. Design This study is cross-sectional in design using data collected via the Internet from the Survey of Minnesotans About Screening and HPV study. Setting and participants The sample consists of 760 individuals aged 18–30 years nested within 99 ZIP codes surrounding the downtown area of Minneapolis, Minnesota. Results In all, 46.2% of participants had received≥1 dose of HPV vaccine (67.7% of women and 13.0% of men). Prevalence of HPV vaccination was found to exhibit strong spatial dependence () across ZIP codes. Accounting for spatial dependence, age (OR=0.76, 95% CI 0.70 to 0.83) and male gender (OR=0.04, 95% CI 0.03 to 0.07) were negatively associated with vaccination, while liberal political preferences (OR=4.31, 95% CI 2.32 to 8.01), and college education (OR=2.58, 95% CI 1.14 to 5.83) were found to be positively associated with HPV vaccination. Conclusions Strong spatial dependence and heterogeneity of HPV vaccination prevalence were found across ZIP codes, indicating that spatial statistical models are needed to accurately identify and estimate factors associated with vaccine uptake across geographic units. This study also underscores the need for more detailed data collected at local levels (eg, ZIP code), as patterns of HPV vaccine receipt were found to differ significantly from aggregated state and national patterns. Future work is needed to further pinpoint areas with the greatest disparities in HPV vaccination and how to then access these populations to improve vaccine uptake.
    BMJ Open 08/2015; 5(8). DOI:10.1136/bmjopen-2015-008617 · 2.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to examine sociodemographic factors surrounding human papillomavirus (HPV) vaccine initiation and three-dose completion rates in the Intermountain West (IW). Analysis of the Centers for Disease Control and Prevention's 2012 National Immunization Survey-Teen dataset was conducted with a survey-weighted Pearson chi-square test and multivariable Poisson regression to produce bivariate and multivariate analyses. Participants with daughters aged 13-17 with provider-verified immunization records were included. Dual-frame adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were produced with provider-phase sampling weights. Factors included parents' and adolescents' sociodemographic and healthcare usage variables. Outcome measures included adolescents' receipt and completion of the HPV vaccine. Older parental ages (45 years and above) showed lower prevalence of adolescent HPV vaccine initiation (PR = 0.73, 95% CI = 0.59-0.87, p = .003) and completion (PR = 0.65, 95% CI = 0.44-0.96, p = .031) compared with parents younger than 35. Seventeen-year-old adolescents demonstrated highest prevalence of initiating (PR = 1.88, 95% CI = 1.47-2.39, p < .001) and completing (PR = 2.92, 95% CI = 1.97-4.33, p < .001) the vaccination series compared to 13-year olds. Those who had received meningitis vaccinations had high prevalence of initiating (PR = 1.93, 95% CI = 1.50-2.48, p < .001) and completing the HPV vaccine (PR = 2.52, 95% CI = 1.64-3.86, p < .001). This study highlights parental, adolescent, and health care characteristics related to use of the HPV vaccine. Future research to investigate specific barriers and strategies for addressing HPV vaccination use in the IW is recommended. © 2015 Wiley Periodicals, Inc.
    Public Health Nursing 08/2015; DOI:10.1111/phn.12223 · 0.83 Impact Factor