Human Papillomavirus Vaccine Use Among Adolescent Girls and Young Adult Women: An Analysis of the 2007 California Health Interview Survey

Division of Behavioral and Communication Sciences, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390-9066, USA.
Journal of Women's Health (Impact Factor: 2.05). 03/2012; 21(6):656-65. DOI: 10.1089/jwh.2011.3284
Source: PubMed


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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    • "A recent study conducted on older adolescents (16–17 year old girls) in the Netherlands found that vaccinated and unvaccinated girls were comparable with respect to most sexual risk behaviours (a slightly higher percentage of vaccinated girls were sexually active, but this group had fewer total lifetime numbers of sexual partners) and no difference was found for history of STIs in the sexually active group [19]. There have been differing results from other international studies that have assessed HPV vaccination in relation to sexual behaviour; some studies in young adult women have found a positive association between vaccination initiation or completion and a history of STIs [10–12,15] or increasing number of sexual partners [13] [20], while other studies reported no association with these characteristics [14] [21]. Other studies in young adult women have also found an association between vaccination status and being single, unmarried or never married (with the exact measure being study dependent) [12] [14] [15] [22]. "
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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.
    Full-text · Article · Apr 2015 · Vaccine
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    • "Social determinants of rationales for delaying or forgoing the HPV vaccine remain underexplored despite research noting significant variations in HPV vaccination initiation by gender, race/ethnicity, and socioeconomic status (Kester et al., 2013; Polonijo and Carpiano, 2013; Reiter et al., 2013c; Tiro et al., 2012 "
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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.
    Full-text · Article · Dec 2014
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    • "The vaccine is most effective when given to women who have not yet become sexually active and younger women, especially below the age of 18 [9]. It is therefore highly recommended for adolescent girls and young adult women [10]. Many countries have implemented HPV vaccination programmes to reduce the burden of HPV-associated diseases [11,12]. "
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    ABSTRACT: Background Significant others are noted to be remarkable influences in modelling children’s and young people’s health perceptions and their adoption of health behaviour. The vaccinations which a child receives are shown to be significantly influenced by his or her parents. However, there is a paucity of Chinese-based studies. When discussing the Human Papillomavirus (HPV) vaccine, very few studies examine the perceptions of Chinese parents regarding the vaccine as a preventive health measure, and even fewer examine how these perceptions of the vaccine and sexual values influence their motivations in encouraging their children to be vaccinated. In view of the literature gap, this article investigates the perceptions of Hong Kong mothers in regard to vaccinating their daughters against HPV in Hong Kong. Methods A qualitative research approach with individual semi-structured interviews was conducted with 35 mothers aged 30 to 60 years old with daughter(s) between 9 and 17 years old. Results Six connected themes emerged. The participants commonly perceived the HPV vaccination as being unnecessary for their daughters in view of their young age. They worried that it would encourage their daughters to engage in premarital sex, and perceived the vaccination to be potentially harmful to health. Also, their low perceived risk of HPV in addition to the lack of reassurance from their health care providers failed to convince the participants that the vaccination was important for their daughters’ health. Finally, the participants found the vaccine to be expensive and perceived it to have little protection value in comparison to other optional vaccines. Conclusion The sampled mothers did not have a positive perception of the HPV vaccine. The cultural association between receiving the vaccination and premarital sex was prevalent. Bounded by their cultural values, the participants also had many misconceptions regarding the vaccine and the transmission of HPV, which discouraged them from having their daughters vaccinated. Furthermore, a lack of support from health care providers and the government health authorities concerning HPV vaccination failed to provide confidence and reassurance to mothers, and conveyed a meaning to these mothers that HPV vaccine is relatively unimportant.
    Full-text · Article · Jun 2014 · BMC Women's Health
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