Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation among Adolescent Girls in the United States

Henry, Kevin A.; Stroup, Antoinette M.; Warner, Echo L.; Kepka, Deanna

doi:10.1158/1055-9965.epi-15-0658

Cited by 58 publications

(42 citation statements)

References 60 publications

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“…We observed that children and adolescents who lived in areas of low SES were less likely to get vaccinated. This finding is counter to recently published data from NIS-Teen data that revealed higher rates of HPV vaccine series completion among adolescents living below poverty compared to those living above poverty(13). Considerable variation in the association between HPV vaccination rates and socioeconomic status has been observed in prior research (3–7).…”

Section: Discussioncontrasting

confidence: 99%

“…As more healthcare systems move toward population health management models, health services researchers have an opportunity to systematically link area-level data to electronic health records (EHR). Prior studies have used this approach to evaluate the impact of geographic or area-level characteristics on HPV vaccination rates (3–7,12,13). Identification of geographic variation in HPV vaccination and associated variation in SES can inform health systems and public health practitioners of disparities in health care delivery.…”

Section: Introductionmentioning

confidence: 99%

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A Population-Based Study of Sociodemographic and Geographic Variation in HPV Vaccination

Rutten

Wilson

Jacobson

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background HPV vaccination rates in the U.S. remain low and lag behind other recommended adolescent vaccines. Studies evaluating the association of geographic and area-level characteristics with HPV vaccination rates provide a valuable resource for public health planning Method We used the Rochester Epidemiology Project data linkage system to ascertain HPV vaccination rates between 2010 and 2015 in a 7-county region of southern MN. Geocoded individual patient data was spatially linked to socioeconomic data from the American Community Survey at the census block group level. Bayesian hierarchical logistic regression was used to model incident vaccination rates, adjusting for individual- and area-level sociodemographic characteristics, and geolocation. Geolocation was modelled as an approximated Gaussian field using a Stochastic Partial Differential Equations approach. All models were estimated using Integrated Nested Laplace Approximations. Results In adjusted models, increasing age and female sex were associated with increased HPV vaccination. Lower socioeconomic status was associated with decreased rates of initiation (adjusted odds ratio (AOR) (95% credible interval) = 0.90 (0.86, 0.95)), completion of the 2nd dose (AOR=0.88 (0.83, 0.93) and completion of the 3rd dose (AOR =0.85 (0.80, 0.92)). Geographic spatial analysis demonstrated increased odds of vaccination for the eastern regionand in the greater Rochester metropolitan area, showing significant spatial variation not explained by individual level characteristics and ACS block group level data. Conclusion HPV vaccination rates varied geographically, and by individual- and geographically-indexed sociodemographic characteristics. Impact Identifying geographic regions with low HPV vaccination rates can help target clinical and community efforts to improve vaccination rates.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Population-Based Study of Sociodemographic and Geographic Variation in HPV Vaccination

Rutten

Wilson

Jacobson

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…However, a recent study noted that HPV vaccination uptake was highest for teen girls living in communities with high rates of poverty and among those with parents with low levels of education, and lowest for teen girls living in communities with low rates of poverty [35]. This was especially the case for Hispanic girls, who had a higher prevalence of HPV vaccination initiation than NH Black (NHB) and NH White (NHW) girls did.…”

Section: Introductionmentioning

confidence: 99%

Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States

et al. 2017

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BackgroundThis study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.).MethodsData from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately.ResultsIn 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32) than Hispanic boys in low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas.ConclusionHigher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with high poverty may be attributable to factors such as vaccine acceptance, health-care practices, and their access to HPV vaccines through the Vaccines for Children Program, which provides free vaccines to uninsured and under-insured children. Given the low HPV vaccination rates among boys in the U.S., these results provide important evidence to inform public health interventions to increase HPV vaccination.

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“…Current strategies to increase HPVV in the United States focus on improving provider recommendations and parental acceptability of HPVV because these factors are strongly related to utilization [15][16][17][18] and were recommended by the President's Cancer Panel and the National Vaccine Advisory Committee. We estimated that an additional 6.77 million girls and an additional 7.62 million boys aged 11 to 12 years would need to receive 2 doses of the vaccine between 2018 and 2026 for 80% prevalence to be achieved by 2026.…”

Section: Discussionmentioning

confidence: 99%

Reaching 80% human papillomavirus vaccination prevalence by 2026: How many adolescents need to be vaccinated and what are their characteristics?

Fedewa

Preiss

Fisher‐Borne

et al. 2018

Cancer

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Background Human papillomavirus vaccination (HPVV) prevents several types of cancer. The American Cancer Society recently established a goal that by 2026, 80% of adolescents will be up to date (UTD) before their 13th birthday. However, the number in need of vaccination to reach this goal is unknown. This study estimated the number of additional adolescents (11‐12 years old) who need HPVV for 80% prevalence to be reached by 2026. Methods The study used de‐identified and publicly available data and exempt from institutional review board approval and informed consent. The 2016 National Immunization Survey for Teens was used to estimate the baseline HPVV prevalence. Linear growth to 80% HPVV prevalence by 2026 was applied to set intermediate targets. US Census Bureau data were used for population projections. This study estimated the cumulative number of additional adolescents 11 to 12 years old who would need to become UTD (ie, receive 2 doses) by first subtracting the number who would need to be vaccinated to achieve an intermediate target prevalence from the estimated number currently compliant and then summing these numbers between 2018 and 2026. Results Nationwide, an additional 7.62 million males (95% confidence interval [CI], 6.78 million to 8.40 million) and an additional 6.77 million females (95% CI, 5.95 million to 7.55 million), aged 11 to 12 years, would need to receive 2 doses of the vaccine between 2018 and 2026 for 80% prevalence to be achieved. Most adolescents not UTD (80%) also needed to initiate vaccination, and more than 90% recently visited a health care provider. Conclusions It is estimated that at least 14.39 million additional adolescents aged 11 to 12 years in the United States will need to receive 2 doses of HPVV for a UTD HPVV prevalence of 80% to be achieved by 2026. To reach this goal, improvements in facilitators of HPVV initiation, including physician recommendations and parental acceptability, are needed.

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Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation among Adolescent Girls in the United States

Cited by 58 publications

References 60 publications

A Population-Based Study of Sociodemographic and Geographic Variation in HPV Vaccination

A Population-Based Study of Sociodemographic and Geographic Variation in HPV Vaccination

Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States

Reaching 80% human papillomavirus vaccination prevalence by 2026: How many adolescents need to be vaccinated and what are their characteristics?

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