ASPO Abstracts
Disparities in provider recommendations for HPV vaccination: the role of state and adolescent characteristics
Category: Behavioral Science & Health Communication
Conference Year: 2020
Abstract Body:
Purpose
HPV vaccination could prevent the majority of >34,000 HPV cancers diagnosed in the US each year.
However, the percentage of parents who receive a provider recommendation to vaccinate varies
dramatically by state, from 91% in Massachusetts to 60% in Mississippi. To understand these
disparities, we examined state and adolescent characteristics associated with receipt of a provider
recommendation for HPV vaccination.
Methods
Participants were a national probability sample of 20,949 parents who completed the 2017 National
Immunization Survey-Teen about their 13- to 17-year-old children. Analyses also used data on states’
Vaccines for Children (VFC) programs that distribute free vaccines to all adolescents or limit eligibility
based on need. We used unweighted multilevel logistic regression to examine how state-level
characteristics (e.g., VFC program type) and adolescent characteristics predict receipt of a provider
recommendation (yes/no).
Results
With respect to state characteristics, adolescents living in states with universal versus more limited
VFC programs were more likely to have received a provider recommendation (78% vs. 71%;
aOR:1.48; 95% CI:1.18:1.87). There was no association for state per capita income or state proportion
of Black or Hispanic residents. With respect to family characteristics, adolescents were more likely to
have had a recommendation if they had a recent doctors’ visit (74% vs. 61%; aOR:1.61; 95%
CI:1.47:1.76) or saw a provider who participated in the VFC program (73% vs. 71%; aOR:1.17; 95%
CI:1.08:1.28). Receiving a provider recommendation was also associated with the following
adolescent characteristics: being female, being Non-Hispanic White, lower maternal education, lower
household income, and private insurance. No effect was observed for race (Black vs. White).
Conclusions
Findings suggest that generous VFC programs may support recommendations for HPV vaccination,
but adolescents of lower socioeconomic status less often receive recommendations. These findings
can offer insight into state-based disparities in HPV vaccine recommendations, while also helping to
target interventions to improve provider recommendations.
Funded by CDC grant #3U48DP005017-03S6 and NCI grant #T32CA057726
Keywords: HPV Cancer Prevention Health Disparities