ASPO Abstracts
Disparities by Sex, Race/Ethnicity, and Education among US Adults for Human Papillomavirus Vaccine Awareness: Results from the 2018 Health Information National Trends Survey
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose: HPV vaccine awareness and completion rates are lower among racial/ethnic minority adolescents and
young adults, but to date no study has examined racial/ethnic differences in vaccine awareness among adults who
fall within the expanded age of FDA approval (18-45 years).
Methods: The 2018 Health Information National Trends Survey (HINTS) conducted by the National Cancer
Institute to monitor the US population’s use of cancer-related information provided the data for this analysis. We
assessed HPV vaccine awareness (yes or no) available in the 2018 HINTS. The item asked if the respondent had
ever heard of the vaccine prior to completing the survey. Covariates included age, sex, race/ethnicity (including
Hispanic, non-Hispanic black [NHB], and non-Hispanic white [NHW]), education level, general health status, and
insurance status. Weighted logistic regression models evaluated the odds of HPV vaccine awareness adjusted for
the other variables. The model also tested interactions among sex, race/ethnicity, and education.
Results: Overall, HPV vaccine awareness was 66.5%. The sample consisted of 959 respondents with a mean age
of 30 and were 49.9% female. The majority of the sample were NHWs (66.4%), followed by Hispanics (22.0%),
and NHBs (11.6%). NHW respondents (72.3%) had the highest prevalence of HPV vaccine awareness compared
to NHBs (59.6%) and Hispanics (55.2%). College educated respondents had the highest rate of vaccine
awareness (76.6%), followed by high school educated respondents (37.3%), and respondents with less than a
high school education (33.9%). In the regressions, females had over 5 times the odds of vaccine awareness
compared to males, and the odds of HPV vaccine awareness also varied significantly by education level. Graphed
predicted probabilities of HPV awareness confirmed the interaction effect between sex and race/ethnicity. NHWs
experience higher awareness and greater benefits by education compared to the other groups.
Conclusions: A social gradient of HPV and vaccine awareness exists by education level, with lower levels of HPV
vaccine awareness among adults with less education. These findings suggest that outreach efforts to increase
vaccination rates among newly eligible adults should target men and less educated minority women
Keywords: HPV, vaccine, disparities, education, awareness