Gender, Regional and Ethno-racial Disparities in HPV Vaccination Uptake within Routine Recommended Ages in the United States: an analysis of vaccination trends from 2008 to 2017

Authors: Chido-Amajuoyi OG, Talluri R, Shete S

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Background: The Advisory Committee on Immunization Practices (ACIP) recommends routine HPV vaccination at ages 11-12 years, and allows for initiation as early as 9 years of age. HPV vaccination within the routine recommended period has important implications for vaccine efficacy and vaccination coverage rates. Methods: Data for this study were derived from the National Immunization Survey-Teen (NIS-Teen), spanning years 2008 to 2017. Using health care provider documented vaccination histories, we examined the trends in HPV vaccination initiation and completion within the routine recommended period. Further, we stratified vaccination status in relation to sociodemographic factors and region (US state of residence). Results: HPV vaccination within routine recommended ages increased over the years, with initiation rates rising from 17.3% in 2008 to 60.7% in 2017 and completion rates rising from 13.5% to 33.2% between 2011 and 2017. Since introduction of gender-neutral HPV vaccination, the rates of vaccination completion among boys rose more than 27% between 2011 and 2017, while completion rates increased by only 13% over the same period in girls. Blacks had higher rates of initiation and completion of HPV vaccination than Whites. Hispanic males and females consistently recorded higher HPV vaccination uptake rates than their non-Hispanic counter parts for the most part of the study period. However, HPV vaccination completion rates among Hispanics has declined in recent years, decreasing by 7% between 2015 and 2017. In 2017, while HPV vaccination initiation within the routine recommended period approached rates exceeding 70% in several US states, most states had vaccination completion rates well below 50% - excluding only Rhode Island (59.6%) and Arizona (51.3%). Conclusion: HPV vaccination during the routine recommended period in the US is sub-optimal, representing a missed opportunity for effective vaccination against HPV infection and HPV-related cancers. Further investigations are needed to uncover the underlying factors that contribute to the disparities observed in HPV vaccination uptake within the routine recommended period.

Keywords: HPV HPV vaccine Vaccination Disparities