Race-specific trends in HPV vaccinations and provider recommendations: persistent disparities or social progress?

Although racial and ethnic differences in HPV vaccination initiation are well established, it is unclear whether these disparities have changed over time. The role of health provider recommendations in reducing any racial and ethnic inequalities is also uncertain. This study addresses these gaps in the literature. Repeated cross-sectional design. Using data from the National Immunization Survey-Teen (2008-2013), we estimated a series of binary logistic regressions to model race-specific trends in (1) provider recommendations to vaccinate against HPV and (2) HPV vaccine initiation for males (n = 56,632) and females (n = 77,389). Provider recommendations to vaccinate and HPV vaccination uptake have increased over time for adolescent males and females and across all racial and ethnic groups. Among girls, minority youths have seen a sharper increase in provider recommendations and HPV vaccination uptake than their White counterparts. Among boys, minority teens maintain higher overall rates of HPV vaccine uptake, however, Hispanics have lagged behind non-Hispanic Whites in the rate of increase in provider recommendations and HPV vaccinations. Our results suggest that racial and ethnic disparities in provider recommendations and HPV vaccinations have waned over time among males and females. While these trends are welcomed, additional interventions are warranted to increase overall rates of vaccination across race, ethnicity, and gender.

Burdette AM ，Webb NS ，Hill TD ，Jokinen-Gordon H ... -  《-》

Correlates of HPV vaccine initiation and provider recommendation among male adolescents, 2014 NIS-Teen.

Vaccination is a safe and effective way to prevent Human Papillomavirus (HPV) infection and related cancers; however, HPV vaccine uptake remains low in the US. After the 2011 Advisory Committee on Immunization Practices (ACIP) recommendation for routine HPV vaccination of adolescent males, several studies have examined predictors for initiating the vaccine series in this population of interest, particularly with regard to provider recommendations. This study examined racial and ethnic differences for HPV vaccine initiation and provider recommendation in male adolescents. Based on prior HPV vaccine uptake estimates and healthcare utilization data, we hypothesized that minority adolescents would be more likely to initiate HPV vaccines, but less likely to receive a provider recommendation compared to white counterparts. We analyzed the 2014 National Immunization Survey-Teen (NIS-Teen), which included 10,753 male adolescents with provider-verified vaccination data in 50 US states, using multivariate logistic regression models to evaluate racial/ethnic differences in HPV vaccine initiation and provider recommendation. The odds of HPV vaccine initiation were 76 percent higher for Hispanic adolescents and 43 percent higher for non-Hispanic Other or Multiple race adolescents compared to white adolescents. Approximately half of parents reported receiving a provider recommendation for vaccination, with no significant difference in the odds of receiving a provider recommendation across racial/ethnic groups. Despite similar frequency of recommendations across racial and ethnic groups, male adolescents who are racial/ethnic minorities are more likely to initiate vaccination. Future research should focus on developing tailored interventions to increase HPV vaccine receipt among males of all racial/ethnic groups.

Landis K ，Bednarczyk RA ，Gaydos LM 《-》

Human papillomavirus (HPV) vaccine initiation in minority Americans.

Transmission of the human papillomavirus (HPV) is a significant public health concern. HPV is preventable through a series of vaccinations; however, knowledge gaps exist as to which groups are least likely to initiate vaccination. Considering this gap, the aim of this study is to examine HPV vaccine initiation rates in racial minorities, comparing foreign-born individuals to their American-born peers. Population-based data from the 2013 National Health Interview Survey (NHIS), a repeated large-scale household interview survey of a statistically representative sample of the United States civilian non-institutionalized population, were applied. Data were derived from two survey modules: the family and summary adult modules. Sampling weights were employed to logistic regression modelling the outcome of HPV vaccine initiation. Foreign-born persons, African Americans, males, those lacking health insurance coverage and those without a medical home (usual place to receive care) held statistically lower rates of HPV vaccine initiation. Being college educated was associated with higher odds of HPV vaccine initiation. Our findings support the persistence of health disparities in racial minorities and foreign-born persons residing in the United States. Addressing these gaps will likely require both individual-level (e.g. targeted health education) and system-level (e.g. HPV vaccine promoting policies) interventions. Since health insurance coverage and having a medical home were significant associates of HPV vaccine initiation, attempts to coverage may improve HPV vaccine initiation rates. Additionally, policies which require HPV vaccination for school entry could boost coverage across all population groups, including boys, foreign-born persons and racial minorities.

De P ，Budhwani H 《-》

Health care provider recommendation, human papillomavirus vaccination, and race/ethnicity in the US National Immunization Survey.

Ylitalo KR ，Lee H ，Mehta NK 《-》

Racial/Ethnic Disparities in HPV Vaccine Uptake Among a Sample of College Women.

Okafor C ，Hu X ，Cook RL 《-》