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HPV vaccination in teen girls highest in poor Hispanic communities
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HPV vaccination rates among teenage girls are highest in the poorest communities and among those who are Hispanic and living in predominantly Hispanic or mixed-race areas, according to data published in Cancer Epidemiology, Biomarkers and Prevention.
“In the United States, approximately 20,589 HPV-associated cancers are diagnosed each year among females, many of which may be preventable with the current HPV vaccine,” Kevin A. Henry, PhD, of the department of geography and urban studies at Temple University and the Fox Chase Cancer Center’s Cancer Prevention and Control Program, and colleagues wrote.
Kevin A. Henry
To examine the associations between HPV vaccination rates and geographic and community-level factors, the researchers analyzed data from the 2011 and 2012 National Immunization Survey-Teen, which included girls and boys aged 13 to 17 years in all 50 states and Washington, D.C. Narrowing their sample to 20,565 girls who had provider-verified vaccination records, the researchers analyzed associations of HPV vaccine initiation, in which at least one of the recommended three doses had been administered, with ZIP code-level geographic factors.
At the individual level, the researchers studied age, race and ethnicity, health insurance type, family income and the mother’s age, marital status and education level. Income status categories included “above poverty, high income,” defined as more than $75,000; “above poverty, moderate income,” defined as no more than $75,000, and below poverty, as defined by the U.S. Census family poverty threshold. They noted each area’s percentage of residents living below the federal poverty level, median household income, population density and racial-ethnic composition. The researchers used logistic regression to estimate the odds of HPV vaccine initiation.
Overall, 53.5% of girls received more than one dose of the HPV vaccine; 53.2% in 2011 and 53.8% in 2012. The vaccination rate among girls in high poverty communities was 61.1%, while in communities with low poverty, the rate was 52.4%. HPV vaccine initiation also was higher among girls in communities that were predominantly Hispanic, with 69% receiving at least one dose, compared with 49.9% in areas where the majority were non-Hispanic white. In non-Hispanic mixed-race communities, the rate was 60.4%. In addition, the odds of HPV vaccine initiation was significantly higher among Hispanic girls from communities where the majority race-ethnic group was Hispanic vs. Hispanic girls living in predominantly non-Hispanic white (adjusted OR = 2.23; 95% CI, 1.87-2.65) or non-Hispanic black (aOR = 1.9; 95% CI, 1.2-3.04) communities.
“This study found that initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial-ethnic composition was predominantly Hispanic or mixed race,” Henry and colleagues wrote. “It also found that regardless of individual race/ethnicity, girls living in predominantly [non-Hispanic white] and [non-Hispanic black] communities had the lowest rates. The reasons are unknown, but if public health officials wish to increase vaccination coverage in girls in these communities, they should obtain a better understanding of the individual characteristics and geographic or contextual factors that may lead to barriers to HPV vaccination and ineffective public health interventions.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
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