Human Papillomavirus Vaccination Trends and Disparities in the United States: Who Is Getting Left Behind?. Issue 10 (October 2021) - Chan, John K.
Abstract : Background: United States guidelines recommend human papillomavirus (HPV) vaccination for males and females up to 26, with more recent extended coverage for those 27 to 45 years based on discussion with patients' clinician. This study seeks to assess trends and disparities of vaccination in the United States based on demographic characteristics. Methods: Data were obtained from the National Health and Nutrition Examination Survey between 2007 and 2016. χ 2 Analyses were used for statistical methods. Results: Of 12, 844 participants (median age, 22 years; range, 9–36 years), 2711 (21.3%) initiated HPV vaccination, of which 1358 (56.3%) completed the 3-dose vaccination series. Vaccination rates were higher in females compared with males (24.6% vs 13.0%; P < 0.001) and in Whites compared to Mexican Americans (22.6% vs 19.4%; P = 0.02). The uninsured had lower vaccination rates than private insurance and Medicaid (12.5% vs 22.4% vs 28.5%; P < 0.001). We divided the 10 year study into five separate periods (2007–2008, 2009–2010, 2011–2012, 2013–2014, and 2015–2016) to analyze trends. Vaccine initiation increased from 19.6% to 49.6% for 14–19-year olds ( P < 0.001), 10.4% to 35.5% for females ( P < 0.001), and 8.5% to 32.9% for Blacks ( P < 0.001). Although on trend analyses, the vaccination rates with the highest proportional increase were found in those: older than 25 to 29 years (4.56-fold), Mexican Americans (4.56 fold), below high school education (2.32 fold), and low income group (2.90 fold) over time. Conclusions: The HPV vaccination rates in Mexican Americans increased nearly 5-fold over the last 10 years. However, their vaccination rates continue to lag behind Whites and Blacks. Abstract : Overall, human papillomavirus vaccination rates fall short of the 80% coverage target set by Healthy People 2020. Vaccination rates in Mexican Americans increased nearly 5-fold, though lagging behind Whites and Blacks.Supplemental digital content is available in the text.