Abstract
Introduction: The human papillomavirus (HPV) vaccine was approved by the Food and Drug Administration in 2006. Since that time, limited research has examined HPV vaccine uptake among adolescent females and no studies have examined the role of disparities in HPV vaccination. The purpose of this study is to examine geographic disparity in the prevalence of HPV vaccination and to examine individual‐, county‐, and state‐level correlates of vaccination.
Methods: Three‐level random intercept logistic regression models were fitted to data from 1,709 girls aged 13–17 living in 6 U.S. states using 2008 Behavioral Risk Factor Surveillance System and 2000 U.S. Census data.
Results: Overall, 34.4% of girls were vaccinated. Significant geographical disparity across states (Var: 0.134 SE: 0.065) and counties (Var: 0.146 SE: 0.063) was present, which was partially explained by state‐ and county‐level poverty rates. Independent of individual‐level factors, poverty had differing effects at the state‐ and county‐level: girls in higher poverty states were less likely while girls in higher poverty counties were more likely to be vaccinated. Household income demonstrated a similar pattern to that of county‐level poverty: compared to girls in the highest income families, girls in the lowest income families were more likely to be vaccinated.
Conclusions: The results of this study suggest geographic disparity in HPV vaccination and area‐level effects of poverty that have not previously been studied. The higher odds of vaccination among girls living in higher poverty counties and low income families may indicate the success of publicly‐funded vaccination efforts targeting the underserved or a bias against vaccination among higher income groups. Overall vaccination rates continue to be sub‐optimal however, and future research is needed to examine the impact of state‐ and local‐area policies and to increase vaccination among eligible girls.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):B9.
RSS Feeds