Status of Human Papillomavirus Vaccination in Hispanic Teenagers vs. Non-Hispanic Teenagers: Findings From the CDC National Immunization Survey - Teen, 2020
Abstract
Introduction and Objective. Human Papillomavirus (HPV) vaccination hesitancy has increased in the past several years. Vaccination rates in minority populations tend to be lower, possibly due to limited access to healthcare and increased vaccine hesitancy. The objective is to examine if Hispanic ethnicity is associated with up-to-date (UTD) HPV vaccination coverage among teenagers aged 13-17 in the US. Methods. We conducted a cross-sectional comparative study using data from the CDC NIS-Teen 2020. Inclusion criteria were male and female US teenagers aged 13-17. Exclusion criteria were teenagers without adequate provider data or with missing information of key variables. The exposure was the ethnicity of the teen categorized as “Hispanic” or “non-Hispanic”, reported by the participant's parents or guardian. The outcome was HPV vaccination status, categorized as “up-to-date” or “not up-to-date” (with UTD being 3+ shots of HPV vaccine for those receiving first shot at 15 y or older and 2 shots for those with first shot under 15 y) as reported by the teenager’s provider. Both unadjusted and adjusted for potential confounders (multiple logistic regression) odds ratios and 95% confidence intervals (OR 95% CI) between ethnicity and vaccination status were estimated. Results. Our sample consisted of 14,782 participants of which 2,767 (25.4.%) were Hispanic and 12,015 (74.6%) were non-Hispanic. As compared to non-Hispanic teenagers, Hispanics had mother’s with less formal education, higher poverty proportions, higher frequency of Medicaid or no insurance, and lower frequency of vaccination recommendation from their primary healthcare provider. The overall proportion of participants with UTD HPV vaccination was not different between Hispanic and non-Hispanic teenagers (79.9% and 81.3%, respectively with a p < 0.394). After adjustment the odds of UTD were higher among Hispanic participants: OR 95%, CI 1.32 [1.02-1.70], and p-value < 0.037). Conclusions-Implications. Our study found that overall HPV vaccination coverage among teenagers is satisfactory, with Hispanic Teenagers having slightly higher odds of UTD vaccination status. A limitation is that only 45% of NIS Teen participants had documented information on HPV vaccination status. Efforts to improve coverage and quality of vaccine records are needed.
Keywords
HPV vaccine, social determinants of health, vaccine hesitancy, Hispanic and non-Hispanic populations
Presentation Type
Poster Presentation
Status of Human Papillomavirus Vaccination in Hispanic Teenagers vs. Non-Hispanic Teenagers: Findings From the CDC National Immunization Survey - Teen, 2020
Introduction and Objective. Human Papillomavirus (HPV) vaccination hesitancy has increased in the past several years. Vaccination rates in minority populations tend to be lower, possibly due to limited access to healthcare and increased vaccine hesitancy. The objective is to examine if Hispanic ethnicity is associated with up-to-date (UTD) HPV vaccination coverage among teenagers aged 13-17 in the US. Methods. We conducted a cross-sectional comparative study using data from the CDC NIS-Teen 2020. Inclusion criteria were male and female US teenagers aged 13-17. Exclusion criteria were teenagers without adequate provider data or with missing information of key variables. The exposure was the ethnicity of the teen categorized as “Hispanic” or “non-Hispanic”, reported by the participant's parents or guardian. The outcome was HPV vaccination status, categorized as “up-to-date” or “not up-to-date” (with UTD being 3+ shots of HPV vaccine for those receiving first shot at 15 y or older and 2 shots for those with first shot under 15 y) as reported by the teenager’s provider. Both unadjusted and adjusted for potential confounders (multiple logistic regression) odds ratios and 95% confidence intervals (OR 95% CI) between ethnicity and vaccination status were estimated. Results. Our sample consisted of 14,782 participants of which 2,767 (25.4.%) were Hispanic and 12,015 (74.6%) were non-Hispanic. As compared to non-Hispanic teenagers, Hispanics had mother’s with less formal education, higher poverty proportions, higher frequency of Medicaid or no insurance, and lower frequency of vaccination recommendation from their primary healthcare provider. The overall proportion of participants with UTD HPV vaccination was not different between Hispanic and non-Hispanic teenagers (79.9% and 81.3%, respectively with a p < 0.394). After adjustment the odds of UTD were higher among Hispanic participants: OR 95%, CI 1.32 [1.02-1.70], and p-value < 0.037). Conclusions-Implications. Our study found that overall HPV vaccination coverage among teenagers is satisfactory, with Hispanic Teenagers having slightly higher odds of UTD vaccination status. A limitation is that only 45% of NIS Teen participants had documented information on HPV vaccination status. Efforts to improve coverage and quality of vaccine records are needed.