Disparities in HPV Vaccination Among Adolescents by Health Care Facility Type
Recommended Citation
Nair M, Fokom Domgue J, Joseph CLM, Alleman ER, Williams AM, Abouelella DK, Babatunde OA, Osazuwa-Peters N, and Adjei Boakye E. Disparities in HPV Vaccination Among Adolescents by Health Care Facility Type. JAMA Pediatr 2024.
Document Type
Article
Publication Date
9-1-2024
Publication Title
JAMA Pediatr
Abstract
IMPORTANCE: Approximately 31 000 cases of human papillomavirus (HPV)-associated cancers are diagnosed annually in the US. The HPV vaccine can prevent more than 90% of these cancers, yet national uptake remains lower than the Healthy People 2030 target of 80% completion. To devise targeted interventions to increase the uptake of HPV vaccines, it is crucial to understand the vaccination rates across various health care settings.
OBJECTIVE: To examine the association between health care facility type and adolescent HPV vaccine uptake and clinician recommendation for the vaccine in the US.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study uses a complex sampling design of data from the 2020 National Immunization Survey-Teen. The study included adolescents aged 13 to 17 years. The data analysis was completed between March 1 and May 31, 2022.
EXPOSURE: Health care facility type classified as public, hospital-based, private, mixed (more than 1 type), and other facilities (eg, military health care facility; Women, Infants, and Children clinic; school-based health center; pharmacy).
MAIN OUTCOMES AND MEASURES: Initiation of HPV vaccination was defined as the receipt of at least 1 dose of the HPV vaccine and completion as receipt of at least 2 or 3 doses, depending on age of initiation. Parent or guardian self-reported clinician recommendation was categorized as yes or no. Weighted, multivariable logistic regression models were used to estimate the odds of initiating and completing the HPV vaccine series and receiving clinician recommendation by health care facility type adjusted for adolescent and maternal characteristics.
RESULTS: A total of 20 162 adolescents (mean [SD] age, 14.9 [1.4] years; 51.0% male) were included. Clinician recommendation for the HPV vaccine was received by 81.4% of adolescents, and 75.1% initiated and 58.6% completed the HPV vaccine series. In the adjusted analyses, adolescents who received recommended vaccinations at public facilities had lower odds of initiating (adjusted odds ratio [AOR], 0.71; 95% CI, 0.58-0.88) and completing (AOR, 0.62; 95% CI, 0.51-0.76) HPV vaccination compared with those who received recommended vaccinations at private facilities. Similarly, adolescents who received recommended vaccinations at public facilities (AOR, 0.62; 95% CI, 0.51-0.77) had lower odds of receiving a clinician recommendation for the HPV vaccine compared with those who received recommended vaccinations at private facilities.
CONCLUSIONS AND RELEVANCE: These findings reveal health disparities in HPV vaccination among adolescent populations served by public health care facilities, suggesting that a greater focus is needed on vaccine recommendations and uptake in public facilities.
Medical Subject Headings
Humans; Adolescent; Papillomavirus Vaccines; Female; Cross-Sectional Studies; Male; Papillomavirus Infections; United States; Healthcare Disparities; Vaccination; Health Facilities
PubMed ID
39073824
ePublication
ePub ahead of print
Volume
178
Issue
9
First Page
932
Last Page
939
