A Cross-Sectional Analysis of 2017-2022 National Immunization Survey: Sociodemographic Disparities Associated With Human Papillomavirus Vaccine Initiation and Completion Series Among US Adolescents

Abstract

Objective: The introduction of the Human Papillomavirus (HPV) vaccine has led to future decline in prevalence of HPV-causing cancers; however, disparities in early HPV vaccine uptake and coverage may contribute to persistent inequalities in HPV-related cancers in the United States. We assess the current trend of sociodemographic factors significantly associated with the initiation and Up To Date (UTD) HPV vaccine series among adolescents in the U.S.

Methods: The retrospective National Immunization Survey-Teen data were analyzed for a cohort of adolescents aged 13-17 years who initiated HPV vaccine and completed the series from 2017 to 2022. A multivariable logistic regression estimated the correlation of sociodemographic variables to determine the odds of HPV vaccine initiation and completion as the outcomes.

Results: There were 3.2% and 5% surge in HPV vaccine initiation and UTD, respectively, with teens' mean age of 14.98 over the years. The unvaccinated dropped by 5.6%, and those not UTD declined by 4.6% in the HPV vaccine series during this period. The proportion of teens who initiated and completed the vaccine series were mostly older female teens, non-Hispanics, regularly insured with private coverage, raised by educated older mothers, above poverty status, and living in the South. The adjusted multivariable logistic regression shows the odds of initiating and completing increases over the years, and older teens are more likely to initiate the HPV vaccine and complete the vaccine series. However, boys with non-Medicaid coverage/uninsured in the South have lower odds to initiate and complete the vaccine.

Conclusion: Improved HPV vaccine uptake and UTD were found in older females, insured with Medicaid, and from highly educated mothers in the Northeast. Findings underscore the importance of effective strategies to address current HPV vaccination disparities among identified teens with lower uptake and UTD that may reduce future burden of HPV-related cancers in the U.S.

Keywords: cancer prevention; completion; human Papillomavirus vaccination; national immunization survey-TEEN; socio-demographic disparities; teen initiation.