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. 2025 Jan 21;13(2):98.
doi: 10.3390/vaccines13020098.

Racial and Ethnic Disparities in Human Papillomavirus Vaccination Among US-Born and Foreign-Born Adults Aged 18 to 26 Years in the United States

Itunu Sokale  1   2 , Jane Montealegre  3 , Ann O Amuta  4 , Abiodun Oluyomi  1   2 , Aaron P Thrift  1   2
Affiliations

Racial and Ethnic Disparities in Human Papillomavirus Vaccination Among US-Born and Foreign-Born Adults Aged 18 to 26 Years in the United States

Itunu Sokale et al. Vaccines (Basel). .

Abstract

Background/objectives: Human papillomavirus (HPV) is linked to multiple cancers that can be prevented through vaccination. While the optimal age for vaccination is in childhood and adolescence, vaccination recommendations include adults through age 26 who missed childhood/adolescent vaccination. There are limited data about disparities among adults eligible for catch-up HPV vaccination. We conducted a comprehensive examination of HPV vaccination among US young adults, disaggregating the group by race/ethnicity and nativity status to identify subgroups that may require additional interventions.

Methods: We analyzed 2019 and 2022 data of individuals aged 18-26 years from the National Health Interview Survey. Generalized linear models using Poisson regression with log link were used to examine the receipt of 1+ dose of HPV vaccine, race/ethnicity, and nativity (i.e., US- versus foreign-born) status.

Results: The overall receipt of 1+ doses of HPV vaccine was 47.5%. The vaccination rate among the US-born group was 49.7% versus 31.9% among the foreign-born group with an adjusted prevalence ratio (APR) of 0.72; (95% CI, 0.62-0.82). Foreign-born non-Hispanic (NH) Black individuals (APR 0.31; 95% CI, 0.13-0.70) were less likely to be vaccinated against HPV than foreign-born NH White individuals, while US-born NH Asians (APR 1.27; 95% CI, 1.09-1.48) had a higher prevalence of the vaccination than the US-born NH White group. Additionally, foreign-born NH Asian (APR 0.60; 95% CI, 0.46-0.77), NH Black (APR 0.27; 95% CI, 0.12-0.61), and Hispanic (APR 0.76; 95% CI, 0.60-0.97) populations were less likely to be vaccinated than their respective US-born counterparts. Conclusion: Profound HPV vaccination inequalities exist among US young adults with particularly low vaccine coverage among racially and ethnically minoritized immigrant populations.

Keywords: HPV vaccination; foreign-born populations; human papillomavirus; racial and ethnic minority populations; vaccine inequalities; young adults.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Weighted HPV vaccination rates among US young adults aged 18–26 years, by nativity and race/ethnicity. Abbreviations: HPV, human papillomavirus; NH, non-Hispanic. Race/ethnicity groups are mutually exclusive, and Hispanic/Latinos could be of any race. Other includes American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, and multiple races. Respondents were considered foreign-born if they reported that they were not born in the United States or any of its territories.
Figure 2
Figure 2
Weighted HPV vaccination rates among racial–ethnic groups of US young adults aged 18–26 years stratified by nativity. Abbreviations: HPV, human papillomavirus; NH, non-Hispanic; Race/ethnicity groups are mutually exclusive, and Hispanic/Latinos could be of any race; Other includes American Indian/Alaska Native; Asian, Native Hawaiian/Pacific Islander, and multiple races. Respondents were considered foreign-born if they reported that they were not born in the United States or any of its territories.
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