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Variation in Human Papillomavirus Vaccine Uptake and Acceptability Between Female and Male Adolescents and Their Caregivers

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Abstract

HPV vaccination coverage is suboptimal. Previous research largely focused on vaccinating girls. This study aimed to identify factors associated with HPV vaccination among male and female adolescents. We conducted secondary analyses using the National Immunization Survey-Teen. We specified parallel logistic models to examine associations of adolescent, caregiver, and provider characteristics with vaccination status among boys and girls. The primary outcome was HPV vaccination status defined as unvaccinated, initiated, or completed. Additionally, we analyzed caregivers’ intent to initiate or complete the three-dose series. The vaccination completion rate was 26 %. Among teens aged 13–17 years, 19 % initiated, but did not complete the vaccine. Additionally, 14 % of males completed the 3-dose series as compared to 38 % of females. Vaccination rates were higher among teens receiving a provider recommendation [girls: adjusted odds ratio (AOR) = 3.33, 95 % confidence interval (CI) (2.44, 4.55); boys: AOR = 10.0, 95 % CI (7.69, 12.5)]. Moreover, provider recommendation was associated with caregivers’ intent to initiate vaccination [girls: AOR = 2.32, 95 % CI (1.77, 3.02); boys: AOR = 2.76, 95 % CI (2.22, 3.43)]. Other associations differed by gender. Higher vaccine initiation rates were associated with younger age and residing in the mid-west for girls and racial/ethnic minority and eligibility for the “Vaccine for Children” program for boys. Provider recommendation for vaccination was the strongest predictor for both genders; however, it is insufficient to achieve high coverage rates, especially among boys. Factors associated with HPV vaccination were different for males and females. These findings suggest providers should consider gender bias with regard to HPV vaccination.

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References

  1. Saslow, D., et al. (2007). American Cancer Society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. C CA: A Cancer Journal for Clinicians, 57(1), 7–28.

    Google Scholar 

  2. Markowitz, L. E., et al. (2007). Quadrivalent human papillomavirus vaccine: Recommendations of the advisory committee on immunization practices (ACIP). MMWR Recommendations and Reports, 56(RR-2), 1–24.

    PubMed  Google Scholar 

  3. Committee on Infectious Diseases. (2012). HPV vaccine recommendations. Pediatrics, 129(3), 602–605.

    Article  Google Scholar 

  4. Centers for Disease Control and Prevention. (2010). FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morbidity and Mortality Weekly Report, 59(20), 626–629.

    Google Scholar 

  5. American College of Obstetricians and Gynecologists. (2010). Committee opinion no. 467: Human papillomavirus vaccination. Obstetrics & Gynecology, 116(3), 800–803.

    Article  Google Scholar 

  6. Friedman, L., et al. (2011). Human papillomavirus vaccine: An updated position statement of the Society for Adolescent Health and Medicine. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 48(2), 215–216.

    Article  Google Scholar 

  7. Statistics, N.C.f.H. (2013). Health, United States, 2013: With special feature on prescription drugs.

  8. Centers for Disease Control and Prevention. (2013). National and state vaccination coverage among adolescents aged 13–17 years–United States, 2012. MMWR Morbidity and Mortality Weekly Report, 62(34), 685–93.

    Google Scholar 

  9. Stokley, S., et al. (2014). Human papillomavirus vaccination coverage among adolescents, 2007–2013, and postlicensure vaccine safety monitoring, 2006–2014—United States. MMWR Morbidity and Mortality Weekly Report, 63(29), 620–624.

    PubMed  Google Scholar 

  10. Lu, P. J., et al. (2015). HPV vaccination coverage of male adolescents in the United States. Pediatrics, 136(5), 839–849.

    Article  PubMed  Google Scholar 

  11. Elam-Evans, L. D., Yankey, D., Jeyarajah, J., Singleton, J. A., Curtis, R. C., MacNeil, J., Hariri, S. (2014). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2013. MMWR Morbidity and Mortality Weekly Report, 63(29), 625–633.

    PubMed  Google Scholar 

  12. Munoz, N., et al. (2010). Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on all HPV-associated genital diseases in young women. Journal of the National Cancer Institute, 102(5), 325–339.

    Article  CAS  PubMed  Google Scholar 

  13. Cogliano, V., et al. (2005). Carcinogenicity of human papillomaviruses. The Lancet Oncology, 6(4), 204.

    Article  PubMed  Google Scholar 

  14. Dorell, C. G., et al. (2011). Human papillomavirus vaccination series initiation and completion, 2008–2009. Pediatrics, 128(5), 830–839.

    Article  PubMed  Google Scholar 

  15. Wang, E., et al. (2014). Nonmedical exemptions from school immunization requirements: A systematic review. American Journal of Public Health, 101, e1–e23.

    Google Scholar 

  16. Constable, C., Blank, N. R., & Caplan, A. L. (2014). Rising rates of vaccine exemptions: Problems with current policy and more promising remedies. Vaccine, 32(16), 1793–1797.

    Article  PubMed  Google Scholar 

  17. CDC.(2012). Vaccination coverage among children in kindergarten—United States, 2011–12 school year. MMWR. Morbidity and Mortality Weekly Report, 61(33), 647–652.

    Google Scholar 

  18. Parker Fiebelkorn, A., et al. (2010). Measles in the United States during the postelimination era. The Journal of Infectious Diseases, 202(10), 1520–1528.

    Article  Google Scholar 

  19. Gastanaduy, P. A., et al. (2014). Measles—United States, January 1-May 23, 2014. MMWR. Morbidity and Mortality Weekly Report, 63(22), 496–499.

    PubMed  Google Scholar 

  20. Atwell, J. E., et al. (2013). Nonmedical vaccine exemptions and pertussis in California, 2010. Pediatrics, 132(4), 624–630.

    Article  PubMed  Google Scholar 

  21. Omer, S. B., et al. (2009). Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. The New England Journal of Medicine, 360(19), 1981–1988.

    Article  CAS  PubMed  Google Scholar 

  22. Salmon, D. A., & Siegel, A. W. (2001). Religious and philosophical exemptions from vaccination requirements and lessons learned from conscientious objectors from conscription. Public Health Reports (Washington, D. C.: 1974), 116(4), 289–295.

    Article  CAS  Google Scholar 

  23. Smith, P.J., et al. (2011). Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model. Public Health Reports, 126(Suppl 2), 135–146.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gaudino, J. A., & Robison, S. (2012). Risk factors associated with parents claiming personal-belief exemptions to school immunization requirements: Community and other influences on more skeptical parents in Oregon, 2006. Vaccine, 30(6), 1132–1142.

    Article  PubMed  Google Scholar 

  25. Cooper, L. Z., Larson, H. J., & Katz, S. L. (2008). Protecting public trust in immunization. Pediatrics, 122(1), 149–153.

    Article  PubMed  Google Scholar 

  26. Myers, E., et al. (2008). The current and future role of screening in the era of HPV vaccination. Gynecologic Oncology, 109(2 Suppl), S31–S39.

    Article  PubMed  Google Scholar 

  27. Oldach, B. R., & Katz, M. L. (2012). Ohio Appalachia public health department personnel: Human papillomavirus (HPV) vaccine availability, and acceptance and concerns among parents of male and female adolescents. Journal of Community Health, 37(6), 1157–1163.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Liddon, N. C., Hood, J. E., & Leichliter, J. S. (2012). Intent to receive HPV vaccine and reasons for not vaccinating among unvaccinated adolescent and young women: Findings from the 2006–2008 National Survey of Family Growth. Vaccine, 30(16), 2676–2682.

    Article  PubMed  Google Scholar 

  29. Zimmerman, R. K. (2006). Ethical analysis of HPV vaccine policy options. Vaccine, 24(22), 4812–4820.

    Article  PubMed  Google Scholar 

  30. Vamos, C. A., McDermott, R. J., & Daley, E. M. (2008). The HPV vaccine: Framing the arguments FOR and AGAINST mandatory vaccination of all middle school girls. The Journal of School Health, 78(6), 302–309.

    Article  PubMed  Google Scholar 

  31. Chicago, N.a.t.U.o. (2012). National immunization survey-teen: A user’s guide for the 2012 public-use data file, C.f.D.C.a. Prevention, Editor.

  32. Dorell, C., Yankey, D., & Strasser, S. (2011). Parent-reported reasons for nonreceipt of recommended adolescent vaccinations, national immunization survey: Teen, 2009. Clinical Pediatrics, 50(12), 1116–1124.

    Article  PubMed  Google Scholar 

  33. Ojha, R. P., et al. (2013). The accuracy of human papillomavirus vaccination status based on adult proxy recall or household immunization records for adolescent females in the United States: Results from the National Immunization Survey-Teen. Annals of Epidemiology, 23(5), 281–285.

    Article  PubMed  Google Scholar 

  34. Katz, I. T., et al. (2010). Scaling up human papillomavirus vaccination: A conceptual framework of vaccine adherence. Sexual Health, 7(3), 279–286.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Brewer, N. T., & Fazekas, K. I. (2007). Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine, 45(2–3), 107–114.

    Article  PubMed  Google Scholar 

  36. Holman, D. M., et al. (2014). Barriers to human papillomavirus vaccination among US adolescents: A systematic review of the literature. JAMA Pediatrics, 168(1), 76–82.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kessels, S. J., et al. (2012). Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine, 30(24), 3546–3556.

    Article  PubMed  Google Scholar 

  38. CDC. (2012) Vaccines for children program. http://www.cdc.gov/vaccines/programs/vfc/index.html.

  39. Gilkey, M. B., et al. (2015). Quality of physician communication about human papillomavirus vaccine: Findings from a national survey. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 24(11), 1673–1679.

    Article  Google Scholar 

  40. Reiter, P. L., Katz, M. L., & Paskett, E. D. (2013). Correlates of HPV vaccination among adolescent females from Appalachia and reasons why their parents do not intend to vaccinate. Vaccine, 31(31), 3121–3125.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Dorell, C., et al. (2013). Factors that influence parental vaccination decisions for adolescents, 13 to 17 years old: National Immunization Survey-Teen, 2010. Clinical Pediatrics, 52(2), 162–170.

    Article  PubMed  Google Scholar 

  42. Ylitalo, K. R., Lee, H., & Mehta, N. K. (2013). Health care provider recommendation, human papillomavirus vaccination, and race/ethnicity in the US National Immunization Survey. American Journal of Public Health, 103(1), 164–169.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Jacobson, R. M., et al. (2016). The most effective and promising population health strategies to advance human papillomavirus vaccination. Expert Review Vaccines, 15(2), 257–269.

    Article  CAS  Google Scholar 

  44. Tierney, C. D., et al. (2003). Adoption of reminder and recall messages for immunizations by pediatricians and public health clinics. Pediatrics, 112(5), 1076–1082.

    Article  PubMed  Google Scholar 

  45. Perkins, R. B., & Clark, J. A. (2012). Providers’ attitudes toward human papillomavirus vaccination in young men: Challenges for implementation of 2011 recommendations. American Journal of Men’s Health, 6(4), 320–323.

    Article  PubMed  Google Scholar 

  46. Kepka, D., et al. (2012). Human papillomavirus vaccine practices in the USA: Do primary care providers use sexual history and cervical cancer screening results to make HPV vaccine recommendations? Sexually Transmitted Infections, 88(6), 433–435.

    Article  PubMed  Google Scholar 

  47. Gerend, M. A., Lee, S. C., & Shepherd, J. E. (2007). Predictors of human papillomavirus vaccination acceptability among underserved women. Sexually Transmitted Diseases, 34(7), 468–471.

    PubMed  Google Scholar 

  48. Bingham, A., Drake, J. K., & LaMontagne, D. S. (2009). Sociocultural issues in the introduction of human papillomavirus vaccine in low-resource settings. Archives of Pediatrics and Adolescent Medicine, 163(5), 455–461.

    Article  PubMed  Google Scholar 

  49. Conroy, K., et al. (2009). Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination. Journal of Women’s Health (2002), 18(10), 1679–1686.

    Article  Google Scholar 

  50. Zimet, G.D. (2006). Understanding and overcoming barriers to human papillomavirus vaccine acceptance. Current Opinion in Obstetrics and Gynecology, 18(Suppl 1), s23–s28.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Global Health, Boston University School of Public Health, Boston, MA, USA

    Kristin L. Johnson

  2. John Snow Inc., Boston, MA, USA

    Kristin L. Johnson

  3. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA

    Meng-Yun Lin

  4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Howard Cabral

  5. Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA

    Lewis E. Kazis

  6. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Ingrid T. Katz

  7. Harvard Medical School, Boston, MA, USA

    Ingrid T. Katz

  8. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA

    Ingrid T. Katz

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  1. Kristin L. Johnson
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Correspondence to Kristin L. Johnson.

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The Authors declare that there is no conflict of interest. This research was conducted as a doctoral student project and was not supported by any funding sources.

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Johnson, K.L., Lin, MY., Cabral, H. et al. Variation in Human Papillomavirus Vaccine Uptake and Acceptability Between Female and Male Adolescents and Their Caregivers. J Community Health 42, 522–532 (2017). https://doi.org/10.1007/s10900-016-0284-5

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  • DOI: https://doi.org/10.1007/s10900-016-0284-5

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