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Race, Nativity, and Sex Disparities in Human Papillomavirus Vaccination Among Young Adults in the USA

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Abstract

Research has demonstrated that the human papillomavirus (HPV) vaccine is a safe and effective way to decrease HPV-related cervical cancers; however, the vaccination rate in the USA is suboptimal. The current study examined racial and ethnic disparities in HPV vaccination among a nationally representative sample, including Native Hawaiian and Pacific Islanders (NHPI). This study also investigated the associations between nativity and vaccination, and sex differences between race/ethnicity and vaccination and nativity and vaccination. A cross-sectional study was conducted with a sample of adults aged 18–26 years drawn from the 2014 NHPI National Health Interview Survey (n = 2590) and the general 2014 National Health Interview Survey (n = 36,697). Log-binomial models were fitted to examine differences in vaccination. There was a statistically significant racial/ethnic difference in HPV vaccination (p = 0.003). More women than men were vaccinated (41.8% vs. 10.1%) (p < 0.001). There was a significant difference in HPV vaccination based on nativity: 27.4% of adults aged 18 to 26 years who were born in the USA and 27.7% born in a US territory received the HPV vaccine compared with 14.3% among those not born in the USA or a US territory (p < 0.001). The association of HPV vaccination with nativity and race/ethnicity differed by sex and showed several nuanced differences. Overall, the prevalence of HPV vaccination was low. The study’s findings demonstrate the need for public health strategies to increase vaccination rates among all populations, with the critical need to identify strategies that are effective for men, racial/ethnic minorities, and immigrant women born outside the USA.

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Funding

Support for this study was partially supported by a Translational Research Institute grant (no. 1U54TR001629-01A1) through the National Center for Advancing Translational Sciences of the National Institutes of Health.

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Authors and Affiliations

  1. College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR, 72703, USA

    Pearl A. McElfish, Marie-Rachelle Narcisse & Nirav Nagarsheth

  2. Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA

    Holly C. Felix & Mohammed F. Faramawi

  3. Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA

    Diana C. Cascante

  4. College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA

    Ben Teeter

Authors
  1. Pearl A. McElfish
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  2. Marie-Rachelle Narcisse
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  3. Holly C. Felix
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  4. Diana C. Cascante
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  5. Nirav Nagarsheth
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  7. Mohammed F. Faramawi
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Contributions

All authors contributed to drafting and revising the manuscript. The conception and design of work was conducted by Pearl A. McElfish, PhD, Marie-Rachelle Narcisse, PhD, and Holly C. Felix, PhD. Data analysis was conducted by Marie-Rachelle Narcisse, PhD. All authors contributed in interpreting the data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pearl A. McElfish.

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The authors have no conflicts of interest to declare.

Ethical Standards Disclosure

This study was ruled exempt as non-human subjects research by the University of Arkansas for Medical Sciences Institutional Review Board (IRB#206591).

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The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Analysis, interpretation, and/or conclusions based on the NHIS are solely those of the authors and do not represent those of the NCHS, which are responsible for the data.

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McElfish, P.A., Narcisse, MR., Felix, H.C. et al. Race, Nativity, and Sex Disparities in Human Papillomavirus Vaccination Among Young Adults in the USA. J. Racial and Ethnic Health Disparities 8, 1260–1266 (2021). https://doi.org/10.1007/s40615-020-00886-5

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  • DOI: https://doi.org/10.1007/s40615-020-00886-5

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