International Journal of Public Health

, Volume 64, Issue 3, pp 323–332 | Cite as

Clinician offering is a key factor associated with HPV vaccine uptake among Mexican mothers in the USA and Mexico: a cross-sectional study

  • Yvonne N. FloresEmail author
  • Jorge Salmerón
  • Beth A. Glenn
  • Cathy M. Lang
  • L. Cindy Chang
  • Roshan Bastani
Original Article



To compare the knowledge, beliefs, and practices regarding HPV vaccination among mothers of vaccine-eligible girls in Mexico and the USA.


Similar samples of Mexican mothers with vaccine-eligible daughters were surveyed at two clinics in Cuernavaca, Morelos, from July to October 2012 (n = 200) and at two clinics in Oxnard, California, from August to November 2013 (n = 200).


Although mothers in the USA had less knowledge and more negative attitudes toward the vaccine than their counterparts in Mexico, vaccine uptake rates were higher in the USA (49% vs. 40%). US mothers were more likely to have discussed and been offered the HPV vaccine by a clinician than mothers in Mexico. In multivariate analyses, having been offered the HPV vaccine was the most important predictor of vaccine uptake.


Our results suggest that healthcare access or other system, clinic, or provider factors are the main drivers of vaccine receipt in this binational sample of Mexican mothers. Interventions and programs that encourage clinicians to offer the HPV vaccine should be developed to increase vaccine uptake in both countries.


Human papillomavirus Vaccination Cervical cancer prevention Health disparities Mexico Latinos 



This work was supported by the Programa de Investigación en Migracion y Salud (PIMSA), Berkeley, CA, the Mexican Institute of Social Security [grant number FIS/IMSS/PROT/G11/970], and the UCLA Kaiser Permanente Center for Health Equity. YNF was also supported by NIH/NCI K07CA197179. The authors would like to thank the study participants and our collaborators at Clinicas del Camino Real (Dr. Gagan Pawar, Patricia Andrade and Laura Aguiniga), IMSS (Griselda Diaz, Lucy Cruz), and UCLA (Mayra Macias).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests to disclose.

Ethical standard

All study procedures were performed in accordance with the ethical standards of the UCLA and IMSS research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


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Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Yvonne N. Flores
    • 1
    • 2
    • 3
    Email author
  • Jorge Salmerón
    • 1
    • 4
  • Beth A. Glenn
    • 2
    • 3
  • Cathy M. Lang
    • 5
  • L. Cindy Chang
    • 3
  • Roshan Bastani
    • 2
    • 3
  1. 1.Unidad de Investigación Epidemiológica y en Servicios de SaludInstituto Mexicano del Seguro SocialCuernavacaMexico
  2. 2.UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health EquityFielding School of Public HealthLos AngelesUSA
  3. 3.UCLA Cancer Prevention and Control Research CenterFielding School of Public Health and Jonsson Comprehensive Cancer CenterLos AngelesUSA
  4. 4.Centro de Investigación en Salud PoblacionalInstituto Nacional de Salud PúblicaCuernavacaMexico
  5. 5.Department of Community Health SciencesUCLA Fielding School of Public HealthLos AngelesUSA

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