Journal of Community Health

, Volume 42, Issue 3, pp 522–532 | Cite as

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

  • Kristin L. Johnson
  • Meng-Yun Lin
  • Howard Cabral
  • Lewis E. Kazis
  • Ingrid T. Katz
Original Paper


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.


HPV vaccination Gender Adolescents Secondary data 


Compliance with Ethical Standards

Conflict of interest

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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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kristin L. Johnson
    • 1
    • 2
  • Meng-Yun Lin
    • 3
  • Howard Cabral
    • 4
  • Lewis E. Kazis
    • 5
  • Ingrid T. Katz
    • 6
    • 7
    • 8
  1. 1.Department of Global HealthBoston University School of Public HealthBostonUSA
  2. 2.John Snow Inc.BostonUSA
  3. 3.Department of Health Law, Policy and ManagementBoston University School of Public HealthBostonUSA
  4. 4.Department of BiostatisticsBoston University School of Public HealthBostonUSA
  5. 5.Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Law, Policy and ManagementBoston University School of Public HealthBostonUSA
  6. 6.Department of MedicineBrigham and Women’s HospitalBostonUSA
  7. 7.Harvard Medical SchoolBostonUSA
  8. 8.Center for Global HealthMassachusetts General HospitalBostonUSA

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