Skip to main content

Advertisement

SpringerLink
Log in

Young Adult Human Papillomavirus and Influenza Vaccine Coverage: A Comparison Across College Enrollment Status

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

To determine human papillomavirus and influenza vaccine coverage among young adults in the US and assess differences in vaccine uptake by college enrollment status, we conducted an online survey of young adults aged 18–26 (n = 417) using Survey Monkey, with recruitment occurring through Amazon’s Mechanical Turk (MTurk) platform. We collected data on self-reported preventive health behaviors, including vaccine receipt, current college enrollment status, and other demographics. Overall, 49% of participants reported receiving at least one dose of human papillomavirus vaccine and 57% reported receiving at least one influenza vaccine over the past three years. Vaccine coverage estimates did not differ between college-enrolled and non-enrolled respondents. Low vaccine coverage rates demonstrate the need to improve vaccine strategies for young adults. The strongest predictor of vaccine receipt was having received a provider recommendation. There does not appear to be healthcare utilization differences related to ability to access care through student health or community-based settings. Additional research is needed to develop interventions to improve vaccination coverage among young adults, both currently enrolled and not enrolled in college.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Committee on Improving the Health, S., and Well-Being of Young Adults; Board on Children, Youth, and Families; Institute of Medicine; National Research Council. (2015). Investing in the Health and Well-Being of Young Adults (C. S. Richard J. Bonnie, and Heather Breiner Ed.). Washington, DC: National Academies Press, US.

  2. United States Census Bureau. (2011). Census Briefs: Age and Sex Composition, 2010. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2011/dec/c2010br-03.pdf.

  3. Neinstein, L. (2012). The new adolescents: An analysis of health conditions, behaviors and risks and access to services among emerging adults. Retrieved from Los Angeles, CA: http://www.usc.edu/student-affairs/Health_Center/thenewadolescents/doc/TheNewAdolescents_Final_Locked.pdf.

  4. Pazol, K., Robbins, C. L., Black, L. I., Ahrens, K. A., Daniels, K., Chandra, A., & Gavin, L. E. (2017). Receipt of selected preventive health services for women and men of reproductive age—United States, 2011–2013. MMWR Surveillance Summaries, 66(20), 1–31. https://doi.org/10.15585/mmwr.ss6620a1

    Article  PubMed Central  Google Scholar 

  5. Lau, J. S., Adams, S. H., Irwin, C. E., Jr., & Ozer, E. M. (2013). Receipt of preventive health services in young adults. Journal of Adolescent Health, 52(1), 42–49. https://doi.org/10.1016/j.jadohealth.2012.04.017

    Article  Google Scholar 

  6. Boersma, P., B. L. (2020). Human papillomavirus vaccination among adults aged 18–26, 2013–2018. Retrieved from Hyattsville, MD.

  7. Marchand, E., Glenn, B. A., & Bastani, R. (2012). Low HPV vaccine coverage among female community college students. Journal of Community Health, 37(6), 1136–1144. https://doi.org/10.1007/s10900-012-9572-x

    Article  PubMed  PubMed Central  Google Scholar 

  8. Williams, W. W., Lu, P. J., O’Halloran, A., Bridges, C. B., Pilishvili, T., Hales, C. M., & Markowitz, L. E. (2014). Noninfluenza vaccination coverage among adults—United States, 2012. Morbidity and Mortality Weekly Report, 63(5), 95–102.

    PubMed  PubMed Central  Google Scholar 

  9. Kim, J., & Nan, X. (2015). Consideration of future consequences and HPV vaccine uptake among young adults. Journal of Health Communication, 20(9), 1033–1040. https://doi.org/10.1080/10810730.2015.1018583

    Article  PubMed  Google Scholar 

  10. Licht, A. S., Murphy, J. M., Hyland, A. J., Fix, B. V., Hawk, L. W., & Mahoney, M. C. (2010). Is use of the human papillomavirus vaccine among female college students related to human papillomavirus knowledge and risk perception? Sexually Transmitted Infections, 86(1), 74–78. https://doi.org/10.1136/sti.2009.037705

    Article  PubMed  Google Scholar 

  11. American College Health Association-National College Health Assessment II: Undergraduate Student Executive Summary Spring 2019. (2019). Retrieved from Silver Spring, MD.

  12. National Center for Education Statistics. (2015). Table 303.55. Total Fall Enrollment in Degree-Granting Postsecondary Institutions, by Control and Level of Institution, Attendance Status, and Age of Student: 2013. Retrieved from http://nces.ed.gov/programs/digest/d14/tables/dt14_303.55.asp?current=yes.

  13. Buhrmester, M., Kwang, T., & Gosling, S. (2011). Amazon’s Mechanical Turk: A new source of inexpensive, yet high-quality, data? Sage Journals, 6(1), 3–5.

    Google Scholar 

  14. Peer, E., Vosgerau, J., & Acquisti, A. (2014). Reputation as a sufficient condition for data quality on Amazon Mechanical Turk. Behavior Research Methods, 46(4), 1023–1031. https://doi.org/10.3758/s13428-013-0434-y

    Article  PubMed  Google Scholar 

  15. National Cancer Institute. Health Information National Trends Survey Questionnaires: 2003–2017. Retrieved from https://hints.cancer.gov/view-questions-topics/all-hints-questions.aspx.

  16. Frew, P. M., Murden, R., Mehta, C. C., Chamberlain, A. T., Hinman, A. R., Nowak, G., …, Bednarczyk, R. A. (2019). Development of a US trust measure to assess and monitor parental confidence in the vaccine system. Vaccine, 37(2), 325–332. doi:https://doi.org/10.1016/j.vaccine.2018.09.043.

    Article  PubMed  Google Scholar 

  17. Weber, E. U., Johnson, E. J., Milch, K. F., Chang, H., Brodscholl, J. C., & Goldstein, D. G. (2007). Asymmetric discounting in intertemporal choice: A query-theory account. Psychological Science, 18(6), 516–523. https://doi.org/10.1111/j.1467-9280.2007.01932.x

    Article  CAS  PubMed  Google Scholar 

  18. Zou, G. (2004). A modified poisson regression approach to prospective studies with binary data. American Journal of Epidemiology, 159(7), 702–706. https://doi.org/10.1093/aje/kwh090

    Article  PubMed  Google Scholar 

  19. Petersen, M. R., & Deddens, J. A. (2008). A comparison of two methods for estimating prevalence ratios. BMC Medical Research Methodology, 8(1), 9. doi:https://doi.org/10.1186/1471-2288-8-9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Opel, D. J., Taylor, J. A., Zhou, C., Catz, S., Myaing, M., & Mangione-Smith, R. (2013). The relationship between parent attitudes about childhood vaccines survey scores and future child immunization status: A validation study. JAMA Pediatrics, 167(11), 1065–1071. https://doi.org/10.1001/jamapediatrics.2013.2483

    Article  PubMed  PubMed Central  Google Scholar 

  21. Centers for Disease Control and Prevention. (2016). Human Papillomavirus (HPV): How do people get HPV? Retrieved from https://www.cdc.gov/hpv/parents/whatishpv.html.

  22. Lyons, H. A., Manning, W. D., Longmore, M. A., & Giordano, P. C. (2015). Gender and casual sexual activity from adolescence to emerging adulthood: Social and life course correlates. Journal of Sex Research, 52(5), 543–557. https://doi.org/10.1080/00224499.2014.906032

    Article  PubMed  Google Scholar 

  23. Markowitz, L. E., Dunne, E. F., Saraiya, M., Chesson, H. W., Curtis, C. R., Gee, J., & Unger, E. R. (2014). Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommendations and Reports, 63(Rr-05), 1–30.

    PubMed  Google Scholar 

  24. Arriola, C. S., Brammer, L., Epperson, S., Blanton, L., Kniss, K., Mustaquim, D., & Jhung, M. (2014). Update: Influenza activity—United States, September 29, 2013-February 8, 2014. Morbidity and Mortality Weekly Report, 63(7), 148–154.

    PubMed  PubMed Central  Google Scholar 

  25. Budd, A. P., Wentworth, D. E., Blanton, L., Elal, A. I. A., Alabi, N., Barnes, J., & Jernigan, D. (2018). Update: Influenza Activity—United States, October 1, 2017-February 3, 2018. Morbidity and Mortality Weekly Report, 67(6), 169–179. https://doi.org/10.15585/mmwr.mm6706a1

    Article  PubMed  PubMed Central  Google Scholar 

  26. Santibanez, T. A., & Kennedy, E. D. (2016). Reasons given for not receiving an influenza vaccination, 2011-12 influenza season, United States. Vaccine, 34(24), 2671–2678. doi:https://doi.org/10.1016/j.vaccine.2016.04.039.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bednarczyk, R. A., Chu, S. L., Sickler, H., Shaw, J., Nadeau, J. A., & McNutt, L. A. (2015). Low uptake of influenza vaccine among university students: Evaluating predictors beyond cost and safety concerns. Vaccine, 33(14), 1659–1663. https://doi.org/10.1016/j.vaccine.2015.02.033

    Article  PubMed  Google Scholar 

  28. Ratanasiripong, N. T. (2015). Factors related to human papillomavirus (HPV) vaccination in college men. Public Health Nursing, 32(6), 645–653. https://doi.org/10.1111/phn.12198

    Article  PubMed  Google Scholar 

  29. Dillard, J. P., & Spear, M. E. (2010). Knowledge of human papillomavirus and perceived barriers to vaccination in a sample of US female college students. Journal of American College Health, 59(3), 186–190. https://doi.org/10.1080/07448481.2010.493189

    Article  PubMed  Google Scholar 

  30. 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. https://doi.org/10.2105/ajph.2011.300600

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lu, P. J., Yankey, D., Jeyarajah, J., O’Halloran, A., Meyer, S. A., Elam-Evans, L. D., & Reagan-Steiner, S. (2017). Impact of provider recommendation on tdap vaccination of adolescents aged 13–17 years. American Journal of Preventive Medicine, 53(3), 373–384. https://doi.org/10.1016/j.amepre.2017.03.022

    Article  PubMed  PubMed Central  Google Scholar 

  32. Vadaparampil, S. T., Malo, T. L., Sutton, S. K., Ali, K. N., Kahn, J. A., Casler, A., & Giuliano, A. R. (2016). Missing the target for routine human papillomavirus vaccination: Consistent and strong physician recommendations are lacking for 11- to 12-year-old males. Cancer Epidemiology, Biomarkers & Prevention, 25(10), 1435–1446. https://doi.org/10.1158/1055-9965.epi-15-1294

    Article  CAS  Google Scholar 

  33. Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., & Kronick, R. (2013). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Affairs (Millwood), 32(1), 165–174. https://doi.org/10.1377/hlthaff.2012.0552

    Article  Google Scholar 

  34. Han, X., Zhu, S., & Jemal, A. (2016). Characteristics of young adults enrolled through the affordable care act-dependent coverage expansion. Journal of Adolescent Health, 59(6), 648–653. https://doi.org/10.1016/j.jadohealth.2016.07.027

    Article  Google Scholar 

  35. Shui, I. M., Weintraub, E. S., & Gust, D. A. (2006). Parents concerned about vaccine safety: Differences in race/ethnicity and attitudes. American Journal of Preventive Medicine, 31(3), 244–251. https://doi.org/10.1016/j.amepre.2006.04.006

    Article  PubMed  Google Scholar 

  36. Prislin, R., Dyer, J. A., Blakely, C. H., & Johnson, C. D. (1998). Immunization status and sociodemographic characteristics: The mediating role of beliefs, attitudes, and perceived control. American Journal of Public Health, 88(12), 1821–1826. https://doi.org/10.2105/ajph.88.12.1821

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Opel, D. J., Taylor, J. A., Mangione-Smith, R., Solomon, C., Zhao, C., Catz, S., & Martin, D. (2011). Validity and reliability of a survey to identify vaccine-hesitant parents. Vaccine, 29(38), 6598–6605. doi:https://doi.org/10.1016/j.vaccine.2011.06.115.

    Article  PubMed  Google Scholar 

  38. Goodman, J. K., Cryder, C. E., & Cheema, A. (2013). Data collection in a flat world: The strengths and weaknesses of Mechanical Turk samples. Journal of Behavioral Decision Making, 26(3), 213–224. https://doi.org/10.1002/bdm.1753

    Article  Google Scholar 

  39. Huff, C., & Tingley, D. (2015). “Who are these people?” Evaluating the demographic characteristics and political preferences of MTurk survey respondents. Research & Politics, 2(3), 2053168015604648. doi:https://doi.org/10.1177/2053168015604648.

    Article  Google Scholar 

  40. Berinsky, A. J., Huber, G. A., & Lenz, G. S. (2017). Evaluating online labor markets for experimental research: Amazon.com’s Mechanical Turk. Political Analysis, 20(3), 351–368. https://doi.org/10.1093/pan/mpr057

    Article  Google Scholar 

  41. Brusco, N. K., & Watts, J. J. (2015). Empirical evidence of recall bias for primary health care visits. BMC Health Services Research, 15, 381. doi:https://doi.org/10.1186/s12913-015-1039-1.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Turner, J. C., & Keller, A. (2015). College health surveillance network: Epidemiology and health care utilization of college students at US 4-year universities. J Am Coll Health, 63(8), 530–538. https://doi.org/10.1080/07448481.2015.1055567

    Article  PubMed  PubMed Central  Google Scholar 

  43. Zimet, G. D., Weiss, T. W., Rosenthal, S. L., Good, M. B., & Vichnin, M. D. (2010). Reasons for non-vaccination against HPV and future vaccination intentions among 19–26 year-old women. BMC Women’s Health, 10, 27. https://doi.org/10.1186/1472-6874-10-27

    Article  PubMed  PubMed Central  Google Scholar 

  44. Patel, D. A., Zochowski, M., Peterman, S., Dempsey, A. F., Ernst, S., & Dalton, V. K. (2012). Human papillomavirus vaccine intent and uptake among female college students. J Am Coll Health, 60(2), 151–161. doi:https://doi.org/10.1080/07448481.2011.580028.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Johnson, O. (2016, December 5). UW-Madison meningitis outbreak spurs widespread vaccination. Minnesota Daily. Retrieved from http://www.mndaily.com/article/2016/12/meningitis-outbreak-in-madison-calls-for-new-vaccine.

  46. University of Wisconsin-Madison: University Health Services. (2016). UW-Madison confirms third case of meningococcal disease; free vaccine offered to students. Retrieved from https://news.wisc.edu/uw-madison-identifies-possible-third-case-of-meningococcal-disease-free-vaccine-today-for-undergraduates/.

Download references

Acknowledgements

The authors have no conflicts of interest to declare. Dr. Bednarczyk is supported by National Institutes of Health (Grant K01AI106961). Dr. Sundaram is supported by the Emory Vaccinology Training Program of the National Institute of Allergy and Infectious Diseases (Award T32AI074492). No external funding was used for conducting The Young Adult Health Care Study. The authors would like to thank Avnika B. Amin and Cameron Warner for technical assistance in the survey administration process.

Author information

Authors and Affiliations

  1. Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA

    Kara Mathewson, Maria Sundaram & Robert A. Bednarczyk

  2. Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, 1365-C Clifton Road NE, Atlanta, GA, USA

    Robert A. Bednarczyk

  3. Emory Vaccine Center, Emory University, 954 Gatewood Road, Atlanta, GA, USA

    Robert A. Bednarczyk

Authors
  1. Kara Mathewson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Sundaram
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert A. Bednarczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert A. Bednarczyk.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mathewson, K., Sundaram, M. & Bednarczyk, R.A. Young Adult Human Papillomavirus and Influenza Vaccine Coverage: A Comparison Across College Enrollment Status. J Community Health 46, 13–21 (2021). https://doi.org/10.1007/s10900-020-00833-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-020-00833-9

Keywords

Search

Navigation