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Barriers to Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: a Systematic Review

Journal of Racial and Ethnic Health Disparities volume 8, pages 1192–1207 (2021)Cite this article

Abstract

Background

Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups.

Methods

The PubMed database was searched on July 30, 2020, for peer-reviewed articles and abstracts that had been published in English from July 2010 to July 2020 and covered racial/ethnic disparities in HPV vaccination.

Results

Similar findings were observed among the articles reviewed. The low HPV vaccination initiation and completion rates among racial/ethnic minority populations were found to be associated with lack of provider recommendations, inadequate knowledge and awareness of HPV and HPV vaccination, medical mistrust, and safety concerns.

Conclusions

Provider recommendations and accurate distribution of information must be increased and targeted to racial/ethnic minority populations in order to bolster the rate of vaccine uptake. To effectively target these communities, multi-level interventions need to be established. Further, research to understand the barriers that may affect unvaccinated adults in the catch-up age range, including males, may be beneficial, as majority of the previous studies focused on either parents of adolescents or women.

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Fig. 1

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Acknowledgments

This work was supported in part by NIH R01 Grant number R01AI116914 from the NIH Institute of Allergy and Infectious Diseases.

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Funding

This work was supported in part by NIH R01 Grant number R01AI116914 from the NIH Institute of Allergy and Infectious Diseases.

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Affiliations

  1. Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA

    Trisha L. Amboree & Charles Darkoh

  2. Microbiology and Infectious Diseases Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA

    Charles Darkoh

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  1. Trisha L. Amboree
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Contributions

Both authors contributed to the study idea. Review of the literature was performed by Trisha Amboree. Synthesis of review findings was performed by Trisha Amboree and Charles Darkoh. The first draft of the manuscript was written by Trisha Amboree and both authors commented on previous versions of the manuscript. Charles Darkoh critically revised the work. Both authors read and approved the final manuscript.

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Correspondence to Charles Darkoh.

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Appendices

Appendix 1

Table 4 Summary of main qualitative findings related to barriers to HPV vaccine uptake among racial/ethnic minorities
Full size table

Appendix 2. Search strategy (PubMed)—MeSH terms

  • (((“papillomaviridae”[MeSH Terms] OR “papillomaviridae”[All Fields]) OR ((“human”[All Fields] AND “papillomavirus”[All Fields]) AND “hpv”[All Fields])) OR “human papillomavirus hpv”[All Fields]) AND (((((((((((((((((((“vaccin”[Supplementary Concept] OR “vaccin”[All Fields]) OR “vaccination”[MeSH Terms]) OR “vaccination”[All Fields]) OR “vaccinable”[All Fields]) OR “vaccinal”[All Fields]) OR “vaccinate”[All Fields]) OR “vaccinated”[All Fields]) OR “vaccinates”[All Fields]) OR “vaccinating”[All Fields]) OR “vaccinations”[All Fields]) OR “vaccination s”[All Fields]) OR “vaccinator”[All Fields]) OR “vaccinators”[All Fields]) OR “vaccine s”[All Fields]) OR “vaccined”[All Fields]) OR “vaccines”[MeSH Terms]) OR “vaccines”[All Fields]) OR “vaccine”[All Fields]) OR “vaccins”[All Fields]) AND ((“barrier”[All Fields] OR “barrier s”[All Fields]) OR “barriers”[All Fields])

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Amboree, T.L., Darkoh, C. Barriers to Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: a Systematic Review. J. Racial and Ethnic Health Disparities 8, 1192–1207 (2021). https://doi.org/10.1007/s40615-020-00877-6

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Keywords

  • HPV
  • Human papillomavirus
  • Health disparities
  • Racial/ethnic minority