Elsevier

Public Health

Volume 142, January 2017, Pages 167-176
Public Health

Original Research
Race-specific trends in HPV vaccinations and provider recommendations: persistent disparities or social progress?

https://doi.org/10.1016/j.puhe.2016.07.009Get rights and content

Highlights

  • We examined racial and ethnic differences in HPV vaccination initiation over time.

  • We examined the role of health provider recommendations in reducing racial and ethnic inequalities in HPV vaccination uptake.

  • Provider recommendations to vaccinate and HPV vaccination uptake have increased over time for all adolescents.

  • Among girls, minority youths have seen a sharper increase in provider recommendations and HPV vaccination uptake.

  • Among boys, Hispanics have lagged behind non-Hispanic Whites in the rate of provider recommendations and HPV vaccinations.

Abstract

Objectives

Although racial and ethnic differences in HPV vaccination initiation are well established, it is unclear whether these disparities have changed over time. The role of health provider recommendations in reducing any racial and ethnic inequalities is also uncertain. This study addresses these gaps in the literature.

Study design

Repeated cross-sectional design.

Methods

Using data from the National Immunization Survey-Teen (2008–2013), we estimated a series of binary logistic regressions to model race-specific trends in (1) provider recommendations to vaccinate against HPV and (2) HPV vaccine initiation for males (n = 56,632) and females (n = 77,389).

Results

Provider recommendations to vaccinate and HPV vaccination uptake have increased over time for adolescent males and females and across all racial and ethnic groups. Among girls, minority youths have seen a sharper increase in provider recommendations and HPV vaccination uptake than their White counterparts. Among boys, minority teens maintain higher overall rates of HPV vaccine uptake, however, Hispanics have lagged behind non-Hispanic Whites in the rate of increase in provider recommendations and HPV vaccinations.

Conclusions

Our results suggest that racial and ethnic disparities in provider recommendations and HPV vaccinations have waned over time among males and females. While these trends are welcomed, additional interventions are warranted to increase overall rates of vaccination across race, ethnicity, and gender.

Section snippets

Data

Our study employs data from the 2008–2013 National Immunization Survey-Teen (NIS-Teen). The National Center for Immunization and Respiratory Diseases and the National Center for Health Statistics collected the telephone survey data from a random digit sample of parents of adolescent children.33 The NIS-Teen survey implemented a dual-frame sampling design with independent landline and cell phone samples. Response rates for these samples averaged 56.4% and 23.1%, respectively. The primary aim of

Results

In the pooled sample, approximately 44% of females initiated the HPV vaccine, although the proportion is highest among Hispanic teens (48%) and lowest among African American adolescents (40%). Provider recommendations among females also appear to vary by race and ethnicity, ranging from approximately 52% among African Americans to 61% among non-Hispanic Whites. A slightly different trend exists among adolescent males. Only about 14% of teenage boys initiated the HPV vaccine, ranging from

Discussion

Recent scholarship suggests that rates of vaccine uptake have increased across racial and ethnic groups;30, 31 however, it is unclear whether racial and ethnic disparities in HPV vaccination uptake have changed over time. In addition to examining racial and ethnic trends in vaccination, we examined racial and ethnic variations in provider recommendation to vaccinate against HPV, as well as the role of these recommendations in explaining racial and ethnic disparities in vaccine uptake. Our

Ethical approval

The current study employs secondary data analysis, drawing on a large national sample of de-identified respondents. The National Immunization Survey-Teen is publicly available through the Centers for Disease Control and Prevention (http://www.cdc.gov/nchs/nis/data_files_teen.htm.); thus, this study did not require IRB review.

Funding

None declared.

Competing interests

None declared.

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