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Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care
Division of Gynecologic Oncology, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 634, MSC 619, Charleston, SC 29425, USA
Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St., Charleston, SC 29425, USA
Department of Pediatrics, Medical Center Boulevard, Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA
Department of Obstetrics & Gynecology, University of Virginia Health System, Charlottesville, VA 22903, USA
* Author to whom correspondence should be addressed.
Received: 29 May 2013; in revised form: 8 June 2013 / Accepted: 11 July 2013 / Published: 17 July 2013
Abstract: Since introduction of the human papillomavirus (HPV) vaccine, there remains low uptake compared to other adolescent vaccines. There is limited information postapproval about parental attitudes and barriers when presenting for routine care. This study evaluates HPV vaccine uptake and assesses demographics and attitudes correlating with vaccination for girls aged 11–12 years. A prospective cohort study was performed utilizing the University of Virginia (UVA) Clinical Data Repository (CDR). The CDR was used to identify girls aged 11–12 presenting to any UVA practice for a well-child visit between May 2008 and April 2009. Billing data were searched to determine rates of HPV vaccine uptake. The parents of all identified girls were contacted four to seven months after the visit to complete a telephone questionnaire including insurance information, child’s vaccination status, HPV vaccine attitudes, and demographics. Five hundred and fifty girls were identified, 48.2% of whom received at least one HPV vaccine dose. White race and private insurance were negatively associated with HPV vaccine initiation (RR 0.72, 95% CI 0.61–0.85 and RR 0.85, 95% CI 0.72–1.01, respectively). In the follow-up questionnaire, 242 interviews were conducted and included in the final cohort. In the sample, 183 (75.6%) parents reported white race, 38 (15.7%) black race, and 27 (11.2%) reported other race. Overall 85% of parents understood that the HPV vaccine was recommended and 58.9% of parents believed the HPV vaccine was safe. In multivariate logistic regression, patients of black and other minority races were 4.9 and 4.2 times more likely to receive the HPV vaccine compared to their white counterparts. Safety concerns were the strongest barrier to vaccination. To conclude, HPV vaccine uptake was higher among minority girls and girls with public insurance in this cohort.
Keywords: human papillomavirus; HPV; vaccine; barriers; adolescent; well child care; cervical cancer prevention
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MDPI and ACS Style
Pierce, J.Y.; Korte, J.E.; Carr, L.A.; Gasper, C.B.; Modesitt, S.C. Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care. Vaccines 2013, 1, 250-261.
Pierce JY, Korte JE, Carr LA, Gasper CB, Modesitt SC. Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care. Vaccines. 2013; 1(3):250-261.
Pierce, Jennifer Y.; Korte, Jeffrey E.; Carr, Laura A.; Gasper, Catherine B.; Modesitt, Susan C. 2013. "Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care." Vaccines 1, no. 3: 250-261.