Racial/Ethnic and poverty disparities in human papillomavirus vaccination completion

Am J Prev Med. 2011 Oct;41(4):428-33. doi: 10.1016/j.amepre.2011.06.032.


Background: Two vaccines against human papillomavirus (HPV), a necessary cause of cervical cancer, are currently licensed and recommended for routine administration in the U.S. to girls in a three-dose series.

Purpose: This study examined effects of race/ethnicity, poverty, and year on completion of the three-dose HPV vaccine series among those who initiated vaccination.

Methods: Data from the 2008-2009 National Immunization Survey-Teen for girls aged 13-17 years who received at least one dose of HPV vaccine (n=7606) were analyzed in 2010-2011 using logistic regression to adjust for covariates including measures of access to care.

Results: During this 2-year period, 55% of adolescent girls who initiated vaccination completed the three-dose series. Completion was significantly higher in 2009 (60%) compared to 2008 (48%; p<0.001). After controlling for covariates, adolescents who were black (AOR=0.48, 95% CI=0.40, 0.57) or Hispanic (AOR=0.75, 95% CI=0.64, 0.88) were significantly less likely to complete vaccination than whites. Adolescents living below the federal poverty level were significantly less likely to complete vaccination than adolescents with household incomes >$75,000 (AOR=0.76, 95% CI=0.63, 0.92). There was no significant interaction between race/ethnicity and year (p=0.92). Although poverty was associated with lower completion rates in 2008, this association was not observed in 2009 (p<0.05 for poverty-year interaction).

Conclusions: HPV vaccination completion rates increased between 2008 and 2009. However, significant differences by race/ethnicity and poverty were observed, and the racial/ethnic differences persisted.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Services Accessibility
  • Health Status Disparities
  • Health Surveys
  • Healthcare Disparities*
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Immunization / statistics & numerical data*
  • Immunization Programs
  • Logistic Models
  • Papillomavirus Vaccines / administration & dosage*
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Poverty*
  • United States
  • Uterine Cervical Neoplasms / prevention & control*
  • White People / psychology
  • White People / statistics & numerical data


  • Papillomavirus Vaccines