Human papillomavirus vaccination history among women with precancerous cervical lesions: disparities and barriers

Obstet Gynecol. 2012 Mar;119(3):575-81. doi: 10.1097/AOG.0b013e3182460d9f.


Objective: To estimate racial, ethnic, and socioeconomic differences in human papillomavirus (HPV) vaccination history among women aged 18-27 years with precancerous cervical lesions diagnosed, barriers to vaccination, and timing of vaccination in relation to the abnormal cytology result that preceded the diagnosis of the cervical lesion.

Methods: High-grade cervical lesions are reportable conditions in Connecticut for public health surveillance. Telephone interviews and medical record reviews were conducted during 2008-2010 for women (n=269) identified through the surveillance registry.

Results: Overall, 43% of women reported history of one or more doses of HPV vaccine. The mean age at vaccination was 22 years. Publicly insured (77%) and uninsured (85%) women were more likely than privately insured women (48%) to report no history of vaccination (P<.05). Among unvaccinated women, being unaware of HPV vaccine was reported significantly more often among Hispanics than non-Hispanics (31% compared with 13%, P=.02) and among those with public or no insurance compared with those with private insurance (26% and 36% compared with 6%, P<.05 for both). The most commonly reported barrier was lack of provider recommendation (25%). Not having talked to a provider about vaccine was reported significantly more often among those with public compared with private insurance (41% compared with 18%, P<.001). Approximately 35% of women received vaccine after an abnormal cytology result; this occurred more frequently among African American women compared with white women (80% compared with 30%, P<.01).

Conclusion: Catch-up vaccination strategies should focus on provider efforts to increase timely coverage among low-income and minority women.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Black People / statistics & numerical data
  • Connecticut / epidemiology
  • Female
  • Health Knowledge, Attitudes, Practice / ethnology
  • Healthcare Disparities
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / therapeutic use*
  • Precancerous Conditions / epidemiology*
  • Precancerous Conditions / ethnology
  • Precancerous Conditions / pathology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / ethnology
  • Uterine Cervical Neoplasms / pathology
  • White People / statistics & numerical data
  • Young Adult


  • Papillomavirus Vaccines