Correlates of HPV vaccination among adolescent females from Appalachia and reasons why their parents do not intend to vaccinate

Vaccine. 2013 Jun 28;31(31):3121-5. doi: 10.1016/j.vaccine.2013.04.068. Epub 2013 May 9.


Limited research has examined HPV vaccination in Appalachia, a region with cervical cancer disparities. We analyzed 2008-2010 National Immunization Survey-Teen data for adolescent females ages 13-17 from Appalachia (n=1951) to identify correlates of HPV vaccination and reasons why their parents do not intend to vaccinate. HPV vaccine initiation was 40.8%, completion was 27.7%, and follow-through was 67.8%. Vaccination outcomes tended to be higher among females who were older, had visited their healthcare provider in the last year, or whose parents reported receiving a provider recommendation to vaccinate. Only 41.0% of parents with unvaccinated daughters intended to vaccinate in the next year. The most common reasons for not intending to vaccinate were believing vaccination is not needed or not necessary (21.5%) and lack of knowledge (18.5%). Efforts to reduce missed opportunities for vaccination at healthcare visits and address reasons why parents are not vaccinating may help increase HPV vaccination in Appalachia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Appalachian Region
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intention
  • Logistic Models
  • Multivariate Analysis
  • Papillomavirus Vaccines / administration & dosage*
  • Parents / psychology*
  • Uterine Cervical Neoplasms / prevention & control
  • Uterine Cervical Neoplasms / virology
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data


  • Papillomavirus Vaccines