Race, ethnicity, and income factors impacting human papillomavirus vaccination rates

Clin Ther. 2014 Jan 1;36(1):24-37. doi: 10.1016/j.clinthera.2013.11.001.


Background: Human papillomavirus (HPV) infection and cervical cancer disproportionately affect low-income and minority women. HPV vaccines have the potential to either reduce or exacerbate racial disparities in HPV-related diseases and cervical cancers, depending on the equitability of vaccine uptake.

Objectives: This review aims to identify barriers and facilitators of equitable uptake of HPV vaccination among low-income and minority girls. This review discusses factors related to race, ethnicity, and income that are associated with initiation and completion rates of the 3-dose HPV vaccine series and presents targets for intervention.

Methods: We reviewed relevant English-language literature to identify current vaccination rates and factors associated with vaccine uptake. Study findings related to race (black, Latino, Asian), and incomes were summarized.

Results: Current trends in the United States indicate low uptake among all adolescents, and that rates stagnated between 2011 and 2012. Low-income and minority adolescents are equally or more likely to start the HPV vaccination series than are white and higher-income adolescents, but are less likely to complete all 3 shots. Provider recommendation is a key factor in HPV vaccination, and minorities are less likely to report receiving recommendations for HPV vaccination.

Conclusions: As black, Hispanic, and Asian populations continue to grow in the United States over the next several decades, it is imperative that we not only improve HPV vaccination rates overall, but also focus on high-risk populations to prevent an increase in cervical cancer disparities.

Keywords: HPV; ethnicity; human papillomavirus; income; race; racial disparities; vaccination.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Ethnic Groups / education
  • Ethnic Groups / statistics & numerical data
  • Female
  • Humans
  • Immunization Programs* / economics
  • Immunization Programs* / statistics & numerical data
  • Immunization Programs* / trends
  • Male
  • Papillomavirus Infections / ethnology
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / administration & dosage*
  • Papillomavirus Vaccines / economics
  • Poverty / economics
  • Poverty / statistics & numerical data
  • Uterine Cervical Neoplasms / ethnology
  • Uterine Cervical Neoplasms / prevention & control*


  • Papillomavirus Vaccines