Race, Nativity, and Sex Disparities in Human Papillomavirus Vaccination Among Young Adults in the USA

J Racial Ethn Health Disparities. 2021 Oct;8(5):1260-1266. doi: 10.1007/s40615-020-00886-5. Epub 2020 Oct 8.


Research has demonstrated that the human papillomavirus (HPV) vaccine is a safe and effective way to decrease HPV-related cervical cancers; however, the vaccination rate in the USA is suboptimal. The current study examined racial and ethnic disparities in HPV vaccination among a nationally representative sample, including Native Hawaiian and Pacific Islanders (NHPI). This study also investigated the associations between nativity and vaccination, and sex differences between race/ethnicity and vaccination and nativity and vaccination. A cross-sectional study was conducted with a sample of adults aged 18-26 years drawn from the 2014 NHPI National Health Interview Survey (n = 2590) and the general 2014 National Health Interview Survey (n = 36,697). Log-binomial models were fitted to examine differences in vaccination. There was a statistically significant racial/ethnic difference in HPV vaccination (p = 0.003). More women than men were vaccinated (41.8% vs. 10.1%) (p < 0.001). There was a significant difference in HPV vaccination based on nativity: 27.4% of adults aged 18 to 26 years who were born in the USA and 27.7% born in a US territory received the HPV vaccine compared with 14.3% among those not born in the USA or a US territory (p < 0.001). The association of HPV vaccination with nativity and race/ethnicity differed by sex and showed several nuanced differences. Overall, the prevalence of HPV vaccination was low. The study's findings demonstrate the need for public health strategies to increase vaccination rates among all populations, with the critical need to identify strategies that are effective for men, racial/ethnic minorities, and immigrant women born outside the USA.

Keywords: Human papillomavirus; National Health Interview Survey; Nativity; Racial and ethnic disparities; vaccination.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Healthcare Disparities / ethnology
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Male
  • Papillomavirus Vaccines / administration & dosage*
  • Racial Groups / statistics & numerical data*
  • Sex Factors
  • United States
  • Vaccination / statistics & numerical data*
  • Young Adult


  • Papillomavirus Vaccines