Role of the physician recommendation in HPV vaccine pptake among low-income ethnic minority girls in Los Angeles county

Background: Physician recommendation has been shown to be a strong predictor for vaccine utilization in general and specifically for the HPV vaccine. This study examines the role of physician recommendation in HPV vaccine uptake among an ethnically diverse population of low-income girls. Methods: A survey was implemented in five languages via the Los Angeles County Department of Public Health's Office of Women's Health telephone hotline to mothers of girls 9 to 18 years. Results: From January-November 2009, 490 mothers (53% Latina, 20% Chinese, 14% Korean, 8% Black, 5% Other) were interviewed. HPV vaccine initiation rates were 28% overall with rates of only 24% among Koreans, Chinese and Blacks and 33% among Latinas. Vaccine uptake was significantly higher among those that had discussed the vaccine with a physician (81% vs. 19%) and had been offered the vaccine (97% vs. 3%). Among mothers of unvaccinated girls, more Latinas (85%) and Blacks (81%) considered the physician to be very important in decision-making compared to Chinese (38%) and Koreans (36%). Although 79% of Latinas reported their daughter would get the vaccine if physician recommended it, rates were significantly lower among Blacks(55%), Chinese (57%) and Koreans (67%). Conclusion: Although physician recommendation was a strong predictor of HPV vaccine uptake among this population of low-income ethnic minority girls, ethnic differences were apparent with more Latinas relying on physician recommendation than Blacks, Koreans and Chinese. In addition to targeting physicians, cultural barriers and concerns need to be addressed to increase HPV vaccine uptake in this high-risk population.