Adolescent Females and the Human Papillomavirus Vaccine (HPV): Factors Associated with Vaccination and Its Recommendation in the US

Background: The HPV vaccine has been recommended for adolescent females ≥ 11-12 years old since 2007.

Methods: The 2007 National Survey of Children's Health surveyed a nationally representative sample of households with children 0-17 years old. Bivariate and multivariable analyses were used to examine associations of sociodemographic and healthcare factors with HPV vaccination and HCP recommendation of HPV vaccine for all adolescent females 12-17 years old.

Results: Analyses of data on 16,139 adolescent females revealed that significantly higher proportions of HPV-immunized vs. HPV-unimmunized adolescent females received the tetanus/TD/Tdap (94% vs. 81%) and meningitis (65% vs. 31%) vaccines, and had their HCP recommend the HPV vaccine (84% vs. 20%). In multivariable analyses, adolescent females who were Native American had about triple the adjusted odds of HPV vaccine receipt and HCP recommendation of the HPV vaccine was associated with about 18 times the adjusted odds of HPV vaccine receipt. In separate multivariable analyses, adolescent females who were African-American, had parents who were not high-school graduates, were uninsured, had no preventive visit in the past year, and did not live in the Northeast had lower adjusted odds of an HCP recommendation for HPV vaccination.

Conclusions: HCP recommendation has a significant impact on receipt of HPV vaccine in adolescent females. African-American race, lower educational attainment, uninsurance, no preventive visits in the past year, and certain US regions are associated with lower odds of HCP recommendation for HPV vaccine. HCP recommendation of HPV vaccination may substantially improve HPV vaccination rates in adolescent females.