Social Determinates of HPV Vaccination Delay: Results from the National Immunization Survey of Teens

Background: Human papillomavirus, which can cause cervical cancer, genital warts and other anogenital cancers, is the most common sexually transmitted infection in the United States. Although social determinates of HPV vaccination initiation are relatively well-established, research has just begun to identify specific reasons for delay in HPV vaccine uptake.

 Methods: Using data from 2011 United States National Immunization Survey-Teen data, a nationally representative sample detailing vaccination coverage in United States, we examined social disparities in reasons for delaying vaccination among  parents who  opted not to vaccinate their child against HPV.

 Results: Our results reveal notable racial and ethnic variations in reasons for vaccine delay. African American parents (OR=1.20; CI= 1.03-1.39) displayed greater odds of reporting that the delay in initiation was because the vaccine was not needed in comparison to their non-Hispanic white counterparts. Parents who were Hispanic (OR=1.39; CI= 1.11-1.72), Black (OR=1.49; CI= 1.19-1.85), or other race (OR=1.43; CI= 1.13-1.80) all displayed significantly higher odds of reporting that a lack of knowledge about the HPV vaccine was the primary barrier to vaccination in comparison to non-Hispanic whites. Our results show few socioeconomic variations in reasons for HPV vaccination delay among the adolescents in our sample. Gender variations in reasons for delay were overwhelmingly due to a lack of recommendation.

 Conclusion:  Our results suggest that racial and ethnic disparities in vaccine uptake may be due to a lack of knowledge about the HPV vaccine, rather than general concerns about vaccine safety or beliefs about teen sexual activity.