Background: Human papillomavirus (HPV) vaccine coverage remains far below Healthy People 2020 Goals and below coverage for other routine adolescent vaccines. Coverage of childhood vaccines may vary by parent nativity (parent’s country of origin).

Objectives: Assess odds of missed opportunities for HPV vaccination among adolescents in Minnesota by parent’s nativity (non-US origin).

Methods: We conducted a population-based cohort study of 176,403 adolescents born in 2004-2007 and their parents, linking individual birth records with Minnesota vaccine registry data. In logistic regression models we assessed odds of missed opportunities for HPV vaccination by parent’s US-born or non-US-born status. We controlled for parent education levels, child’s gender, child’s age at vaccination, family income by zip code, parity and geographic location by zip code.

Results: Adolescents with at least one parent not born in the U.S. were not more likely to experience a missed opportunity for HPV vaccination than adolescents whose parents were both born in the U.S. (OR=0.98, 95% CI: (0.78,1.24)). Similarly, adolescents of both parents not born in the U.S. were not statistically significantly different in terms of missed opportunities (OR=1.07, CI: (0.83,1.37)). Models restricting by gender found non-significant relationships for girls (OR=0.85, 95% CI:(0.61,1.19)) and boys (OR=1.10, 95% CI: (0.80, 1.52)). Other factors that were significant included geographic location, multiparity, previous vaccination, parent’s education level, and insurance status.

Conclusion: Parental nativity does not explain missed opportunities for HPV vaccination in this cohort. Future studies should examine multiparity and geographic location among other factors as drivers of vaccine hesitancy.