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Vaccine. 2013 Nov 12;31(47):5495-9. doi: 10.1016/j.vaccine.2013.09.022. Epub 2013 Sep 23.

Geographic variation in human papillomavirus vaccination uptake among young adult women in the United States during 2008-2010.

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Department of Obstetrics and Gynecology and the Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas, United States. Electronic address:


Very little is known about geographic variation in human papillomavirus (HPV) vaccine uptake among young adult women in the US. To investigate this, we analyzed data from 12 US states collected through the Behavioral Risk Factor Surveillance System between 2008 and 2010. Among 2632 young adult women (18-26 years old) who responded to HPV vaccine uptake questions, weighted vaccine initiation and completion rates were: 28.0% and 17.0% overall, 14.0% and 6.6% in the South, 28.7% and 19.3% in the Midwest/West, and 37.2% and 23.1% in the Northeast (P<0.001), respectively. Log-binomial regression analysis showed that women living in the South were less likely to initiate (adjusted prevalence ratio (aPR) 0.71, 95% confidence interval (CI) 0.60-0.83) or complete (aPR 0.61, 95% CI, 0.53-0.71) the HPV vaccine series compared to women living in the Northeast. Interventions programs to improve HPV vaccine uptake in the Southern states are warranted.


BRFSS; Cervical cancer; Geographic variation; HPV vaccine; Human papillomavirus

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