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Sex Transm Dis. 2015 Feb;42(2):71-5. doi: 10.1097/OLQ.0000000000000225.

Correlates of human papillomavirus vaccine coverage: a state-level analysis.

Author information

1
From the *Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; and †College of Medicine, The Ohio State University, Columbus, OH.

Abstract

BACKGROUND:

We tested the hypothesis that states with higher rates of cancers associated with human papillomavirus (HPV) would have lower HPV vaccine coverage.

METHODS:

We gathered state-level data on HPV-related cancer rates and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered state-level data on demographic composition and contact with the health care system. We calculated Pearson correlations for these ecological relationships.

RESULTS:

Human papillomavirus vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r = -0.29 and -0.46, respectively). In addition, vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r = -0.30). Other cancer rates were associated with HPV vaccine initiation and follow-through among girls, but not among boys. Human papillomavirus vaccine initiation among girls was lower in states with higher proportions of non-Hispanic black residents and lower proportions of higher-income residents. Human papillomavirus vaccine follow-through was higher in states with greater levels of adolescents' contact with the health care system.

CONCLUSIONS:

Human papillomavirus vaccine coverage for girls was lower in states with higher HPV-related cancer rates. Public health efforts should concentrate on geographic areas with higher cancer rates. Strengthening adolescent preventive health care use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage.

PMID:
25585064
PMCID:
PMC4295643
DOI:
10.1097/OLQ.0000000000000225
[Indexed for MEDLINE]
Free PMC Article
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