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J Rural Health. 2019 Jan 31. doi: 10.1111/jrh.12353. [Epub ahead of print]

HPV Vaccination Coverage Among US Teens Across the Rural-Urban Continuum.

Author information

1
Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
2
Department of Geography, Temple University, Philadelphia, Pennsylvania.
3
Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
4
College of Nursing, University of Utah, Salt Lake City, Utah.
5
Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.

Abstract

BACKGROUND:

In this study, we used data from the National Immunization Survey-Teen (NIS-Teen) to examine HPV vaccination uptake by rural and urban residence defined by ZIP code.

METHODS:

We used 2012-2013 NIS-Teen data to examine associations of HPV vaccination among teens aged 13-17 years with ZIP code measures of rural/urban (Rural-Urban Commuting Area (RUCA) codes, population density). Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation (≥ 1 dose) and completion (≥ 3 doses).

RESULTS:

HPV vaccination was lower among girls from isolated small rural towns (≥1 dose 51.0%; ≥3 doses 30.0%) and small rural towns (≥1 dose 50.2%; ≥3 doses 26.8%) than among urban girls (≥1 dose 56.0%; ≥3 doses 35.9%). Girls from small rural towns had lower odds of completion (0.74, 95% CI: 0.60-0.91) than girls from urban areas. HPV vaccination was lower among boys from isolated small rural towns (≥1 dose 17.3%; ≥3 doses 5.31%) and small rural towns (≥1 dose 18.7%; ≥3 doses 5.50%) than those in urban areas (≥1 dose 28.7%; ≥3 doses 10.7%). Boys in isolated small rural towns had statistically significantly lower odds of initiation (0.68, 95% CI: 0.52-0.88) and completion (0.63, 95% CI: 0.41-0.97) than urban boys. Girls and boys from high-poverty rural areas had lower odds of initiation and completion than did their counterparts from high-poverty urban areas.

CONCLUSION:

Rural girls had lower odds of completing the HPV vaccine than their urban counterparts. Rural boys had lower odds than urban boys for HPV vaccination initiation and completion.

KEYWORDS:

health care disparities; human papilloma virus; human papilloma virus vaccines; preventive health; rural health

PMID:
30703854
DOI:
10.1111/jrh.12353

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