Disparity in HPV Vaccine Use 2009-2015 among Young Adults in the US Interview Survey

Abstract

Objectives: This study aimed to examine difference in HPV vaccine receipt proportion among recipients of different regions, races and genders using national data. Methods: National Health Interview Survey (NHIS) data in year 2009, 2011, 2012, 2013, 2014 and year 2015 were used. All participants in this study were between 18-26 years old as the last day of survey year. The outcomes of interest include 'ever received any HPV vaccine' and 'ever received three-dose HPV vaccine'. Logistic regression models were conducted to test if there is improvement in HPV immunization over the years compared to year 2009. We also examine the HPV immunization disparity due to sex, race, region, etc. The final weighting variable was applied for all the analysis in this study. Results: A total of 1929 (17,969,653 after weighting) in year 2009, 4333 (36,946,340 after weighting) in year 2011, 4369 (36,722,787 after weighting) in year 2012, 4225 (36,221,482 after weighting) in year 2013, 4277 (35,920,194 after weighting) in year 2014, 3674 (35,063,591 after weighting) in year 2015 were included in the final analysis. The average age was 22.0 in each year. Approximately 19% of the participants in year 2009 (female only) received HPV vaccine; it gradually increased to 28% of all (both male and female) in year 2015. Over the years, it increased from 19% in year 2009 to 42% in year 2015 for the females. Meanwhile it increased from 2% in year 2011 to 13% in year 2015 for the males. Over the years, it increased from 26% in year 2009 to 35% in year 2015 for the Northeast region. Meanwhile it increased from 20% in year 2009 to 26% in year 2015 for the Midwest region. It increased from 17% in year 2009 to 26% in year 2015 for the South region. It increased from 18% in year 2009 to 28% in year 2015 for the South region. Over the years, it increased from 21% in year 2009 to 28% in year 2015 for the white. Meanwhile it increased from 15% in year 2009 to 27% in year 2015 for the black. It increased from 12% in year 2009 to 27% in year 2015 for the Asian. It increased from 10% in year 2009 to 19% in year 2015 for the others. All the difference were statistically significnat (p-values<0.05). Simiar results were observed for 3-dose HPV vaccine receipt. Losgitic regression confirmed the regional dispary, sexual disparity, and racial disparity in HPV vaccine receipt were significant. Conclusions: In this study we found that HPV vaccine use increased over the time. However, sexual disparity, regional disparity and racial disparity in HPV vaccine use continuously existed over the years. Measures to improve the proportion as well as to eliminate disparity were still nearly needed.