title: Disparities in human papillomavirus vaccine series initiation among adolescent girls enrolled in Florida Medicaid programs, 2006-2008.
abstract: OBJECTIVE
  To better understand the human papillomavirus (HPV) vaccine series initiation among 9-17-year-old female Medicaid beneficiaries in Florida programs between June 2006 and December 2008 (n = 237,015).
  
  
  METHODS
  Among the Florida Medicaid enrollees with itemized claims collected (non-managed care organization enrollees), we assessed the association between HPV vaccine series initiation (≥1 vaccine claim) and important demographic characteristics (age, race/ethnicity, program enrollment, area of residence, and length of enrollment).
  
  
  RESULTS
  Among 11-17-year-olds, vaccine initiation increased over time from <1% by December 2006 to nearly 19% by December 2008. By December 2008, HPV vaccine initiation increased with respect to age from 9 (1.6%) to 13 years (22.9%), remained relatively stable from ages 13 to 15 years (between 21% and 22%), and decreased among 16- (18.6%) and 17-year-olds (15.7%). Compared with girls in Pilot or Fee for Service programs, the girls in MediPass or Children's Medical Service Network programs were more likely to have initiated the vaccine series. Within three of the four programs, Hispanics were more likely than non-Hispanic white and black girls to have initiated the vaccine series.
  
  
  CONCLUSIONS
  This study expands the understanding of HPV vaccine initiation to low-income adolescents eligible for free vaccine through the Federal Vaccine for Children program. Increased understanding of reasons for the observed differences, especially by program and race/ethnicity, will aid in developing interventions to improve HPV vaccine initiation.
authors.affiliation: Department of Health Outcomes and Policy, and Institute for Child Health Policy, University of Florida, Gainesville, Florida 32610, USA. sstaras@ufl.edu
authors.forename: Stephanie A S
authors.initials: SA
authors.lastname: Staras
authors.forename: Susan T
authors.initials: ST
authors.lastname: Vadaparampil
authors.forename: Laura T
authors.initials: LT
authors.lastname: Haderxhanaj
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Shenkman
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D005260:Female; D005431:Florida; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007345:Insurance Claim Review; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D013221:State Health Plans; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines