title: Human papillomavirus vaccination series initiation and completion, 2008-2009.
abstract: OBJECTIVE
  The goal was to describe factors associated with human papillomavirus (HPV) vaccination series initiation (≥1 dose) and completion (≥3 doses) and parents' intent to have their daughters vaccinated.
  
  
  METHODS
  Data from the 2008 and 2009 National Immunization Survey-Teen were analyzed to estimate HPV vaccination coverage among girls 13 to 17 years of age (N = 18,228) and to examine associations of vaccination coverage with demographic characteristics.
  
  
  RESULTS
  Overall, 40.5% of girls had received ≥1 HPV vaccine dose, and 53.3% of those girls completed the series. Factors independently associated with vaccination initiation included older age, having an 11- to 12-year preventive visit, insurance status, mother's age and marital status, not receiving all vaccines at public facilities, and provider recommendation, which was the factor most strongly associated with initiation (prevalence ratio: 2.6 [95% confidence interval: 2.4-2.9]). Compared with white girls (60.4%), black (46.0%) and Hispanic (40.3%) girls were less likely to complete the series. Lack of knowledge of the vaccine (19.4%), vaccination was not needed (18.8%), the daughter was not sexually active (18.3%), and a provider did not recommend (13.1%) were the most common reasons for parents' nonintent to have their daughters vaccinated.
  
  
  CONCLUSIONS
  Although HPV vaccine coverage rates are increasing, they are still below target levels. Recommendations by providers to adolescent patients and parents likely would improve vaccine uptake. Parental education regarding disease risks and benefits of HPV vaccination before exposure is needed to promote vaccine uptake.
authors: Division of Immunization Services, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cdorell@cdc.gov
authors: Christina G
authors: CG
authors: Dorell
authors: David
authors: D
authors: Yankey
authors: Tammy A
authors: TA
authors: Santibanez
authors: Lauri E
authors: LE
authors: Markowitz
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D030361:Papillomavirus Infections / Q000208:ethnology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000193:education; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016730:Program Development; D015397:Program Evaluation; D018570:Risk Assessment; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control / Q000821:virology; D014611:Vaccination / Q000379:methods* / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines