Health care provider recommendation, human papillomavirus vaccination, and race/ethnicity in the US National Immunization Survey.
OBJECTIVE
Human papillomavirus (HPV) is a common sexually transmitted infection in the United States, yet HPV vaccination rates remain relatively low. We examined racial/ethnic differences in the prevalence of health care provider recommendations for HPV vaccination and the association between recommendation and vaccination.


METHODS
We used the 2009 National Immunization Survey-Teen, a nationally representative cross-section of female adolescents aged 13 to 17 years, to assess provider-verified HPV vaccination (≥ 1 dose) and participant-reported health care provider recommendation for the HPV vaccine.


RESULTS
More than half (56.9%) of female adolescents received a recommendation for the HPV vaccine, and adolescents with a recommendation were almost 5 times as likely to receive a vaccine (odds ratio = 4.81; 95% confidence interval = 4.01, 5.77) as those without a recommendation. Racial/ethnic minorities were less likely to receive a recommendation, but the association between recommendation and vaccination appeared strong for all racial/ethnic groups.


CONCLUSIONS
Provider recommendations were strongly associated with HPV vaccination. Racial/ethnic minorities and non-Hispanic Whites were equally likely to obtain an HPV vaccine after receiving a recommendation. Vaccine education efforts should target health care providers to increase recommendations, particularly among racial/ethnic minority populations.
Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA. kylitalo@umich.edu
Kelly R
KR
Ylitalo
Hedwig
H
Lee
Neil K
NK
Mehta
D000293:Adolescent; D044383:Black People; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006282:Health Personnel; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D019458:Insurance Coverage; D030361:Papillomavirus Infections / Q000208:ethnology* / Q000276:immunology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D044469:Racial Groups; D012923:Social Class; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People; D001741:Black or African American
D053918:Papillomavirus Vaccines