title: Race, ethnicity, and income factors impacting human papillomavirus vaccination rates.
abstract: BACKGROUND
  Human papillomavirus (HPV) infection and cervical cancer disproportionately affect low-income and minority women. HPV vaccines have the potential to either reduce or exacerbate racial disparities in HPV-related diseases and cervical cancers, depending on the equitability of vaccine uptake.
  
  
  OBJECTIVE
  This review aims to identify barriers and facilitators of equitable uptake of HPV vaccination among low-income and minority girls. This review discusses factors related to race, ethnicity, and income that are associated with initiation and completion rates of the 3-dose HPV vaccine series and presents targets for intervention.
  
  
  METHODS
  We reviewed relevant English-language literature to identify current vaccination rates and factors associated with vaccine uptake. Study findings related to race (black, Latino, Asian), and incomes were summarized.
  
  
  RESULTS
  Current trends in the United States indicate low uptake among all adolescents, and that rates stagnated between 2011 and 2012. Low-income and minority adolescents are equally or more likely to start the HPV vaccination series than are white and higher-income adolescents, but are less likely to complete all 3 shots. Provider recommendation is a key factor in HPV vaccination, and minorities are less likely to report receiving recommendations for HPV vaccination.
  
  
  CONCLUSIONS
  As black, Hispanic, and Asian populations continue to grow in the United States over the next several decades, it is imperative that we not only improve HPV vaccination rates overall, but also focus on high-risk populations to prevent an increase in cervical cancer disparities.
authors.affiliation: Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.
authors.forename: Patricia
authors.initials: P
authors.lastname: Jeudin
authors.affiliation: Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Liveright
authors.affiliation: Division of Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Marcela G
authors.initials: MG
authors.lastname: Del Carmen
authors.affiliation: Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts. Electronic address: rebecca.perkins@bmc.org.
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Perkins
mesh_terms: D000293:Adolescent; D005006:Ethnicity / Q000193:education / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D030361:Papillomavirus Infections / Q000208:ethnology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; ethnicity; human papillomavirus; income; race; racial disparities; vaccination