Why are U.S. girls getting meningococcal but not human papilloma virus vaccines? Comparison of factors associated with human papilloma virus and meningococcal vaccination among adolescent girls 2008 to 2012.
BACKGROUND
Human papilloma virus (HPV) vaccination rates in the United States remain low, compared with other recommended adolescent vaccines. We compared factors associated with intention to receive and receipt of HPV and meningococcal vaccines and completion of the HPV vaccine series among U.S. adolescent girls.


METHODS
Secondary analysis of data from the National Immunization Survey-Teen for 2008 through 2012 was performed. Multivariable logistic modeling was used to determine factors associated with intent to receive and receipt of HPV and meningococcal vaccination, completion of the HPV vaccine series among girls who started the series, and receipt of HPV vaccination among girls who received meningococcal vaccination.


RESULTS
Provider recommendation increased the odds of receipt and intention to receive both HPV and meningococcal vaccines. Provider recommendation was also associated with a three-fold increase in HPV vaccination among girls who received meningococcal vaccination (p<.001), indicating a relationship between provider recommendation and missed vaccine opportunities. However, White girls were 10% more likely to report provider recommendation than Black or Hispanic girls (p<.01), yet did not have higher vaccination rates, implying a role for parental refusal. No factors predicted consistently the completion of the HPV vaccine series among those who started.


CONCLUSIONS
Improving provider recommendation for co-administration of HPV and meningococcal vaccines would reduce missed opportunities for initiating the HPV vaccine series. However, different interventions may be necessary to improve series completion.
Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts. Electronic address: rebeccabperkins@gmail.com.
Rebecca B
RB
Perkins
Department of Medicine, Division of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Mengyun
M
Lin
Department of Medicine, Division of Geriatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Rebecca A
RA
Silliman
Boston University School of Public Health, Edith Nourse Rogers Veterans Hospital, Boston, Massachusetts.
Jack A
JA
Clark
Veterans Affairs Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts.
Amresh
A
Hanchate
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D033182:Intention; D016015:Logistic Models; D008589:Meningococcal Infections; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data
D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines