title: Variation in Human Papillomavirus Vaccine Uptake and Acceptability Between Female and Male Adolescents and Their Caregivers.
abstract: HPV vaccination coverage is suboptimal. Previous research largely focused on vaccinating girls. This study aimed to identify factors associated with HPV vaccination among male and female adolescents. We conducted secondary analyses using the National Immunization Survey-Teen. We specified parallel logistic models to examine associations of adolescent, caregiver, and provider characteristics with vaccination status among boys and girls. The primary outcome was HPV vaccination status defined as unvaccinated, initiated, or completed. Additionally, we analyzed caregivers' intent to initiate or complete the three-dose series. The vaccination completion rate was 26 %. Among teens aged 13-17 years, 19 % initiated, but did not complete the vaccine. Additionally, 14 % of males completed the 3-dose series as compared to 38 % of females. Vaccination rates were higher among teens receiving a provider recommendation [girls: adjusted odds ratio (AOR) = 3.33, 95 % confidence interval (CI) (2.44, 4.55); boys: AOR = 10.0, 95 % CI (7.69, 12.5)]. Moreover, provider recommendation was associated with caregivers' intent to initiate vaccination [girls: AOR = 2.32, 95 % CI (1.77, 3.02); boys: AOR = 2.76, 95 % CI (2.22, 3.43)]. Other associations differed by gender. Higher vaccine initiation rates were associated with younger age and residing in the mid-west for girls and racial/ethnic minority and eligibility for the "Vaccine for Children" program for boys. Provider recommendation for vaccination was the strongest predictor for both genders; however, it is insufficient to achieve high coverage rates, especially among boys. Factors associated with HPV vaccination were different for males and females. These findings suggest providers should consider gender bias with regard to HPV vaccination.
authors: Department of Global Health, Boston University School of Public Health, Boston, MA, USA. kljohnson422@hotmail.com.|John Snow Inc., Boston, MA, USA. kljohnson422@hotmail.com.
authors: Kristin L
authors: KL
authors: Johnson
authors: Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
authors: Meng-Yun
authors: MY
authors: Lin
authors: Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors: Howard
authors: H
authors: Cabral
authors: Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
authors: Lewis E
authors: LE
authors: Kazis
authors: Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.|Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
authors: Ingrid T
authors: IT
authors: Katz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D053918:Papillomavirus Vaccines; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescents; Gender; HPV vaccination; Secondary data