title: Characteristics of Adolescents Lacking Provider-Recommended Human Papillomavirus Vaccination.
abstract: OBJECTIVE
  To characterize subgroups of teens in the United States for whom provider recommendation is less likely to impact human papillomavirus (HPV) vaccine initiation.
  
  
  METHODS
  We analyzed provider-verified vaccination data from the Centers for Disease Control and Prevention's 2014 National Immunization Survey-Teen. Poisson regression models identified characteristics associated with the lack of HPV vaccine initiation among teens who received a provider recommendation (n = 12,742). Top qualitative reasons for nonvaccination among teens who received a provider recommendation were summarized (n = 1,688).
  
  
  RESULTS
  Among teens with provider recommendations, males, younger teens, and white teens were less likely to initiate vaccination, compared to peers. Believing the vaccine was unnecessary, concerns about safety and lack of vaccine knowledge were common reasons parents did not initiate the vaccine, despite receiving provider recommendations.
  
  
  CONCLUSIONS
  These key subgroups and barriers to HPV vaccination should be targeted with interventions that complement provider recommendation to achieve broad vaccine uptake in the United States.
authors.affiliation: Cancer Prevention Fellowship Program, National Cancer Institute, Bethesda, Maryland. Electronic address: melinda.krakow@nih.gov.
authors.forename: Melinda
authors.initials: M
authors.lastname: Krakow
authors.affiliation: The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland.
authors.forename: Anna
authors.initials: A
authors.lastname: Beavis
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Olivia
authors.initials: O
authors.lastname: Cosides
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Rositch
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010290:Parents / Q000523:psychology; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescent health; HPV vaccine; Healthy People 2020; Human papillomavirus; Provider recommendation; Vaccination