TY - JOUR
T1 - Socioeconomic disadvantage and human papillomavirus (HPV) vaccination uptake
AU - Kurani, Shaheen
AU - MacLaughlin, Kathy L.
AU - Jacobson, Robert M.
AU - St. Sauver, Jennifer L.
AU - Jenkins, Gregory D.
AU - Fan, Chun
AU - Jacobson, Debra J.
AU - Inselman, Jonathan
AU - Zhu, Xuan
AU - Griffin, Joan M.
AU - Finney Rutten, Lila J.
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2022/1/24
Y1 - 2022/1/24
N2 - Importance: Despite availability of safe and effective human papillomavirus (HPV) vaccines, vaccination uptake remains low in the U.S. Research examining the impact of neighborhood socioeconomic status on HPV vaccination may help target interventions. Objective: To examine the association between area deprivation and HPV vaccine initiation and completion. Design, setting, participants: Retrospective cohort study of individuals aged 11–18 years residing in the upper Midwest region. Receipt of HPV vaccination was examined over a three-year follow-up period (01/01/2016–12/31/2018). Main outcomes and measures: Outcomes of interest were initiation and completion of HPV vaccination. Demographic data were collected from the Rochester Epidemiology Project (REP). Area-level socioeconomic disadvantage was measured by calculating an Area Deprivation Index (ADI) score for each person, a measure of socioeconomic disadvantage derived from American Community Survey data. Multivariable mixed effect Cox proportional hazards models were used to examine the association of ADI quartiles (Q1-Q4) with HPV vaccine series initiation and completion, given initiation. Results: Individuals residing in census block groups with higher deprivation had significantly lower likelihood of HPV vaccine initiation (Q2: HR = 0.91, 0.84–0.99 Q3: HR = 0.83, 0.76–0.90; Q4: HR = 0.84, 0.74–0.96) relative to those in the least-deprived block groups (Q1). Similarly, those living in block groups with higher deprivation had significantly lower likelihood of completion (Q2: HR = 0.91, 0.86–0.97; Q3: HR = 0.87, 0.81–0.94; Q4: HR = 0.82, 0.74–0.92) compared to individuals in the least-deprived block groups (Q1). Conclusions and relevance: Lower probability of both HPV vaccine-series initiation and completion were observed in areas with greater deprivation. Our results can inform allocation of resources to increase HPV vaccination rates in our primary care practice and provide an example of leveraging public data to inform similar efforts across diverse health systems.
AB - Importance: Despite availability of safe and effective human papillomavirus (HPV) vaccines, vaccination uptake remains low in the U.S. Research examining the impact of neighborhood socioeconomic status on HPV vaccination may help target interventions. Objective: To examine the association between area deprivation and HPV vaccine initiation and completion. Design, setting, participants: Retrospective cohort study of individuals aged 11–18 years residing in the upper Midwest region. Receipt of HPV vaccination was examined over a three-year follow-up period (01/01/2016–12/31/2018). Main outcomes and measures: Outcomes of interest were initiation and completion of HPV vaccination. Demographic data were collected from the Rochester Epidemiology Project (REP). Area-level socioeconomic disadvantage was measured by calculating an Area Deprivation Index (ADI) score for each person, a measure of socioeconomic disadvantage derived from American Community Survey data. Multivariable mixed effect Cox proportional hazards models were used to examine the association of ADI quartiles (Q1-Q4) with HPV vaccine series initiation and completion, given initiation. Results: Individuals residing in census block groups with higher deprivation had significantly lower likelihood of HPV vaccine initiation (Q2: HR = 0.91, 0.84–0.99 Q3: HR = 0.83, 0.76–0.90; Q4: HR = 0.84, 0.74–0.96) relative to those in the least-deprived block groups (Q1). Similarly, those living in block groups with higher deprivation had significantly lower likelihood of completion (Q2: HR = 0.91, 0.86–0.97; Q3: HR = 0.87, 0.81–0.94; Q4: HR = 0.82, 0.74–0.92) compared to individuals in the least-deprived block groups (Q1). Conclusions and relevance: Lower probability of both HPV vaccine-series initiation and completion were observed in areas with greater deprivation. Our results can inform allocation of resources to increase HPV vaccination rates in our primary care practice and provide an example of leveraging public data to inform similar efforts across diverse health systems.
KW - Papillomavirus Infections
KW - Papillomavirus vaccines
KW - Social class
KW - Socioeconomic factors
KW - Vaccination
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U2 - 10.1016/j.vaccine.2021.12.003
DO - 10.1016/j.vaccine.2021.12.003
M3 - Article
C2 - 34916103
AN - SCOPUS:85121210346
SN - 0264-410X
VL - 40
SP - 471
EP - 476
JO - Vaccine
JF - Vaccine
IS - 3
ER -