Health Disparities
Disparities in HPV Vaccination in the MIdwest region of the US Kristyne Mansilla Dubon* Kristyne Mansilla Dubon Edward Peters Abraham Mengist
Human papillomavirus (HPV) incidence rates in the Midwest region range between 10 to 13 per 100,000. HPV infection is strongly associated with cancers that are preventable through vaccination. Current guidelines require two or three doses for complete HPV vaccination, depending upon age. Despite recent improvements, the HPV vaccination proportion remains below the Healthy People-2030 80% goal, with lower completion rates among racial and gender minorities. Our objective was to examine the differences in vaccination status among teens and young adults living in the Midwest region of the US. In 2023, we conducted a cross-sectional knowledge attitude and practice survey administered through Qualtrics using their survey panels. The population consisted of participants aged 13 to 26 years old residing in the Midwest region of the US who had agreed to participate in the survey. We estimated summaries of sociodemographic characteristics and conducted a bivariate analysis to identify potential predictors of vaccination status. Lastly, we fitted a generalized ordered logit model to examine disparities in vaccination status. We observed that 30% of participants (n=1306 had completed the vaccination series, almost 10% had initiated HPV vaccination, 35% were unvaccinated, and 25% were unsure of their vaccination status. The adjusted model included age, gender, ethnicity, and educational level. We found that as age increases, the odds of not being vaccinated decrease (aOR 0.9 95% CI 0.85-0.96) . Self-identified female participants had lower odds of being unvaccinated than male participants (aOR 0.68, 95% CI:0.52-0.92). Black or African Americans and American Indian or Alaska Native had almost 3 and 2.5 times, respectively, higher odds of not knowing whether they were vaccinated or not compared to White participants (aOR 0.68, 95% CI:0.52-0.92). Participants with less than a high school education had higher odds of not knowing if they were vaccinated than participants with a graduate education (aOR 2.56, 95% CI:1.01-4.18). These findings suggest that age, race, gender, and educational level are associated with vaccination status and knowledge of vaccination status among the participants in the study. The study’s findings highlight sociodemographic barriers affecting HPV initiation and completeness and provide a guide to prioritize public health interventions that target minority groups to enhance vaccination rates.