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    HPV vaccine rates, race, and income

     

    Dr. Henry and coauthors note that the finding of higher HPV vaccination initiation among girls living in the poorest communities may seem contrary to prevailing beliefs equating socioeconomic disadvantage with barriers to care and underutilization of health services. The explanation may relate in part to the availability of “safety-net” immunization services, such as the State Children’s Health Insurance Program (SCHIP) or Medicaid, along with the federally funded Vaccine for Children program for individuals living at the poverty level.

    “In our study, rates of HPV vaccination were highest among girls with SCHIP or Medicaid health insurance compared with girls who had private insurance,” noted Dr Henry.

    Other possible contributors include healthcare practice and community-based interventions and related strategies supporting HPV vaccination that have focused on poor communities where rates of cervical cancer are highest. Furthermore, there may be positive or protective factors related to living in communities that have a high concentration of ethnic minorities sharing the same health-related values that provide critical social and instrumental support to promote HPV vaccination, said Dr Henry.

    The study also confirmed some previously reported associations between individual factors and HPV vaccination, including age (highest in older girls), mother’s age and education level (highest among girls with younger and less educated mothers) and race/ethnicity (highest among Hispanics vs other groups). The strongest predictor for vaccination, however, was provider recommendation—the vaccination rate was nearly two-fold higher in the cohort where the girls or their parents received a recommendation for vaccine than in those who did not (64% vs 34.8%).

    “Given this information and that HPV vaccination rates in the United States remain substantially below the US Department of Health and Human Service target of 80% at 8 years after the vaccine was first recommended, healthcare providers need to continue talking about HPV vaccination to teens and their parents, regardless of race/ethnicity or where they live,” Dr Henry said.

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