Factors Associated With Human Papillomavirus Vaccine Series Completion Among Adolescents.

Most cancers associated with the human papillomavirus are preventable through vaccination. However, adolescent series completion rates are at 75.8%. Two vaccine doses are recommended for adolescents, but factors influencing 2-dose series completion are not well explored. The purpose of this study is to examine individual-level and community-level factors associated with timely human papillomavirus vaccine series completion among adolescents in the Southeastern U.S.Series completion was assessed from January 2018 to February 2019 among a cohort of adolescents initiating vaccination in 2017. Factors influencing overall series completion and timely series completion were assessed using multivariable logistic regression.Among the sample, 64.4% completed the vaccine series and 53.8% completed it timely (e.g., 14 months). Higher odds of series completion were among adolescents who were younger at vaccine initiation (AOR=1.94, 95% CI=1.50, 2.50), who traveled moderate distances to the clinic (AOR=1.62, 95% CI=1.03, 2.56), and who lived in low-deprivation neighborhoods (AOR=1.85, 95% CI=1.31, 2.60), and lower among Hispanic (AOR=0.62, 95% CI=0.45, 0.87) and non-Hispanic Black (AOR=0.66, 95% CI=0.54, 0.81) adolescents and among those without private insurance (AOR=0.68, 95% CI=0.56, 0.83). Timely series completion resulted in similar findings; however, lower odds were among Hispanic (AOR=0.63, 95% CI=0.43, 0.95) and non-Hispanic Black (AOR=0.68, 95% CI=0.50, 0.92) adolescents than among non-Hispanic other adolescents.Individual-level and community-level factors continue to influence adolescent series completion, despite a reduction in doses. Future research is needed to understand racial/ethnic and regional disparities in human papillomavirus vaccine series completion and to develop interventions to promote series completion.

Duke Scholars

Author Susan Gray Silva School of Nursing

Author Elizabeth Merwin School of Nursing

Author Rosa Gonzalez-Guarda School of Nursing