TY - JOUR
T1 - Impact of human papillomavirus vaccination on racial/ethnic disparities in vaccine-type human papillomavirus prevalence among 14–26 year old females in the U.S.
AU - Hirth, Jacqueline
AU - McGrath, Christine J.
AU - Kuo, Yong Fang
AU - Rupp, Richard E.
AU - Starkey, Jonathan M.
AU - Berenson, Abbey B.
N1 - Funding Information:
This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences, National Institutes of Health. J.M. Hirth and C.J. McGrath were a Scholars supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women's Health Program-BIRCWH; Principal Investigator: Berenson) from the Office of Research on Women's Health (ORWH), the Office of the Director (OD), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health during study conception. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Research Data Center, the National Center for Health Statistics, or the Centers for Disease Control and Prevention. The sponsors did not have any role in the study design, collection, analysis, and interpretation of the data or any other aspect of this study or manuscript.
Funding Information:
This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch , supported in part by a Clinical and Translational Science Award ( UL1 TR001439 ) from the National Center for Advancing Translational Sciences , National Institutes of Health . J.M. Hirth and C.J. McGrath were a Scholars supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women’s Health Program-BIRCWH; Principal Investigator: Berenson) from the Office of Research on Women’s Health (ORWH), the Office of the Director (OD), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health during study conception. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Research Data Center, the National Center for Health Statistics, or the Centers for Disease Control and Prevention. The sponsors did not have any role in the study design, collection, analysis, and interpretation of the data or any other aspect of this study or manuscript.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/11/29
Y1 - 2018/11/29
N2 - Background: Low human papillomavirus (HPV) vaccination rates early after introduction, particularly among low income and minority adolescents, may have resulted in disparities in vaccine-type HPV prevalence (types 6, 11, 16, 18). The purpose of this study was to examine racial/ethnic variations in HPV prevalence, and evaluate how HPV vaccination has affected vaccine-type HPV prevalence across time. Methods: This study was a retrospective analysis of 6 cycles of the National Health and Nutrition Examination Survey (NHANES) data (2003–2014). Results on HPV status from vaginal samples of 14–26 year old females who responded about HPV vaccination were used to determine HPV prevalence. Prevaccine HPV prevalence was compared to post-licensure prevalence. Racial/ethnic comparisons were made across time, and models were developed to examine the role of HPV vaccination in observed variations for vaccine-type HPV prevalence. Results: Among 4080 females, 29.7% were black, 25.6% were Mexican American, 8.9% were Hispanic, and 35.8% were white. Compared to prevaccine years (2003–2006), vaccine-type HPV did not decrease until late post-licensure years (2011–2014; 14.2% vs. 5.2%, p < 0.001). Most of the decrease occurred among white females between prevaccine and late post-licensure periods (15.2% vs. 4.1%, p < 0.001). Although a decrease in prevalence was observed among black females during the same periods (16.9% vs. 9.8%, p < 0.05), it was not as large as among white females. Prevalence decreased among Mexican Americans (8.2 vs. 4.0, p > 0.05) during the same periods, but the difference was not significant. Interactions between race and time were significant (p < 0.001), with uneven vaccination between black and white females contributing to the disparities observed. Conclusions: HPV vaccination was low in among black and Mexican American females, which contributed to disparities in HPV prevalence. Increasing vaccination among all adolescents, particularly 11–12 year olds, is important because most children this age will not have been exposed.
AB - Background: Low human papillomavirus (HPV) vaccination rates early after introduction, particularly among low income and minority adolescents, may have resulted in disparities in vaccine-type HPV prevalence (types 6, 11, 16, 18). The purpose of this study was to examine racial/ethnic variations in HPV prevalence, and evaluate how HPV vaccination has affected vaccine-type HPV prevalence across time. Methods: This study was a retrospective analysis of 6 cycles of the National Health and Nutrition Examination Survey (NHANES) data (2003–2014). Results on HPV status from vaginal samples of 14–26 year old females who responded about HPV vaccination were used to determine HPV prevalence. Prevaccine HPV prevalence was compared to post-licensure prevalence. Racial/ethnic comparisons were made across time, and models were developed to examine the role of HPV vaccination in observed variations for vaccine-type HPV prevalence. Results: Among 4080 females, 29.7% were black, 25.6% were Mexican American, 8.9% were Hispanic, and 35.8% were white. Compared to prevaccine years (2003–2006), vaccine-type HPV did not decrease until late post-licensure years (2011–2014; 14.2% vs. 5.2%, p < 0.001). Most of the decrease occurred among white females between prevaccine and late post-licensure periods (15.2% vs. 4.1%, p < 0.001). Although a decrease in prevalence was observed among black females during the same periods (16.9% vs. 9.8%, p < 0.05), it was not as large as among white females. Prevalence decreased among Mexican Americans (8.2 vs. 4.0, p > 0.05) during the same periods, but the difference was not significant. Interactions between race and time were significant (p < 0.001), with uneven vaccination between black and white females contributing to the disparities observed. Conclusions: HPV vaccination was low in among black and Mexican American females, which contributed to disparities in HPV prevalence. Increasing vaccination among all adolescents, particularly 11–12 year olds, is important because most children this age will not have been exposed.
KW - Cervical cancer prevention
KW - Human papillomavirus disparities
KW - Human papillomavirus vaccination
KW - Racial/ethnic disparities
UR - http://www.scopus.com/inward/record.url?scp=85055569837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055569837&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2018.10.075
DO - 10.1016/j.vaccine.2018.10.075
M3 - Article
C2 - 30377066
AN - SCOPUS:85055569837
SN - 0264-410X
VL - 36
SP - 7682
EP - 7688
JO - Vaccine
JF - Vaccine
IS - 50
ER -