Human papillomavirus vaccination among adults and children in 5 US states

Context: The Centers for Disease Control and Prevention Advisory Committee for Immunization Practices has recommended human papillomavirus (HPV) vaccines for use in children and young adults for preventing HPV-related diseases, but HPV vaccine coverage is low in the United States. Objective: To assess HPV vaccination among US adults and children and to identify characteristics associated with HPV vaccination. Methods: We used the 2010 Behavioral Risk Factors Surveillance System data to examine HPV vaccine initiation and completion among adults aged 18 to 26 years and children aged 9 to 17 years in 5 US states. We performed a multivariate logistic regression to evaluate factors associated with HPV vaccination. Results: We assessed the HPV vaccination status of 706 women and 560 men and 2201 girls and 2292 boys. In 2010, a total of 258 (41.6%) women and 21 (4.3%) men had initiated HPV vaccination. Of those vaccinated women, 182 (75%) completed the 3-dose vaccine series. Rural residence (adjusted odds ratio [aOR] = 0.37) and not having a Papanicolaou test (aOR = 0.44) were negatively associated with HPV vaccine initiation among women. Women who were aged 18 to 20 years (aOR = 2.93) were more likely to complete HPV vaccination. A total of 612 (24.6%) girls and 86 (5.2%) boys received 1 or more doses of HPV vaccines; 308 (50.3%) vaccinated girls and 14 (10.8%) vaccinated boys completed the vaccine series. Younger age (9-12 years: aOR = 0.09) and not receiving a seasonal influenza vaccine (aOR = 0.44) were negatively related to HPV vaccine initiation in girls. Girls were less likely to initiate and complete HPV vaccination if their parents did not have a routine checkup within 1 year. Conclusion: HPV vaccination in the United States remains below the Healthy People 2020 objective (80%). To increase HPV vaccination, strategies still need to focus on improving access to HPV vaccines and utilization of health services.