Racial disparities in human papillomavirus vaccination: Does access matter?

Amanda Gelman, Elizabeth Miller, Eleanor Schwarz, Aletha Y. Akers, Kwonho Jeong, Sonya Borrero

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Purpose To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. Results There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p <.001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR],.76; 95% confidence interval [CI],.50-1.16; and AOR,.67; 95% CI,.37-1.19) but not for African-Americans (AOR,.47, 95% CI,.33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR,.85, 95% CI,.54-1.34; and AOR,.84, 95% CI,.45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR,.49, 95% CI,.36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

Original languageEnglish (US)
Pages (from-to)756-762
Number of pages7
JournalJournal of Adolescent Health
Issue number6
StatePublished - Dec 2013
Externally publishedYes


  • Disparities
  • Human papillomavirus
  • National Survey of Family Growth
  • Race/ethnicity
  • Vaccination

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health


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