Introduction
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.
Methods
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.
Results
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.
Conclusions
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.
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Article Info
Publication History
Published online: July 10, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
