Human Papillomavirus (HPV) Vaccination in Young Adult Women in California--2007

Background:
A quadrivalent human papillomavirus (HPV) vaccine was first licensed in the U.S. in June 2006 for females 9 years through 26 years. Questions about the new HPV vaccine were developed for the 2007 California Women's Health Survey (CWHS).

Objectives:
To determine the rates of HPV vaccine awareness and receipt in young adult women in California in 2007.

Methods:
The CWHS is an ongoing telephone survey of a randomly selected sample of women aged 18 years and older. 2007 CWHS questions assessed awareness and receipt of HPV vaccine, as well as reasons for not receiving HPV vaccine.

Results:
Of the 408 women 18 through 26 years interviewed, 64.9% (95% Confidence Intervals: 59.0%-70.9%) were aware of the HPV vaccine. 8.6% (95% CI: 4.6%-12.6%) of the women were vaccinated with at least one dose of the HPV vaccine. For women 18 through 49 years, white women had the highest HPV vaccine awareness, and Hispanic women had the lowest vaccine awareness. College educated women and women above 45 – 49 years of age had a higher HPV vaccine awareness compared to less educated and women 18-34 years, respectively. Common reasons for not receiving the HPV vaccine in these young women 18 through 26 years included 1) being unaware of the vaccine, 2) no recommendation by provider to receive the vaccine, 3) no recent medical visit, 4) cost, 5) respondent felt vaccine not needed, and 6) safety concerns.

Conclusions:
HPV vaccine immunization rates for adult women were low during its introductory year. Immunization rates are anticipated to be higher in subsequent years. Lower rates of preventive health care and the high cost of HPV vaccine may be a barrier, particularly for the young adults who are more likely to be uninsured or underinsured.