Employment Status and Receipt of HPV Vaccine among Women 18-26 Years of Age

Background:
In 2006, CDC's Advisory Committee on Immunization Practices recommended routine HPV vaccination for girls 11-12 years old, with catch up vaccinations for those 13-26 years of age. Little is known, however, about the facilitators and barriers to HPV vaccination for older adolescents and young adults (ages 18-26).

Objectives:
To examine 1) whether employment status is associated with HPV vaccine receipt and completion of the HPV series, and 2) the extent to which insurance status, HPV knowledge, and other barriers contribute to observed differences between the groups.

Methods:
998 women between the ages of 18 and 26 responded to an on-line survey which assessed their knowledge, attitudes and beliefs about HPV and the HPV vaccine, and obtained information on their HPV vaccination status and barriers to vaccination receipt. Tests of association and regression analyses were performed in SAS using sampling weights to generate nationally representative estimates.

Results:
Women employed full time were about half as likely to receive a HPV vaccine compared to those not working full time, although employment was not associated with completion of the HPV series. Insurance status and knowledge of HPV, however, did not differ between those employed full time and those who were not. Individuals employed full time felt cost was significantly less of a barrier to receipt of the HPV vaccine, were less concerned about their parents finding out, but were more likely to be HPV positive at the time the vaccine was introduced. Differences in HPV vaccination rates by employment status are driven by age, as younger women were significantly more likely to receive the HPV vaccination.

Conclusions:
HPV vaccination rates among older adolescents and young adults are not driven by employment or insurance status. Improving coverage rates among this older population will require additional research on potential barriers and facilitators of HPV vaccination.