National HPV Vaccine Uptake and Vaccination Predictors and Barriers for Girls 8-17 Years Old — United States, 2008

Background: The quadrivalent human papillomavirus (HPV) vaccine was recommended in the U.S. for routine immunization of 11-12 year old girls in 2006. Administration can begin at 9 years with catch-up vaccination through age 26 years.  Depending on uptake patterns, vaccination could reduce disparities in HPV-associated disease burden.

Objectives: To identify demographic and behavioral factors associated with HPV vaccine uptake and barriers to vaccination among U.S. girls 8-17 years of age, including cost of vaccination.

Methods:  We analyzed data from the 2008 National Health Interview Survey child module (response rate: 72.3%), limited to adult respondents for 2415 households with a female child age 8-17 years.  Factors associated with parental-reported vaccine receipt were assessed with chi square statistics.

Results:  Overall, 2% (95%CI: 1-3.9%) of 8-10 year olds, 15% (95%CI: 11.1-19.7%) of 11-12 year olds, and 25% (95%CI: 22.6-28.5%) of 13-17 year olds had received at least one dose of HPV vaccine.  A lower percentage had received the second dose (4% of 8-12 year olds; 18% of 13-17 year olds) and the third dose (2% and 11%, respectively).  Factors associated with vaccine receipt included child race/ethnicity, insurance coverage and receipt of preventive health services in the last year.  The three most common barriers to vaccination were: the belief that the child did not need the vaccine; lack of sufficient vaccine knowledge; and because the child was not sexually active.

Conclusions:  Initiation and completion of HPV vaccination among girls two years after vaccine licensure were low.  A common theme among barriers to vaccinate was a lack of immunization urgency.

Implications for Programs, Policy, and/or Research: Interventions to improve HPV vaccination coverage for girls should reinforce the importance of target age group vaccination and ensure health care providers are prepared to provide information on HPV immunization and vaccine cost to patients and parents.