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Showing content from https://pubmed.ncbi.nlm.nih.gov/30377066/ below:

Impact of human papillomavirus vaccination on racial/ethnic disparities in vaccine-type human papillomavirus prevalence among 14-26 year old females in the U.S

Affiliations

• ¹ Department of Obstetrics & Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555 United States. Electronic address: jmhirth@utmb.edu.
• ² Department of Global Health, University of Washington, Seattle, WA, United States.
• ³ Office of Biostatistics, Division of Epidemiology and Biostatistics, Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, United States.
• ⁴ Department of Pediatrics, School of Medicine, University of Texas Medical Branch, Galveston, TX, United States.
• ⁵ Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, United States.
• ⁶ Department of Obstetrics & Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX, United States.

• PMID: 30377066
• PMCID: PMC6289515
• DOI: 10.1016/j.vaccine.2018.10.075

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Jacqueline Hirth et al. Vaccine. 2018.

• ¹ Department of Obstetrics & Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555 United States. Electronic address: jmhirth@utmb.edu.
• ² Department of Global Health, University of Washington, Seattle, WA, United States.
• ³ Office of Biostatistics, Division of Epidemiology and Biostatistics, Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, United States.
• ⁴ Department of Pediatrics, School of Medicine, University of Texas Medical Branch, Galveston, TX, United States.
• ⁵ Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, United States.
• ⁶ Department of Obstetrics & Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX, United States.

• PMID: 30377066
• PMCID: PMC6289515
• DOI: 10.1016/j.vaccine.2018.10.075

Item in Clipboard

Background: Low human papillomavirus (HPV) vaccination rates early after introduction, particularly among low income and minority adolescents, may have resulted in disparities in vaccine-type HPV prevalence (types 6, 11, 16, 18). The purpose of this study was to examine racial/ethnic variations in HPV prevalence, and evaluate how HPV vaccination has affected vaccine-type HPV prevalence across time.

Methods: This study was a retrospective analysis of 6 cycles of the National Health and Nutrition Examination Survey (NHANES) data (2003-2014). Results on HPV status from vaginal samples of 14-26 year old females who responded about HPV vaccination were used to determine HPV prevalence. Prevaccine HPV prevalence was compared to post-licensure prevalence. Racial/ethnic comparisons were made across time, and models were developed to examine the role of HPV vaccination in observed variations for vaccine-type HPV prevalence.

Results: Among 4080 females, 29.7% were black, 25.6% were Mexican American, 8.9% were Hispanic, and 35.8% were white. Compared to prevaccine years (2003-2006), vaccine-type HPV did not decrease until late post-licensure years (2011-2014; 14.2% vs. 5.2%, p < 0.001). Most of the decrease occurred among white females between prevaccine and late post-licensure periods (15.2% vs. 4.1%, p < 0.001). Although a decrease in prevalence was observed among black females during the same periods (16.9% vs. 9.8%, p < 0.05), it was not as large as among white females. Prevalence decreased among Mexican Americans (8.2 vs. 4.0, p > 0.05) during the same periods, but the difference was not significant. Interactions between race and time were significant (p < 0.001), with uneven vaccination between black and white females contributing to the disparities observed.

Conclusions: HPV vaccination was low in among black and Mexican American females, which contributed to disparities in HPV prevalence. Increasing vaccination among all adolescents, particularly 11-12 year olds, is important because most children this age will not have been exposed.

Keywords: Cervical cancer prevention; Human papillomavirus disparities; Human papillomavirus vaccination; Racial/ethnic disparities.

Copyright © 2018 Elsevier Ltd. All rights reserved.

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Conflicts of interest:

The authors have no conflicts of interest to report.

• Regional variations in human papillomavirus prevalence across time in NHANES (2003-2014).

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