Human Papillomavirus Vaccination Estimates Among Adolescents in the Mississippi Delta Region: National Immunization Survey‑Teen, 2015–2017

Human Papillomavirus Vaccination Estimates Among Adolescents in the Mississippi Delta Region: National Immunization Survey‑Teen, 2015–2017

ORIGINAL RESEARCH — Volume 17 — April 16, 2020

David Yankey, PhD1; Laurie D. Elam-Evans, PhD1; Connie L. Bish, PhD2; Shannon K. Stokley, DrPH1 (View author affiliations)

Suggested citation for this article: Yankey D, Elam-Evans LD, Bish CL, Stokley SK. Human Papillomavirus Vaccination Estimates Among Adolescents in the Mississippi Delta Region: National Immunization Survey‑Teen, 2015–2017. Prev Chronic Dis 2020;17:190234. DOI: http://dx.doi.org/10.5888/pcd17.190234external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known about this topic?

Routine human papillomavirus (HPV) vaccination is recommended for children aged 11 or 12 years to prevent HPV and associated cancers.

What is added by this report?

Geographic disparities in HPV vaccine coverage exist in the Mississippi Delta Regional Authority (DRA) counties and other counties in Delta states, compared with states outside the Delta region.

What are the implications for public health practice?

Efforts to improve coverage are needed, particularly in the DRA region and other counties in Delta states. Providing parents and guardians with information and strong, compelling recommendations can improve HPV vaccination coverage.

Abstract

Introduction

The Delta Regional Authority (DRA) consists of 252 counties and parishes in 8 states in the US Mississippi Delta region. DRA areas have high rates of disease, including cancers related to the human papillomavirus (HPV). HPV vaccination coverage in the DRA region has not been documented.

Methods

We analyzed data for 63,299 adolescents aged 13 to 17 years in the National Immunization Survey-Teen, 2015–2017. We compared HPV vaccination initiation coverage estimates (≥1 dose) in the DRA region with coverage estimates in areas in the 8 Delta states outside the DRA region and non-Delta states. We examined correlates of HPV vaccination coverage initiation and reasons parents did not intend to vaccinate adolescents.

Results

Vaccination rates in the DRA region (n = 2,317; 54.3%) and in Delta areas outside the DRA region (n = 6,028; 56.2%) were similar, but these rates were significantly lower than rates in non-Delta states (n = 54,954; 61.4%). Inside the DRA region, reasons for parents’ vaccine hesitancy or refusal were similar to those expressed by parents in the Delta areas outside the DRA region. Some parents believed that the vaccine was not necessary or had concerns about vaccine safety.

Conclusion

HPV vaccination coverage in the DRA region is similar to coverage in other Delta counties and parishes, but it is significantly lower than in non-Delta states. Activities to address parental concerns and improve provider recommendations for the vaccine in the DRA region are needed to increase HPV vaccination rates.