Teen girls living in high-poverty and in majority Hispanic communities had the highest rates of having received at least 1 dose of the human papillomavirus (HPV) vaccine compared with those in low-poverty communities and in communities of other racial or ethnic compositions. These findings were published in Cancer Epidemiology, Biomarkers & Prevention (doi:10.1158/1055-9965.EPI-15-0658).

HPV is a very common virus, and the Centers for Disease Control and Prevention (CDC) estimates that 1 in 4 people in the United States are infected. HPV infection is responsible for a large proportion of vaginal, vulvar, anal, penile, and oropharyngeal cancers.

A total of 3 shots of the HPV vaccine are recommended by the CDC, starting at age 11 to 12 years for both preteen boys and girls.

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“HPV vaccines could dramatically reduce the incidence of HPV-associated cancers, but uptake of these vaccines is far lower than for other routine childhood and teen immunizations,” said Kevin A. Henry, PhD, an assistant professor in the Department of Geography and Urban Studies at Temple University in Philadelphia, Pennsylvania, member of Fox Chase Cancer Center’s Cancer Prevention and Control program, and first author of this study.

The primary goal of the study was to determine if geographic factors have an affect on vaccination uptake. This knowledge could inform efforts to increase vaccination and prevent cancer, explained Henry.

For the study, Henry and colleagues analyzed data from the 2011 and 2012 National Immunization Survey-Teen, an annual survey conducted by the CDC to monitor vaccination uptake in the United States. They restricted the analysis to the 20 565 girls ages 13 to 17 years for whom provider-verified vaccination records were available. In each year, 53% of the girls had received at least 1 dose of HPV vaccine and were said to have initiated vaccination.

Henry explained that the most important geographic factor affecting HPV vaccine initiation was the racial and ethnic composition of the community. The study found the rate of initiating the HPV vaccine was highest among girls living in communities where the majority of the population was Hispanic (69%), and lowest among girls living in majority non-Hispanic white communities (50%) and non-Hispanic black communities (54%).

The racial composition of the community affected the HPV vaccination rates among Hispanic girls. Rates were lower (approximately 49%) for Hispanic girls living in majority non-Hispanic white communities initiating vaccination, and higher (approximately 68%) for Hispanic girls living in majority Hispanic or mixed race communities.

Regardless of a community’s racial composition, if 20% or more of a population was living below the poverty level, odds of initiating the HPV vaccine were 1.18 times greater than for those living in the least impoverished communities.

“The higher HPV vaccination rates among girls living in poor communities and majority Hispanic communities, which also tend to have high poverty rates, are encouraging because these communities often have higher cervical cancer rates, but continued cervical cancer screening of vaccinated and unvaccinated women is needed because the vaccine does not cover all cancer-causing HPV types and sexually active women could have been infected prior to vaccination.” said Henry. “The higher HPV vaccination rates in these groups also provide some evidence supporting successful health care practice and community-based interventions.

The study was funded in part by the Huntsman Cancer Institute Foundation, Primary Children’s Hospital Foundation, the Beaumont Foundation, and the National Institutes of Health.