Abstract C055: Human papillomavirus vaccination among US military service women
Authors: Matsuno Rayna K. , Porter Ben , Warner Steven , Bookwalter Deborah B. , Wells Natalie 
Published: August 2020

Human papillomavirus (HPV) is the second most commonly diagnosed sexually transmitted infection in US service women, though the incidence has declined over the last decade, from 364.4 per 10,000 woman-years in 2007 to 90.0 per 10,000 woman-years in 2016. Despite the Department of Defense (DoD) routine vaccination recommendation for eligible service members age 17-26 years and provision of the vaccine free of charge, coverage remains low. During the years 2006-2011, only 22.5% of eligible women initiated the 3-dose series of the quadrivalent HPV vaccine, and it is not known whether receipt of the vaccine varies by demographic, military-specific, or other. We evaluated receipt of the HPV vaccine in a large cohort of active duty service women over the period 2001-2015. The women are part of the Millennium Cohort Study, which comprises over 200,000 current and past service members and is the largest longitudinal cohort of service members in military history. Briefly, participants were first enrolled in 2001 and complete follow-up questionnaires approximately every 3 years. Information on military experiences, lifestyle factors, and physical and mental health are collected at each time point. Additionally, participants can be linked to medical encounter, pharmacy, and national death data. Women who were active duty and age 18-26 years at the time of enrollment were included in the analysis. Medical encounter data and the military's central immunization database were used to identify women who had received at least one dose of the HPV (bivalent, quadrivalent, or nonavalent) vaccine. We used logistic regression to evaluate demographic, military, and health-related factors potentially related to receipt of the vaccine. There were n=14,591 women in our study cohort. Of these, n=4,867 (33.4%) had received at least one dose of the HPV vaccine. Women were less likely to be vaccinated if they were older (odds ratio [OR]=0.85, 95% confidence interval [95% CI]=0.77-0.93 for women age 25-26 years compared to women age 20-24 years), married at baseline (OR=0.79, 95% CI=0.73-0.86 compared to women who were never married), or smokers (OR=0.82, 95% CI=0.76-0.89). Women were more likely to be vaccinated if they were health care specialists (OR=1.43, 95% CI=1.30-1.57 compared to other occupations) or in the Air Force (OR=2.51, 95% CI=2.30-2.75 compared to Army). There were no differences by race, education, or military rank. In the general US population, non-white women are less likely to be vaccinated (41.5% of black, 44.7% of Hispanic or Latino, and 42.3% of Asian women compared to 52.2% in white women). However, in a setting where social determinants of health are in part addressed by equal access to vaccination, no racial differences were observed.

Citation Format: Rayna K. Matsuno, Ben Porter, Steven Warner, Deborah B. Bookwalter, Natalie Wells. Human papillomavirus vaccination among US military service women [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C055.