Abstract PO-271: Racial and ethnic disparities in human papillomavirus (HPV) vaccine uptake among adults aged 27-45 years in the United States
Authors: Osazuwa-Peters Nosayaba , Rincon Natalie , McDowell Kelsey Rae , Ritchwood Tiarney , Boakye Eric Adjei 
Published: January 2022

Abstract
Background: More than 36,000 new cases of human papillomavirus (HPV)-associated cancers are diagnosed annually in the United States, with racial/ethnic differences observed in incidence and mortality. HPV vaccination is a means of primary prevention against HPV-associated cancers, and in 2018, the Food and Drug Administration expanded age of eligibility for the HPV vaccine to 27-45 years. However, no study has examined differences in vaccine uptake based on race/ethnicity since the expansion of age of eligibility. Objective: To characterize racial/ethnic differences in HPV vaccine uptake among eligible adults aged 27-45 years in the United States, and identify socioeconomic factors associated with differential vaccine uptake. Methods: We analyzed nationally representative, cross-sectional data from the 2019 National Health Interview Survey (n = 9,440). Outcome of interest was HPV vaccine uptake, defined as receipt of at ≥ 1 dose of the vaccine. Main independent variable was race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic other). Other covariates included age, sex, marital status, highest level of education, annual income, insurance status, having a usual place of care, and geographic region of residence. Weighted, multivariable logistic regression model estimated odds of HPV vaccine uptake based on race/ethnicity, while adjusting for other covariates. Results: Majority of respondents were non-Hispanic whites (60.7%). Vaccine uptake rate was only 15.5%. In the unadjusted analysis, there were associations between HPV vaccine uptake and race/ethnicity, sex, marital status, education, income, insurance, place of care, and geography (p &lt; 0.001). After adjusting for covariates, significant racial/ethnic differences in HPV vaccine uptake persisted. Compared to non-Hispanic whites, non-Hispanic blacks were 36% (aOR = 1.36; 95% CI 1.09, 1.70) more likely to receive the HPV vaccine. However, Hispanics were 27% less likely than non-Hispanic whites to receive the HPV vaccine (aOR = 0.73; 95% CI 0.58, 0.92). Additionally, individuals who did not have a usual place of care had lower odds of vaccine uptake (aOR = 0.72; 95% CI 0.57, 0.93), as were those with lower educational levels (high school aOR = 0.62; 95% CI 0.50, 0.78; some college aOR = 0.83; 95% CI 0.70, 0.98), compared to college graduates or more. Compared to participants residing in the South, those in the West were more likely to receive the vaccine (aOR = 1.49; 95% CI 1.24, 1.80); and females had over three times the odds of receiving the vaccine (aOR = 3.58; 95% CI 3.03, 4.23) than males. Conclusions: Only 1-in-6 adults between 27 and 45 years in the United States have received at least one dose of the HPV vaccine, and Hispanics are significantly less likely to do so, as are individuals without a usual place of care. Given the importance of the vaccine in cancer prevention, it is critical that these disparities be mitigated.
Citation Format: Nosayaba Osazuwa-Peters, Natalie Rincon, Kelsey Rae McDowell, Tiarney Ritchwood, Eric Adjei Boakye. Racial and ethnic disparities in human papillomavirus (HPV) vaccine uptake among adults aged 27-45 years in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-271.