ArticleAmerican journal of preventive medicine2010
Geographic disparity, area poverty, and human papillomavirus vaccination.
Article in American journal of preventive medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- A systematic review of human papillomavirus vaccination among US adolescents.Research in nursing & health · 2021Pooled it
- Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Pooled it
- Interventions to reduce inequalities in vaccine uptake in children and adolescents aged <19 years: a systematic review.Journal of epidemiology and community health · 2017Pooled it
- Inequalities in the uptake of human papillomavirus vaccination: a systematic review and meta-analysis.International journal of epidemiology · 2013Pooled it
- The rural adolescent vaccine enterprise (RAVE): a cluster-randomized trial testing a multicomponent intervention to improve HPV vaccination in rural primary care settings.BMC primary care · 2025Trial
- Article
- Inequalities in adolescent HPV, Td/IPV and MenACWY vaccination coverage by socio-economic status: an ecological study, England, 2017 to 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Correlates of Integrated Human Papillomavirus Vaccination and Cervical Cancer Screening Protection in U.S. Low-Income Women.Vaccines · 2026Article
- A comprehensive review of HPV vaccination policies in the United States.Frontiers in public health · 2026Review
- HPV vaccination in community health organizations: what is going right and how can it be replicated?Cancer causes & control : CCC · 2025Observational
- Socioeconomic/health-related factors associated with HPV vaccination initiation/completion among females of paediatric age: A systematic review with meta-analysis.Public health in practice (Oxford, England) · 2025Review
- Temporal trends of cervical cancer demographics: a CDC WONDER database study.Frontiers in oncology · 2025Article
- Assessment of human papillomavirus literacy among midwifery students: a cross-sectional study.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Neighborhood-level social determinants of health burden among adolescent and young adult cancer patients and impact on overall survival.JNCI cancer spectrum · 2024Article
- Understanding Prognostic Factors for Human Papillomavirus Vaccination: A Rural Community Case-Control Study.Vaccines · 2023Article
- Differences in stakeholder-reported barriers and implementation strategies between counties with high, middle, and low HPV vaccine initiation rates: a mixed methods study.Implementation science communications · 2022Article
- Factors Associated with HPV Vaccine Adherence among Latino/a Adolescents in a Rural, Texas-Mexico Border County.Ethnicity & disease · 2022Article
- Reducing Poverty-Related Disparities in Cervical Cancer: The Role of HPV Vaccination.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Trends in HPV Vaccination Initiation and Completion Within Ages 9-12 Years: 2008-2018.Pediatrics · 2021Article
- Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundA human papillomavirus (HPV) vaccine was approved by the Food and Drug Administration for use among women/girls in 2006. Since that time, limited research has examined HPV vaccine uptake among adolescent girls and no studies have examined the role of geographic disparities in HPV vaccination. PURPOSE: The purpose of this study is to examine geographic disparity in the prevalence of human papillomavirus (HPV) vaccination and to examine individual-, county-, and state-level correlates of vaccination.
methodsThree-level random intercept multilevel logistic regression models were fitted to data from girls aged 13-17 years living in six U.S. states using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) and the 2000 U.S. census.
resultsData from 1709 girls nested within 274 counties and six states were included. Girls were predominantly white (70.6%) and insured (74.5%). Overall, 34.4% of girls were vaccinated. Significant geographic disparity across states (variance=0.134, SE=0.065) and counties (variance=0.146, SE=0.063) was present, which was partially explained by state and county poverty levels. Independent of individual-level factors, poverty had differing effects at the state and county level: girls in states with higher levels of poverty were less likely whereas girls in counties with higher poverty levels were more likely to be vaccinated. Household income demonstrated a similar pattern to that of county-level poverty: Compared to girls in the highest-income families, girls in the lowest-income families were more likely to be vaccinated.
conclusionsThe results of this study suggest geographic disparity in HPV vaccination. Although higher state-level poverty is associated with a lower likelihood of vaccination, higher county-level poverty and lower income at the family level is associated with a higher likelihood of vaccination. Research is needed to better understand these disparities and to inform interventions to increase vaccination among all eligible girls.
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Registered trials
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