ArticleBMC public health2019
Going beyond the individual: how state-level characteristics relate to HPV vaccine rates in the United States.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- A Systematic Review of the Effectiveness of Health Education Programs for Cervical Cancer Prevention in Rural Communities: Implications for Promoting Health Equity.Journal of cancer education : the official journal of the American Association for Cancer Education · 2024Pooled 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
- Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake.BMC public health · 2021Trial
- Efficient information extraction using LLMs and knowledge distillation: A study on HPV health communication.PLOS digital health · 2026Article
- A comprehensive review of HPV vaccination policies in the United States.Frontiers in public health · 2026Review
- Analysis of factors driving HPV vaccination coverage and associated cost savings in the united States.BMC public health · 2025Article
- The association of caregiver attitudes, information sources, and trust with HPV vaccine initiation among adolescents.Human vaccines & immunotherapeutics · 2024Article
- Article
- The impact of regional disparities on the availability of meningococcal vaccines in the US.BMC public health · 2024Article
- Barriers to the assessment and recommendation of HPV vaccination among healthcare providers in Texas.Vaccine: X · 2024Article
- Associations of geographic-based socioeconomic factors and HPV vaccination among male and female children in five US states.BMC public health · 2024Article
- Evaluation of Theoretical Frameworks to Detect Correlates of HPV Vaccination in the Midwest, US, Using Structural Equation Modeling.Vaccines · 2023Article
- Article
- Barriers to human papillomavirus vaccine uptake: role of state religiosity and healthcare professionals' participation in a state vaccine program.JNCI cancer spectrum · 2023Article
- Individual, systemic and state factors associated with provider recommendation of HPV vaccination: Findings from NIS-Teen, 2020.Human vaccines & immunotherapeutics · 2023Article
- The influence of political ideology on awareness of HPV and HPV vaccine among adults in the United States.Human vaccines & immunotherapeutics · 2023Article
- Article
- Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools.Vaccines · 2023Article
- Article
- HPV and COVID-19 vaccines: Social media use, confidence, and intentions among parents living in different community types in the United States.Journal of behavioral medicine · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe human papillomavirus (HPV) vaccine is an underutilized cancer control practice in the United States. Although individual contextual factors are known to impact HPV vaccine coverage rates, the impact of macro-level elements are still unclear. The aim of this analysis was to use HPV vaccination rates to explore the underuse of an evidence-based cancer control intervention and explore broader-level correlates influencing completion rates.
methodsA comprehensive database was developed using individual-level date from the National Immunization Survey (NIS)-Teen (2016) and state-level data collected from publically available sources to analyze HPV vaccine completion. Multi-level logistic models were fit to identify significant correlates. Level-1 (individual) and level-2 (state) correlates were fitted to a random intercept model. Deviance and AIC assessed model fit and sampling weights were applied.
resultsThe analysis included 20,495 adolescents from 50 U.S. states and the District of Columbia. Teen age, gender, race/ethnicity, and maternal education were significant individual predictors of HPV completion rates. Significant state-level predictors included sex education policy, religiosity, and HPV vaccine mandate. States with the lowest HPV coverage rates were found to be conservative and highly religious. Little variation in vaccine exemptions and enacted sex and abstinence education polices were observed between states with high and low HPV vaccine coverage suggesting various contextual and situational factors impact HPV vaccine completion rates.
conclusionsGiven that gender, religiosity, political ideology, and education policies are predictors of HPV vaccine completion, the interaction and underlying mechanism of these factors can be used to address the underutilization of the HPV vaccine.
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