Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018-2023).

Objectives: As the first socio-demographic profiling of HPV vaccines in Chinese cities, this study assesses equity implications through compositional analysis of covered populations, with multilevel examination of vaccine-type selection determinants. Method: Utilizing HPV vaccination data obtained from the Jinnan Center for Disease Control and Prevention (CDC) spanning from 2018 to 2023, we conducted a retrospective analysis. Hierarchical logistic regression was employed to model the joint effects of age, ethnicity, occupation, and urban-rural residence on vaccination behaviors. Vaccine type preference was categorized as bivalent, quadrivalent, or nonavalent. Result: Three key disparities were revealed in the analysis. Age-stratified access revealed the highest proportion of recipients among women aged 33-38 years (29.6%) and 39-44 years (21.9%), contrasting with less than 1% participation in the 9-14 year-old cohort. Educationally, 87.3% held at least a bachelor's degree, compared to 12.7% with below-college education ( Conclusion: Demonstrating Hart's Inverse Care Law, Tianjin's program disproportionately immunizes socioeconomically secure urbanites. We propose: (1) school-based mandates for pre-sexual debut cohorts; (2) rural vaccination-social insurance integration; (3) domestic 9-valent vaccine development with needs-based subsidies. These evidence-based reforms are critical for achieving equitable 90% coverage by 2030.