Role of Race, Rurality, and Age in Human Papillomavirus Vaccine Initiation among US Women

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with a lifetime prevalence of more than 80%. HPV is associated with cervical cancer, which affects thousands of US women each year. A vaccine was introduced in 2006 to mitigate the prevalence and mortality of HPV-associated cancers. Although HPV vaccine adherence has increased over time, disparities in vaccine uptake exist among adolescents, and likely within adult communities. This study explored the impact of race/ethnicity, rural classification, and age on vaccine initiation among adult women in the United States.

The final sample included N = 4666 females aged 18 to 43 years from the 2022 National Health Interview Survey. A logistic regression model explored the association of race/ethnicity, rural classification, and age with HPV vaccine initiation.

Only 40.1% of our sample ever received an HPV vaccine. Urban residents were significantly more likely than rural residents to have ever gotten an HPV vaccine. Hispanic, Black, and Asian participants had significantly lower HPV vaccine initiation rates compared with their White counterparts. Finally, as age increased, HPV vaccine initiation decreased.

Efforts to increase HPV vaccine uptake for future generations of women and girls in the United States should focus on rural communities, as well as Black, Hispanic, and Asian racial minorities. Because so many women within our sample had not received any HPV vaccine, we must emphasize the importance of HPV testing and cervical cancer screening, especially among aging women.