Human Papillomavirus Vaccination Series Initiation and Completion, 2008-2009

OBJECTIVE: The goal was to describe factors associated with human papillomavirus (HPV) vaccination series initiation (>= 1 dose) and completion (>= 3 doses) and parents' intent to have their daughters vaccinated. METHODS: Data from the 2008 and 2009 National Immunization Survey-Teen were analyzed to estimate HPV vaccination coverage among girls 13 to 17 years of age (N = 18 228) and to examine associations of vaccination coverage with demographic characteristics. RESULTS: Overall, 40.5% of girls had received >= 1 HPV vaccine dose, and 53.3% of those girls completed the series. Factors independently associated with vaccination initiation included older age, having an 11- to 12-year preventive visit, insurance status, mother's age and marital status, not receiving all vaccines at public facilities, and provider recommendation, which was the factor most strongly associated with initiation (prevalence ratio: 2.6 [95% confidence interval: 2.4-2.9]). Compared with white girls (60.4%), black (46.0%) and Hispanic (40.3%) girls were less likely to complete the series. Lack of knowledge of the vaccine (19.4%), vaccination was not needed (18.8%), the daughter was not sexually active (18.3%), and a provider did not recommend (13.1%) were the most common reasons for parents' nonintent to have their daughters vaccinated. CONCLUSIONS: Although HPV vaccine coverage rates are increasing, they are still below target levels. Recommendations by providers to adolescent patients and parents likely would improve vaccine uptake. Parental education regarding disease risks and benefits of HPV vaccination before exposure is needed to promote vaccine uptake. Pediatrics 2011;128:830-839