National patterns in human papillomavirus vaccination: an analysis of the National Survey of Family Growth.

Human papillomavirus (HPV) vaccine has shown effectiveness for girls and young women. Despite this, there are population disparities in vaccine utilization rates. The purpose of this study was to evaluate maternal correlates of HPV vaccination among their adolescent daughters using a nationally-representative population-based sample, emphasizing race/ethnicity-specific disparities and barriers. Mothers of 9-18 y-old girls having heard of HPV vaccine and completing the HPV vaccine survey module from the 2006-2008 National Survey of Family Growth (NSFG) (n = 444) were analyzed for maternally-reported adolescent HPV vaccination and maternal intent to vaccinate her adolescent daughter if no dose had been received. Correlates of uptake and intent were examined using multivariate logistic regression. 27% of mothers (n = 98) reported that their daughters were vaccinated against HPV. Independent correlates of vaccination included African-American race (adjusted odds ratio (AOR),0.29; 95% confidence interval (CI),0.11-0.77), and living below the poverty level (AOR,4.43; 95%CI, 1.53-12.82). 46% (n = 152) of mothers of non-vaccinated daughters intended to vaccinate them. Correlates of maternal intention included maternal pelvic exam history (AOR,0.06; 95%CI, 0.007-0.51), multiple male lifetime sexual partners (AOR,3.22 ; 95% CI, 1.34-7.76), religiosity (AOR,0.37; 95% CI,0.16-0.87) and acceptability of premarital sex among 18 y-olds (AOR,2.45; 95% CI, 1.16-5.20). In conclusion, HPV vaccination initiation among adolescent daughters of mothers participating in the NSFG continues to lag among African-American participants. However, no racial/ethnic differences in maternal intent-to-vaccinate her daughter were detected. Future interventions need to address specific maternal barriers to vaccine uptake and how these may differ from vaccine intention.