Correlates of HPV vaccination among adolescent females from Appalachia and reasons why their parents do not intend to vaccinate.

Limited research has examined HPV vaccination in Appalachia, a region with cervical cancer disparities. We analyzed 2008-2010 National Immunization Survey-Teen data for adolescent females ages 13-17 from Appalachia (n=1951) to identify correlates of HPV vaccination and reasons why their parents do not intend to vaccinate. HPV vaccine initiation was 40.8%, completion was 27.7%, and follow-through was 67.8%. Vaccination outcomes tended to be higher among females who were older, had visited their healthcare provider in the last year, or whose parents reported receiving a provider recommendation to vaccinate. Only 41.0% of parents with unvaccinated daughters intended to vaccinate in the next year. The most common reasons for not intending to vaccinate were believing vaccination is not needed or not necessary (21.5%) and lack of knowledge (18.5%). Efforts to reduce missed opportunities for vaccination at healthcare visits and address reasons why parents are not vaccinating may help increase HPV vaccination in Appalachia.