Table 3.
Factors associated with not receiving HPV vaccine by MSA status – National Immunization Survey–Teen, United States, 2016–2017, N = 41, 424.
| Characteristic | Overall |
Metropolitan Statistical Area (MSA) |
||
|---|---|---|---|---|
| Mostly urban |
Suburban |
Mostly rural |
||
| aPR % (95% CI) | aPR % (95% CI) | aPR % (95%CI) | aPR % (95% CI) | |
|
Metropolitan Statistical Area (MSA) Mostly urban* Suburban Mostly rural |
Ref. 1.11 (1.06–1.18)† 1.18 (1.10–1.26)† |
|||
|
Age (years) 13–15* 16–17 |
Ref. 0.92 (0.87–0.97)† |
Ref. 0.94 (0.84–1.04) |
Ref. 0.90 (0.83–0.97)† |
Ref. 0.94 (0.85–1.03) |
|
Sex Female* Male |
Ref. 1.08 (1.03–1.13)† |
Ref. 1.09 (1.00–1.19) |
Ref. 1.08 (1.02–1.16)† |
Ref. 1.06 (0.98–1.15) |
|
Race/ethnicity Non-Hispanic white* Non-Hispanic black Hispanic AI/AN Asian Other |
Ref. 0.85 (0.78–0.92)† 0.75 (0.69–0.81)† 1.02 (0.80–1.28) 0.78 (0.67–0.90)† 0.93 (0.83–1.03) |
Ref. 0.94 (0.83–1.07) 0.72 (0.63–0.83)† 0.85 (0.55–1.33) 0.67 (0.51–0.87)† 0.93 (0.76–1.13) |
Ref. 0.75 (0.66–0.86)† 0.77 (0.68–0.87)† 1.25 (0.89–1.76) 0.87 (0.73–1.04) 0.93 (0.80–1.07) |
Ref. 0.79 (0.64–0.98)† 0.77 (0.65–0.91)† 0.89 (0.64–1.22) 0.66 (0.40–1.10) 0.95 (0.80–1.14) |
|
Region Northeast* Midwest South West |
Ref. 1.10 (1.03–1.17)† 1.22 (1.15–1.30) † 1.01 (0.93–1.10) |
Ref. 1.26 (1.09–1.45)† 1.55 (1.35–1.78)† 1.26 (1.07–1.49)† |
Ref. 1.05 (0.97–1.14) 1.11 (1.03–1.20)† 0.91 (0.80–1.02) |
Ref. 1.20 (1.02–1.41)† 1.32 (1.12–1.56)† 1.19 (1.00–1.42)† |
|
Maternal education <High school* High school Some college/college graduate >College graduate |
Ref. 1.21 (1.07–1.37)† 1.35 (1.20–1.53)† 1.29 (1.14–1.46)† |
Ref. 1.28 (1.03–1.58)† 1.40 (1.13–1.74)† 1.33 (1.07–1.66)† |
Ref. 1.16 (0.97–1.38) 1.30 (1.08–1.56)† 1.19 (0.99–1.43) |
Ref. 1.17 (0.96–1.43) 1.29 (1.07–1.56)† 1.42 (1.17–1.73)† |
|
Maternal marital status Married* Widowed/divorced/separated Never married |
Ref. 0.93 (0.87–0.99)† 0.86 (0.77–0.97)† |
Ref. 0.91 (0.81–1.03) 0.91 (0.76–1.08) |
Ref. 0.94 (0.86–1.03) 0.77 (0.62–0.94)† |
Ref. 0.92 (0.83–1.02) 0.88 (0.73–1.06) |
|
Maternal age (years) ≤34* 35–44 ≥45 |
Ref. 1.14 (1.03–1.26)† 1.14 (1.02–1.26)† |
Ref. 1.18 (0.99–1.40) 1.19 (0.99–1.42) |
Ref. 1.20 (1.01–1.42)† 1.17 (0.98–1.40) |
Ref. 0.93 (0.80–1.07) 0.98 (0.84–1.14) |
|
Income to poverty ratio <133%* 133%–<322% 322%–<503% >503% |
Ref. 1.14 (1.05–1.24)† 1.11 (1.01–1.22)† 1.01 (0.92–1.12) |
Ref. 1.15 (1.01–1.32)† 1.14 (0.96–1.35) 1.03 (0.86–1.24) |
Ref. 1.16 (1.02–1.31)† 1.13 (0.98–1.30) 1.01 (0.88–1.16) |
Ref. 1.07 (0.95–1.20) 0.98 (0.84–1.13) 1.04 (0.88–1.24) |
|
Medical insurance‡ Private only* Any Medicaid Other¶ Uninsured |
Ref. 0.84 (0.78–0.91)† 0.99 (0.90–1.08) 1.02 (0.89–1.16) |
Ref. 0.86 (0.74–0.99)† 1.08 (0.92–1.26) 0.94 (0.74–1.19) |
Ref. 0.83 (0.74–0.94)† 0.99 (0.87–1.13) 1.04 (0.86–1.25) |
Ref. 0.88 (0.78–0.99)† 0.86 (0.71–1.02) 1.09 (0.88–1.36) |
|
11–12 y.o. well-child visit** Yes* No Don’t know |
Ref. 1.39 (1.30–1.48)† 1.31 (1.24–1.39)† |
Ref. 1.47 (1.30–1.66)† 1.40 (1.25–1.56)† |
Ref. 1.35 (1.24–1.48)† 1.24 (1.15–1.34)† |
Ref. 1.33 (1.20–1.48)† 1.33 (1.19–1.48)† |
|
Provider recommendation for HPV vaccine†† Yes* No |
Ref. 2.10 (2.00–2.20)† |
Ref. 2.06 (1.89–2.25)† |
Ref. 2.16 (2.02–2.30)† |
Ref. 1.99 (1.82–2.16)† |
|
Vaccination facility type All private facilities* All public facilities All hospital facilities All STD/school/teen clinics or other facilities Mixed‡‡ Other¶¶ |
Ref. 0.94 (0.86–1.02) 0.91 (0.83–0.98)† 0.97 (0.80–1.19) 0.88 (0.81–0.94)† 1.14 (0.96–1.35) |
Ref. 0.96 (0.83–1.12) 0.89 (0.77–1.03) 1.03 (0.80–1.32) 0.76 (0.66–0.88)† 0.8 0.89 (0.64–1.22) |
Ref. 0.89 (0.77–1.02) 0.88 (0.79–0.99)† 0.84 (0.58–1.20) 0.95 (0.86–1.05) 1.25 (1.00–1.57) |
Ref. 1.00 (0.89–1.12) 1.02 (0.88–1.17) 1.44 (1.12–1.85)† 0.96 (0.85–1.08) 1.42 (1.04–1.94) |
Abbreviations: aPR = adjusted prevalence ratio; CI = confidence interval; HPV = human papillomavirus; STD = sexually transmitted disease; y.o. = year old.
*Reference level.
†p < .05 by t-test compared with reference group.
‡Insurance categories are mutually exclusive.
¶Includes Indian Health Service, military, Children’s Health Insurance Program, and some private.
**Status of health-care visit at age 11–12 years based on provider-reported data.
††By parental report.
‡‡Mixed indicates that the facility is identified to be in more than one of the facility categories such as private, public, hospital, STD/school/teen clinics.
¶¶Includes military, Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics, and pharmacies.