What explains the different rates of human papillomavirus vaccination among adolescent males and females in the United States?

PURPOSE: To identify factors that explain differences in HPV vaccination rates for male and female adolescents and to determine self-reported barriers by parents affecting vaccination decisions.

METHODS: The sample included adolescents 13-17 years old with a vaccination record documented in the 2012 and 2013 National Immunization Survey-Teen dataset. A logistic regression model was developed with 13 socio-demographic factors and survey year, along with significant interaction pairs with gender.

RESULTS: Subjects included 20,355 and 18,350 adolescent boys and girls, respectively. About half of the females (56%) received at least one dose of HPV vaccine, compared to 28% of males. Several factors differed between males and females, including higher vaccination rates among non-Hispanic Black males and lower vaccination rates for non-Hispanic Black females compared to Whites; and a stronger association with health care provider recommendation among males. The most common parental reasons for not vaccinating their children included 'not recommended by a health care provider' for males (24%), and 'unnecessary' for females (18%).

CONCLUSION: We found a significant gender interaction with several socio-demographic variables in predicting vaccination uptake. These gender differences may be partially an artifact of timing, because male vaccination became routine approximately five years after female vaccination.