Public Health Resources


Date of this Version



Pediatrics November 2011, VOLUME 128 / ISSUE 5 (with Errata)


U.S. Government Work


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


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.