Disparities in contemporary human papilloma virus vaccination uptake among adult women living in the United States: An All of Us Research Program study.
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OBJECTIVE: Age-adjusted rates of new cervical cancer diagnoses in the United States have remained stable despite increasing availability of Human Papilloma Virus (HPV) vaccination. As it is well established that sociodemographic factors drive cervical cancer care inequity, we aimed to evaluate their impact on catch-up HPV vaccination rates in adults. METHODS: The All of Us (AoU) Research Program is a longitudinal cohort study sponsored by the National Institutes of Health. All participants ages 18-47 assigned female sex at birth enrolled between May 2018 and April 2023 were included in this analysis. Primary outcome was receipt of HPV vaccination. Bivariable and multivariable tests were used to examine associations. RESULTS: A total of 113,344 participants were identified in the AoU program, with 53 % (n = 60,594) self-identifying as a racial or ethnic minority. Only 3575 participants (3.2 %) were documented as having received HPV vaccination. Median age of vaccination was 26 and participants ages 18-27 were more likely to be vaccinated. Participants without health insurance (OR = 0.32, 95 % CI 0.26-0.40), stable employment (OR = 0.85, 95 % CI 0.79-0.91), and those who reported lower income (OR = 0.87, 95 % CI 0.79-0.97) were significantly less likely to have received HPV vaccination. Participants who described cost as a barrier to healthcare were also less likely to have received HPV vaccination (OR = 0.82, 95 % CI 0.73-0.93). CONCLUSION: Sociodemographic factors including low income, lack of health insurance, and lack of stable employment were all associated with lower likelihood of catch-up HPV vaccination among adult women living in the United States.