Human Papillomavirus Vaccination by Country of Birth and Sex Among Adolescents Receiving Care in Community-Based Clinics.
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OBJECTIVE: Human papillomavirus (HPV) is a common sexually-transmitted infection that can lead to the development of multiple cancers, including those that disproportionately burden Latinos. However, it remains uncertain how ethnicity and country of birth relate to HPV vaccination among younger Latinos. Therefore, this study examines differences in HPV vaccine uptake among pediatric patients by ethnicity and country of birth. METHODS: We used data from OCHIN Epic electronic health records from United States community-based clinics in 27 states (2012-2022). This retrospective open cohort of patients included 250,462 females and 238,516 males aged 9-17 years. The main independent variable was ethnicity/country of birth: Latino/a (by country of birth) or non-Hispanic white. Outcomes included HPV vaccination initiation and completion, and analyzed using logistic regression adjusting for relevant covariates. RESULTS: Regardless of sex, all Latino/a groups had higher odds of vaccine initiation and completion compared to non-Hispanic white adolescents. Initiation prevalence ranged 44.4% and 40.8% in Non-Hispanic white girls and boys, to 78.7% for both Guatemalan-born and Salvadoran-born girls, and 79.3% in Guatemalan-born boys. The highest prevalence of completion was among Dominican-born girls (55.8%) and boys (56.5%), and the lowest was in non-Hispanic white girls (30.9%) and boys (25.4%). CONCLUSION: This study shows that among patients receiving care in community-based clinics, Latino adolescents, especially those who were foreign-born, had higher HPV vaccine initiation and completion compared to non-Hispanic white patients of the same age. Community strengths that might lead to increased vaccination rates should be examined and leveraged to design interventions across care settings.