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Using immunization registry data to explore initiation of HPV vaccination at ages 9 and 10

Ryan, Grace W
Kahl, Amanda
Janio, Emily
Kintigh, Bethany
Callaghan, Don
Askelson, Natoshia M
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Abstract

Despite evidence highlighting benefits of age 9/10 initiation of human papillomavirus (HPV) vaccination, little is known about who is initiating the series earlier. We describe the population of children who initiate earlier and assess the relationship of earlier initiation with series completion. We used individual-level immunization registry data from Iowa which contained data on male (49.9%) and female (50.1%) children born between 2004-2013 ages 9 and 17. We compared sociodemographic characteristics using chi-square statistics and used logistic regression to assess odds of initiation. Of children with a record of HPV vaccination, only 3.2% initiated early. In comparison to children who initiated at later, the early initiator group had a higher percentage of females ( < .0001), greater representation of nonwhite children ( < .0001), higher percentage living in urban areas ( < .0001) and higher private insurance ( < .0001). In logistic regression models, earlier initiation was significantly associated with higher rates of on-time completion (OR: 10.8 (8.6, 13.5)). These results can support prioritization of efforts to promote earlier initiation. For example, rural areas may need targeted outreach. Future work could integrate geospatial analyses so that local organizations could be able to target specific counties or even zip codes with the lowest rates of initiation.

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Ryan GW, Kahl A, Janio E, Kintigh B, Callaghan D, Askelson NM. Using immunization registry data to explore initiation of HPV vaccination at ages 9 and 10. Hum Vaccin Immunother. 2025 Dec;21(1):2547432. doi: 10.1080/21645515.2025.2547432. Epub 2025 Aug 17. PMID: 40820295; PMCID: PMC12363527.

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10.1080/21645515.2025.2547432
PubMed ID
40820295
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© 2025 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4. 0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.