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Table 2 Multivariable analysis of factors associated with HPV initiation and completion among female and male adolescents, NIS-Teen 2013a

From: White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study – teen

FEMALES

 

≥1 dose of HPV vaccine (N = 8256)

HPV vaccine completion (N = 8256)

 

Adjusted vaccination coverageb % (95%CI)

Adjusted prevalence ratio (95%CI)c

p-value

Adjusted vaccination coverageb % (95%CI)

Adjusted prevalence ratio (95%CI)c

p-value

Age(Mother/Parent)

  ≤ 34 years old

64.9 (59.1, 70.7)

Reference

 

41.7 (35.3, 48.1)

Reference

 

 35–44 years old

56.4 (53.6, 59.1)

0.87 (0.79, 0.96)

<0.01

36.8 (34.0, 39.6)

0.88 (0.75, 1.05)

0.15

  ≥ 45 years old

56.8 (54.1, 59.4)

0.87 (0.79, 0.97)

0.01

37.5 (34.8, 40.2)

0.90 (0.76, 1.07)

0.23

Education (Mother)

  < High school

61.7 (56.9, 66.5)

Reference

 

39.8 (33.2, 46.4)

Reference

 

 High school

59.1 (55.2, 62.9)

0.96 (0.87, 1.05)

0.35

41.6 (37.3, 45.9)

1.04 (0.87, 1.25)

0.63

 Some college

55.2 (51.7, 58.7)

0.90 (0.81, 0.99)

0.03

34.6 (31.2, 37.9)

0.87 (0.72, 1.05)

0.15

 College graduate

56.1 (52.9, 59.3)

0.91 (0.82, 1.01)

0.07

36.2 (33.0, 39.4)

0.91 (0.74, 1.11)

0.36

Poverty status

 Above poverty (>$75 k)

57.5 (54.0, 61.0)

Reference

 

37.9 (34.1, 41.6)

Reference

 

 Above poverty (<=$75 k)

55.4 (52.5, 58.4)

0.96 (0.89, 1.04)

0.35

36.5 (33.4, 39.5)

0.96 (0.85, 1.09)

0.55

 Below poverty

60.1 (56.0, 64.3)

1.05 (0.94, 1.16)

0.39

38.7 (33.8, 43.6)

1.02 (0.85, 1.23)

0.82

Marital status of mother

 Married

54.5 (52.1, 56.8)

Reference

 

36.1 (33.7, 38.4)

Reference

 

 Otherd

62.7 (59.5, 65.8)

1.15 (1.08, 1.23)

<0.01

40.4 (36.9, 43.8)

1.12 (1.01, 1.25)

0.04

Ethnicity/Race of teens

 Hispanic

61.1 (56.8, 65.4)

Reference

 

41.2 (36.1, 46.2)

Reference

 

 Non-Hispanic White only

56.5 (54.1, 59.0)

0.93 (0.85, 1.01)

0.07

36.4 (34.0, 38.7)

0.88 (0.77, 1.02)

0.09

 Otherd

55.9 (52.4, 59.4)

0.91 (0.84, 1.00)

0.05

37.0 (33.5, 40.5)

0.90 (0.78, 1.04)

0.16

Age in years of selected teen

 13 years old

48.7 (45.2, 52.2)

Reference

 

24.3 (21.0, 27.7)

Reference

 

 14 years old

53.0 (49.2, 56.7)

1.09 (0.99, 1.19)

0.08

30.2 (26.7, 33.7)

1.24 (1.04, 1.48)

0.01

 15 years old

59.0 (55.1, 62.8)

1.21 (1.10, 1.33)

<0.01

39.6 (35.5, 43.7)

1.63 (1.38, 1.92)

<0.01

 16 years old

62.6 (58.7, 66.5)

1.28 (1.17, 1.41)

<0.01

45.4 (41.1, 49.6)

1.86 (1.58, 2.19)

<0.01

 17 years old

65.1 (60.7, 69.5)

1.34 (1.21, 1.47)

<0.01

52.8 (48.0, 57.5)

2.17 (1.84, 2.55)

<0.01

Source of health insurance for teens

 Provided through employment or union

57.0 (54.4, 59.5)

Reference

 

37.5 (34.9, 40.2)

Reference

 

 Not Provided through employment or union

58.0 (54.7, 61.2)

1.02 (0.94, 1.10)

0.65

37.6 (34.0, 41.1)

1.00 (0.88, 1.14)

0.99

Facility type for teen’s providers

 All public facilities

58.2 (53.8, 62.7)

Reference

 

34.0 (28.8, 39.3)

Reference

 

 All hospital facilities

64.7 (59.7, 69.7)

1.11 (1.00, 1.23)

0.04

41.9 (35.7, 48.0)

1.23 (1.00, 1.51)

0.05

 All private facilities

57.1 (54.4, 59.9)

0.98 (0.90, 1.07)

0.67

38.6 (35.9, 41.3)

1.13 (0.96, 1.34)

0.14

 Mixed/Other

55.0 (51.3, 58.6)

0.94 (0.86, 1.04)

0.25

35.9 (32.3, 39.6)

1.06 (0.88, 1.27)

0.57

Do teen’s providers order vaccination from states/ local health department

 All providers

57.8 (55.6, 60.0)

Reference

 

37.7 (35.5, 39.9)

Reference

 

 Some but possibly not all

60.3 (54.7, 65.9)

1.04 (0.94, 1.15)

0.39

37.4 (31.7, 43.0)

0.99 (0.84, 1.16)

0.91

 No providers

51.5 (46.1, 56.8)

0.89 (0.80, 0.99)

0.03

37.5 (32.2, 42.8)

1.00 (0.86, 1.16)

0.95

 Don’t know

57.5 (50.0, 64.9)

0.99 (0.87, 1.14)

0.94

36.8 (30.1, 43.6)

0.98 (0.81, 1.18)

0.81

Influenza vaccinatione

 No

47.4 (44.8, 50.0)

Reference

 

28.1 (25.6, 30.6)

Reference

 

 Yes

69.2 (66.8, 71.6)

1.46 (1.37, 1.55)

<0.01

48.5 (45.8, 51.3)

1.73 (1.56, 1.91)

<0.01

TDAP vaccinationf

 No

53.7 (49.7, 57.6)

Reference

 

27.5 (23.9, 31.1)

Reference

 

 Yes

58.6 (56.5, 60.7)

1.09 (1.01, 1.18)

0.03

40.9 (38.7, 43.2)

1.49 (1.29, 1.72)

<0.01

Meningitis vaccinationg

 No

26.0 (22.3, 29.8)

Reference

 

12.7 (10.1, 15.3)

Reference

 

 Yes

64.8 (62.7, 67.0)

2.49 (2.15, 2.89)

<0.01

42.6 (40.3, 44.8)

3.35 (2.71, 4.15)

<0.01

MALES

 

≥1 dose of HPV vaccine (N = 9003)

 

HPV vaccine completion (N = 9003)

 
 

Adjusted vaccination coverageb % (95%CI)

Adjusted prevalence ratio (95%CI)c

p-value

Adjusted vaccination coverageb % (95%CI)

Adjusted prevalence ratio (95%CI)c

p-value

Age(Mother/Parent)

  ≤ 34 years old

35.0 (30.3, 39.8)

Reference

 

12.9 (9.4, 16.5)

Reference

 

 35–44 years old

35.2 (32.5, 37.8)

1.00 (0.87, 1.16)

0.97

12.6 (10.6, 14.5)

0.97 (0.71, 1.33)

0.87

  ≥ 45 years old

33.4 (30.6, 36.2)

0.95 (0.81, 1.12)

0.57

14.9 (12.7, 17.1)

1.15 (0.83, 1.60)

0.40

Education (Mother)

  < High school

35.2 (30.4, 39.9)

Reference

 

18.2 (13.4, 23.1)

Reference

 

 High school

34.6 (30.8, 38.3)

0.98 (0.84, 1.14)

0.82

13.5 (10.4, 16.6)

0.74 (0.53, 1.03)

0.08

 Some college

29.6 (26.5, 32.7)

0.84 (0.71, 1.00)

0.05

11.4 (9.3, 13.5)

0.62 (0.45, 0.86)

<0.01

 College graduate

37.4 (33.7, 41.1)

1.06 (0.89, 1.28)

0.51

13.2 (11.1, 15.4)

0.73 (0.52, 1.02)

0.06

Poverty status

 Above poverty (>$75 k)

34.4 (30.6, 38.2)

Reference

 

14.8 (11.8, 17.9)

Reference

 

 Above poverty (<=$75 k)

32.7 (29.7, 35.7)

0.95 (0.83, 1.09)

0.47

13.1 (10.8, 15.4)

0.88 (0.70, 1.11)

0.30

 Below poverty

36.5 (32.5, 40.6)

1.06 (0.88, 1.27)

0.52

13.0 (10.1, 16.0)

0.88 (0.61, 1.27)

0.49

Marital status of mother

 Married

32.7 (30.4, 35.1)

Reference

 

13.6 (11.9, 15.4)

Reference

 

 Otherd

37.2 (34.1, 40.4)

1.14 (1.02, 1.27)

0.02

13.6 (11.4, 15.8)

1.00 (0.81, 1.23)

0.98

Ethnicity/Race of teens

 Hispanic

43.3 (38.8, 47.8)

Reference

 

16.2 (12.9, 19.4)

Reference

 

 Non-Hispanic White

29.5 (27.3, 31.6)

0.68 (0.60, 0.77)

<0.01

12.3 (10.7, 13.8)

0.76 (0.60, 0.96)

0.02

 Otherd

35.7 (32.1, 39.4)

0.83 (0.72, 0.95)

<0.01

13.9 (11.4, 16.5)

0.86 (0.66, 1.12)

0.26

Age in years of selected teen

 13 years old

32.0 (28.4, 35.6)

Reference

 

11.4 (8.8, 14.1)

Reference

 

 14 years old

33.0 (29.7, 36.3)

1.03 (0.90, 1.19)

0.67

11.5 (9.1, 13.9)

1.01 (0.74, 1.37)

0.96

 15 years old

35.9 (31.8, 40.1)

1.12 (0.96, 1.31)

0.14

15.9 (12.4, 19.3)

1.39 (1.01, 1.90)

0.04

 16 years old

36.1 (32.3, 39.8)

1.13 (0.97, 1.31)

0.11

12.9 (10.5, 15.3)

1.13 (0.84, 1.52)

0.41

 17 years old

35.7 (31.5, 39.9)

1.12 (0.95, 1.31)

0.18

17.5 (14.2, 20.8)

1.53 (1.13, 2.05)

<0.01

Source of health insurance for teens

 Provided through employment or union

31.2 (28.7, 33.8)

Reference

 

12.6 (10.9, 14.3)

Reference

 

 Not Provided through employment or union

38.3 (35.1, 41.5)

1.23 (1.08, 1.39)

<0.01

15.0 (12.4, 17.6)

1.18 (0.93, 1.51)

0.17

Facility type for teen’s providers

 All public facilities

32.8 (27.9, 37.7)

Reference

 

13.5 (9.2, 17.8)

Reference

 

 All hospital facilities

37.0 (32.8, 41.2)

1.13 (0.94, 1.35)

0.19

14.6 (10.7, 18.5)

1.08 (0.72, 1.62)

0.71

 All private facilities

33.4 (30.9, 36.0)

1.02 (0.87, 1.20)

0.82

13.2 (11.4, 15.0)

0.97 (0.69, 1.38)

0.88

 Mixed/Other

36.5 (33.1, 40.0)

1.11 (0.94, 1.33)

0.22

14.4 (11.8, 17.1)

1.07 (0.74, 1.54)

0.72

Do teen’s providers order vaccination from states/ local health department

 All providers

36.1 (34.0, 38.3)

Reference

 

15.2 (13.5, 16.8)

Reference

 

 Some but possibly not all

29.6 (24.6, 34.6)

0.82 (0.69, 0.98)

0.02

8.0 (5.6, 10.4)

0.53 (0.39, 0.72)

<0.01

 No providers

29.5 (24.1, 35.0)

0.82 (0.68, 0.99)

0.04

10.7 (7.3, 14.1)

0.71 (0.51, 0.98)

0.04

 Don’t know

31.4 (24.5, 38.3)

0.87 (0.69, 1.09)

0.22

12.0 (8.0, 16.0)

0.79 (0.56, 1.12)

0.19

Influenza vaccinatione

 No

24.5 (22.0, 26.9)

Reference

 

7.8 (6.3, 9.3)

Reference

 

 Yes

44.9 (42.3, 47.6)

1.84 (1.64, 2.05)

<0.01

20.0 (17.9, 22.2)

2.58 (2.07, 3.20)

<0.01

TDAP vaccinationf

 No

31.4 (27.8, 35.0)

Reference

 

11.1 (8.6, 13.5)

Reference

 

 Yes

35.2 (33.1, 37.4)

1.12 (0.99, 1.27)

0.07

14.3 (12.8, 15.9)

1.30 (1.01, 1.67)

0.04

Meningitis vaccinationg

 No

9.0 (6.4, 11.6)

Reference

 

4.0 (2.1, 5.9)

Reference

 

 Yes

39.8 (37.7, 42.0)

4.43 (3.31, 5.93)

<0.01

15.4 (13.9, 16.9)

3.89 (2.39, 6.35)

<0.01

  1. aBold indicates significance at p < 0.05, due to rounding some significant p-values are labeled 0.05
  2. bMultivariable Poisson regression models are not based on an explicit causal structure and therefore the estimates may suffer from a “Table 2 fallacy” as described by Westreich and Greenland: The Table 2 Fallacy: Presenting and Interpreting Confounder and Modifier Coefficients. Am J Epidemiol. 2013;177(4):292–298
  3. cAdjusted multivariable Poisson regressions estimate prevalence ratios by comparing one level of each variable to the reference level. Adjusted prevalence ratios are adjusted for all sociodemographic variables in the tables. Models were ran separately for females and males
  4. dMarital status “other” category includes: never married/widowed/divorced/separated/deceased. Ethnicity/race of teens “other” category includes: Non-Hispanic Black and Non-Hispanic Other & Multiple Race
  5. eAdolescent has taken at least one dose of seasonal influenza vaccination in the past three years
  6. fAdolescent has taken at least one dose of TDAP only vaccination since age 10 years old and before 13 years old
  7. gAdolescent has taken at least one dose of Meningitis vaccination