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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