Comprehensive Analysis of Geographic Variation in Human Papillomavirus Vaccination Initiation in Washington State 2014-2018

Authors: Mark T Roberts*, Fred Hutchinson Cancer Research Center, Teal R Bell, Washington State Department of Health, Patricia deHart, Washington State Department of Health, Margaret Madeleine, Fred Hutchinson Cancer Research Center
Topics: Medical and Health Geography, Urban Geography, Rural Geography
Keywords: spatial epidemiology, HPV, Human Papillomavirus, Washington, vaccine, vaccination, GIS, epidemiology,
Session Type: Poster
Day: 4/4/2019
Start / End Time: 3:05 PM / 4:45 PM
Room: Lincoln 2, Marriott, Exhibition Level
Presentation File: No File Uploaded


The Human Papillomavirus (HPV) vaccine has been shown to be universally effective in reducing the incidence of HPV-associated cancer precursors. However, the proportion of adolescents who initiate HPV vaccination remains far below the target of 80% of the population. This study aims to identify individual- and area-based characteristics associated with HPV vaccine initiation and locates geographic areas with low vaccination initiation in Washington from 2014-2018. We propose to link Washington State Immunization Information System (IIS) records to birth certificate records and geocode the vaccination records. These data will then be linked to demographic and socioeconomic characteristics from the 2012-2016 American Community Survey at the census block group level. We will calculate the proportion of individuals who initiated HPV vaccination at ages 11-17 during the study period and perform logistic regression to determine individual- and area-based characteristics associated with HPV vaccine initiation. We will use co-kriging to identify areas in Washington state that had lower levels of HPV vaccine initiation while controlling for characteristics associated with HPV vaccine initiation. We anticipate that in adjusted models, individual factors, including gender, race, and ethnicity, will be associated with HPV vaccination. Area-based characteristics will also be associated with HPV vaccination. Our study will uncover individual, area-based, and geographic elements that contribute to HPV vaccine initiation or lack of initiation. We anticipate that these results will vastly improve the ability of practitioners and policy-makers to better target available resources for increasing HPV vaccination levels in Washington.

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