Exploring Sociodemographic and Geospatial Variation in Human Papillomavirus Vaccination Uptake in Virginia [37G]

Abstract

INTRODUCTION: Despite strong CDC recommendations and a state school requirement, nearly half of all adolescents in Virginia have not completed the HPV vaccine series. Using ArcGIS software, we aimed to explore the relationship between provider density, socioeconomic status, and HPV vaccination uptake in the state of Virginia. METHODS: HPV vaccination rates among adolescents 11 to 17 years were retrieved at the zip-code level from the Virginia Immunization Information System. Choropleth maps of vaccination rates were produced. The ArcGIS Hot Spot Analysis tool identified spatial clusters of zip codes with high and low vaccination rates. Student t-test was used to compare provider density and various socioeconomic indicators between statistically significant clusters of higher (RR>1.0) or lower (RR<1.0) than expected vaccination rates. RESULTS: High series completion rates were noted in central Virginia and the eastern shore. Regions of northern Virginia, including Shenandoah and Page counties, had lower than expected initiation and completion rates. Clusters with significantly lower initiation rates had a lower number of primary care providers, were less educated, and had a lower median household income (MHI). Regions with significantly lower series completion rates had a higher MHI. While regions with lower rates of series completion for males had a higher concentration of providers and were more educated, there was no difference among these factors for female series completion. CONCLUSION: Regional socioeconomic indicators are significant predictors of HPV vaccination, but may have contrasting implications for series initiation and completion. These findings emphasize the utility of spatial analysis and GIS methodology for identifying cancer prevention disparities.