Abstract B8: Understanding suboptimal HPV vaccine uptake among low-income ethnic minority girls in Los Angeles

Abstract Introduction: The recent availability of an HPV vaccine represents a landmark breakthrough in the primary prevention of cervical cancer, which is a major cause of morbidity and mortality in the United States and world wide. Vaccination is one of the most successful and least costly of all public health interventions but to derive population benefit it is critical to achieve wide utilization, particularly among the highest risk groups. However, in the United States, there is considerable skepticism regarding the rapid deployment of a new technology targeting young girls that is related to a sexually transmitted infection. The purpose of this study, therefore, was to assess vaccine uptake and correlates among low income, ethnic minority girls in Los Angeles. Methods: This study was a collaboration between UCLA and the Los Angeles County Office of Women's Health (OWH), which operates a telephone hotline to provide health information and service referrals to low-income, ethnic minority women in Los Angeles. Telephone interviews were administered, through the hotline, in five languages (English, Spanish, Mandarin, Cantonese, Korean) to mothers of girls aged 9 to 18 years, and assessed: demographics, HPV awareness, acceptance, knowledge, attitudes, barriers, and vaccine receipt in the age-eligible girls. Results: A total of 390 women (54% Latina; 20% Chinese; 13% Korean; 8% African American; 6% other) were interviewed from January–July 2009, and ethnic differences were observed in many of the variables. Overall, 64% of respondents reported having heard of the HPV vaccine, but the rate was only 42% among Koreans. About 30% of girls had received at least one dose of the HPV vaccine (33% Latinas; 22% Chinese; 26% Koreans; 26% African Americans, 32% “other”). Ethnic differences were also observed in perceived risk of contracting HPV, perceived severity of HPV, and perceived vaccine effectiveness. Barriers cited by mothers of unvaccinated girls included concern over side effects, cost and having insufficient information to make a decision. Only 28% reported knowing where they take their daughter to get the vaccine with lower rates among Chinese (19%) and Koreans (16%) compared to African Americans (29%), and Latinas (35%). Similarly, only 28% of women said they had enough information to make a decision about vaccination with fewer Chinese (17%) and Koreans (14%) reporting this versus Latinas (31%) and African Americans (56%). In bivariate analyses the following factors predicted increased likelihood of vaccination: older age of daughter, having a usual source of care, holding positive attitudes towards vaccination, higher perceived risk of HPV, higher perceived effectiveness of the vaccine, higher perceived severity of HPV, and belief that girls should be vaccinated at a younger age. Only three factors were significant in multivariate analyses: older age of daughter, belief that girls should be vaccinated at a younger age, and higher perceived vaccine effectiveness. Conclusion: In general, vaccination rates in our sample were comparable to state and national estimates. However, significant gaps in knowledge and awareness were observed and ethnic differences were striking. Information from this study will provide valuable guidance for targeting and tailoring interventions to increase HPV vaccine uptake in high risk groups. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B8.