Provider facility type and HPV vaccination rate among African American teenagers in the United States


  • Chinenye C. Odo Department of Medicine, University of Wisconsin Madison, Madison, Wisconsin, United States; Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Mesoma A. Igbokwe Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Ikenna S. Odoh Department of Medicine, Rostov State Medical University, Rostov, Russia
  • Ezinne A. Ndu Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Nneoma M. Agbo Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Vivian C. Ugwunweze Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Nzubechukwu G. Okeke Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Chiadikaobi A. Okwu Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Obinna V. Chukwuma Department of Medicine, University of Nigeria, Nsukka, Nigeria
  • Cynthia O. Okolie Department of Medicine, University of Nigeria, Nsukka, Nigeria



Vaccination predictors, Human Papilloma virus vaccine, HPV Vaccination, African American research, Health-provider facility, NIS-Teen


Background: The Human Papilloma Virus vaccine is one of the most efficient preventive vaccinations on the market to prevent HPV infection and has made significant advances in human vaccination. This study aimed to examine the relationship between the provider facility type and HPV vaccination rates, among African American teenagers. By exploring the potential relation of the two, we hope to inform programs and further studies into boosting HPV vaccination rates by targeted provider-based interventions.

Methods: This cross-sectional study was conducted using data from the National Immunization Survey for Teen (NIS-TEEN) for the year 2021. This study focused on African American teenagers, aged 13 to 17 years, living in non-institutionalized households in

the United States in 2021. Data was collected in two phases -the household interview phase and the provider data collection phase. Statistical analysis was conducted using weighted provider data, and all analysis was done using SAS Studio 3.81.

Results: Provider facility type was significantly associated with HPV vaccination status (p≤0.0001). Specifically, respondents who used hospital facilities and public facilities had higher odds of having received at least one dose of the HPV vaccine when compared to those who used private facilities (OR=1.86; 95%CI; 1.84,1.89) and (OR=1.72; 95% CI; 1.70, 1.74) respectively.

Conclusions: Results of this study suggest that provider facility type is associated with HPV vaccination status among African American teens in the US. There is however a need for definitive longitudinal studies to establish the relationship between provider type and HPV vaccination rates in African American teens.


Katz IT, Bogart LM, Fu CM. Barriers to HPV Immunization among Blacks and Latinos: a Qualitative Analysis of Caregivers, Adolescents, and Providers . BMC Public Health. 2016;16:32-9.

Epidemiology of Vaccine Preventable Diseases. Available at: pinkbook/hpv.html. Accessed on 20 February 2023.

Markowitz LE, Schiller JT. Human Papillomavirus Vaccines. J Infect Dis. 2021;224:S367-78.

Gilkey MB, McRee AL. Provider Communication about HPV Vaccination: A Systematic Review. Human Vacc Immunother. 2016;12:1454-68.

Herman R, McNutt LA, Mehta M, Salmon DA, Bednarczyk RA, Shaw J. Vaccination Perspectives among Adolescents and their Desired Role in the Decision-Making Process. Human Vacc Immunother. 2019;15:1752-9.

Kaul S, Do TQ, Hsu E, Schmeler KM, Montealegre JR, Rodriguez AM. School-based Human Papillomavirus Vaccination Program for Increasing Vaccine Uptake in an Underserved Area in Texas. Papillomavirus Res. 2019;8:32-8.

Lu P, Yankey D, Jeyarajah J. Association of Health Insurance Status and Vaccination Coverage among Adolescents 13-17 Years of Age. J Pediatr. 2018;195: 256-62.

U.S. Department of Health and Human Services (DHHS). National Center for Immunization and Respiratory Diseases. The 2021 National Immunization Survey - Teen. Atlanta, GA: Centers for Disease Control and Prevention, 2022.

Kuan-Mahecha MA, Rahman S, Martínez-Rivera P, Lamb MM, Asturias EJ. Differences in Parental Vaccine Confidence and Attitudes by Health System in Guatemala and their Impact on Immunization Timeliness. Vaccine. 2023;41:3099-105.

Pandolfi E, Graziani MC, Leraci R, Cavagni G, Tozzi AE. A Comparison of Populations Vaccinated in a Public Service and in a Private Hospital Setting in the Same Area. BMC. 2008;8:278-10.

Feldman W. The Well Child Exam: What, When, and Why?. Canad Family Physic. 1985;31:73-5.

Interventions Reduce Racial Gaps in Pediatric Well-Visit Rates. Available at: https://pursuit.ummhealth. org/articles/interventions-reduce-racial-gaps-pediatric-well-visit-rates. Accessed on 20 February 2023.

Moreno MA. The Well-Child Visit. JAMA Pediatr. 2018;172:104.

Nickel B, Dodd RH, Turner RM. Factors associated with the Human Papillomavirus (HPV) Vaccination across Three Countries following Vaccination Introduction. J Prevent Med Rep. 2017;8:45-9.

Mansfield LN, Onsomu EO, Merwin E, Hall NM, Harper-Harrison A. Association between Parental HPV Knowledge and Intentions to Have Their Daughters Vaccinated. West J Nurs Res. 2018;40:481.

Lu PJ, O’Halloran A, Williams WW. Impact of Health Insurance Status on Vaccination Coverage Among Adult Populations. Am J Prevent Med. 2015;48:647.

Blewett LA, Davidson G, Bramlett MD, Rodin H, Messonnier ML. The Impact of Gaps in Health Insurance Coverage on Immunization Status for Young Children. Health Serv Res. 2008;43:1619-36.

Smith PJ, Lindley MC, Shefer A, Rodewald LE. Underinsurance and adolescent immunization delivery in the United States. Am Acad Pediatr. 2009;124:515-21.

Tsui J, Gee GC, Rodriguez HP, Kominski GF, Glenn BA, Singhal R, Bastani R. Exploring the Role of Neighborhood Socio-Demographic Factors on HPV Vaccine Initiation among Low-Income, Ethnic Minority Girls. J Immigrant Minor Health. 2013;15:732-40.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin. 2021;71:209-49.

Human Papillomavirus Vaccination Coverage Among Adolescents, 2007-2013, and Postlicensure Vaccine Safety Monitoring, 2006. Available at: https://www. Accessed on 20 February 2023.

Liao CI, Francoeur AA, Kapp DS, Caesar MA, Huh WK, Chan JK.: Trends in Human Papillomavirus-Associated Cancers, Demographic Characteristics, and Vaccinations in the US, 2001-2017. JAMA Net. 2022;5:21-9.

Cancers Associated with Human Papillomavirus. Available at: data-briefs/no26-hpv-assoc-cancers-UnitedStates-2014-2018.htm#:~:text=HPV%20cau. Accessed on 20 February 2023.




How to Cite

Odo, C. C., Igbokwe, M. A., Odoh, I. S., Ndu, E. A., Agbo, N. M., Ugwunweze, V. C., Okeke, N. G., Okwu, C. A., Chukwuma, O. V., & Okolie , C. O. (2023). Provider facility type and HPV vaccination rate among African American teenagers in the United States. International Journal Of Community Medicine And Public Health, 10(10), 3406–3413.



Original Research Articles