Socioeconomic/health-related factors associated with HPV vaccination initiation/completion among females of paediatric age: A systematic review with meta-analysis.

OBJECTIVES

To systematically identify, appraise, and summarise published evidence on individual socioeconomic and health-related factors associated with human papillomavirus (HPV) vaccination initiation and completion among females of paediatric age.

STUDY DESIGN

A global systematic review with meta-analysis (PROSPERO: CRD42023445721).

METHODS

We performed a literature search in December 2022 and supplemented the search on August 1, 2023. Appropriate data were pooled using an inverse variance, random-effects model and the results were expressed as odds ratios, with 95 % confidence intervals. A statistically significant point pooled increased/decreased odds of 30-69 % was regarded to be strongly associated, and ≥70 % was very strongly associated.

RESULTS

We included 83 cross-sectional studies. Among several significantly associated factors, being an older girl: 1.67 (1.44-1.93), having health insurance: 1.41 (1.16-1.72), and being in a public school: 1.54 (1.05-2.26) strongly increased the odds of vaccination initiation, and nativity in the country of study: 1.82 (1.33-2.50), use of contraception: 2.00 (1.16-3.46), receipt of influenza vaccination: 1.75 (1.54-2.00) and having visited a healthcare provider: 1.85 (1.51-2.28) in the preceding year very strongly increased the odds of vaccination initiation. Likewise, being an older girl: 1.36 (1.23-1.49) and having visited a healthcare provider in the preceding year: 1.46 (1.05-2.04) strongly increased the odds of vaccination series completion, and school-based vaccination: 3.08 (1.05-9.07), having health insurance: 1.72 (1.27-2.33), and receipt of influenza vaccination in the preceding year: 1.72 (1.62-1.83) very strongly increased the odds of vaccination series completion. We made similar observations when the studies were limited to the United States.

CONCLUSIONS

Several individual socioeconomic/health-related factors may determine initiating and completing the HPV vaccination series among paediatric females. These factors provide insights that may be key to identifying girls at increased risk of not being vaccinated and may aid targeted public health messaging.