Description
- Abstract:
- HPV is prevalent among U.S. adults and is linked to several types of cancers. One preventive measure for such cancers and other HPV-associated health conditions is the HPV vaccine, introduced in 2006 and usually administered to young teenagers. However, vaccination uptake lags behind Healthy People 2020 goals. State policies can be used to raise these low adolescent HPV vaccination rates. State Medicaid expansion of eligibility thresholds after the Affordable Care Act is one such policy. Insurance coverage is associated with increased HPV vaccination, indicating that raising Medicaid thresholds could be effective. This study analyzed whether adolescents in treatment states that expanded Medicaid eligibility on January 1, 2014 had higher rates of HPV vaccination than adolescents in unexpanded control states. The National Immunization Survey Teen was used, combining 2011-2016 data for an analytic sample of 95,987 adolescents ages 13-17 with provider-verified data. Difference-in-differences modeled HPV vaccine initiation and vaccine completion, defined as three shots. Adjusted models controlled for time-varying covariates. Rates of adolescent HPV vaccine initiation increased by 3.8 percentage points (95% CI -0.5-8.1, p=0.079) from 2011-2016 in expansion states as compared to non-expansion states, adjusting for relevant covariates. Adjusted rates of adolescent HPV vaccine completion increased 4.9 percentage points (95% CI 2.6-7.3, p<0.0001) from 2011-2016 in expansion states as compared to non-expansion states. Subgroup analyses by adolescent’s sex revealed significant increases in vaccination initiation and completion rates for males. However, change in initiation rates for females was not significant; only completion rates for females increased significantly. Policymakers can use these findings to improve HPV vaccine initiation and completion rates. Future research should investigate further how state or federal policies can be used to improve vaccination rates.
- Notes:
- Thesis (M. P. H.)--Brown University, 2020
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Citation
Creegan, Emma Kate,
"A Quantitative Examination of Policy Impact on HPV Vaccination Coverage"
(2020).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/r0a5-9369
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....