PROJECT SUMMARY
Human papillomavirus (HPV) is the most common form of sexually transmitted infection in the US, with
approximately 79 million US individuals infected with HPV. The Advisory Committee on Immunization Practices
(ACIP) recommends vaccine initiation between 11–12 years old, and it can be initiated as young as 9 years old.
However, less than half of 13- to 17-year-old girls and less than one-third boys were fully vaccinated against
HPV, much lower than the80% goal of Healthy People 2030. Significant barriers to HPV vaccination have
been identified in 1) missed clinical opportunities due to provider and practice-related barriers, 2) low parental
awareness, and 3) limited access to HPV vaccination services due to sociocultural and financial barriers.
Asian Americans are disproportionally affected by HPV and HPV related conditions. Despite public
health efforts, HPV vaccination rates were suboptimal in Asian American adolescents. Regional data showed
low awareness of HPV vaccine and low vaccination rates in Chinese, Filipino, Japanese, Asian Indian, Korean,
and Vietnamese subgroups. However, literature of the multilevel social determinants of HPV vaccine in Asian
Americans is limited. Identifying high-risk groups and the multilevel mechanisms of HPV vaccine uptake are
crucial in reducing disparities and increasing HPV vaccination rates in Asian American adolescents.
This study will be the first study to use a nationally representative sample to examine the integrative
effects of adolescent, parent, provider, and practice level factors in six Asian American subgroups. The
proposed study will leverage the existing data from the 2010–2019 National Immunization Survey-Teen (NIS-
Teen), the gold standard of US vaccination data. The study sample will include 6,019 boys and girls aged 13–
17 of Chinese (1,613), Filipino (1,383), Japanese (834), Indian (800), Korean (786), and Vietnamese (603)
ethnicity. The specific aims are,
Aim 1: to examine the integrative effects of adolescent, parent, provider, and practice level factors in
their association with adolescent's HPV vaccine initiation and completion among six Asian American
subgroups.
Aim 2: to investigate the parent-reported reasons for delay or refusal of HPV vaccine for adolescents
across six Asian American subgroups.
Each specific aim addresses a unique research question that links practice/provider characteristics with
adolescents/parent level factors, and together provide a comprehensive understanding of the social
mechanisms of HPV vaccine uptake in Asian adolescents.
Findings
of
this
proposed
study
will
provide
subgroup-specific epidemiological data, guide the improvement of clinical practices, and inform the
development of evidence-based strategies to reduce missed opportunities and improve adolescent vaccination
in Asian American adolescents.
