EDUCATIONAL INEQUALITIES IN HPV VACCINE ACCESS AND UTILIZATION: THE RELATIVE ROLES OF ECONOMICS AND AWARENESS

Purpose: This study examines possible explanations for the relationship between maternal education and Human Papillomavirus (HPV) vaccine receipt and decomposes the gap between high and low education groups. I estimate the significance of different channels through which maternal education can affect the probability of receiving doses of the HPV Vaccine. The HPV vaccine is not part of the standard vaccination series provided during early childhood and is less likely to be attached to school entry requirements. Therefore, compared to other more universally received childhood vaccines, the decision to vaccinate for HPV may have a greater association with factors related to parent education, including vaccine awareness, income, and health insurance status.

Method: Using NIS-Teen survey data from 2007 to 2009, a total of 19,603 adolescent girls between 13 and 17 years of age are included in the study. participants are divided into high and low education groups according to the education level of the mother. The gap between the two groups is decomposed to its determinants using the Blinder-Oaxaca method.

Result: HPV Vaccine up-to-date status, defined as receipt of one or more shots prior to the survey date, is 43.2% and 37.5% in the high and low education groups, respectively. Vaccine knowledge and awareness are the major factors in the decomposition model, contributing to 31.5% of the gap. Factors related to healthcare access, including insurance and health facility type, do not contribute to the gap. Results indicate that adolescents with lower incomes and public insurance plans are actually more likely to receive the HPV vaccine. This is perhaps due to 100% coverage of the HPV vaccine through the Vaccines for Children program (VFC), which targets low-income families.

Conclusion: This study empirically tests established theories linking parent education and health behaviors for adolescents. Findings suggest that the influence of maternal education on vaccine use is not entirely explained by income and healthcare access. Simply reducing the cost of vaccines or improving insurance coverage may not be enough to reduce educational disparities. The decision to vaccinate for HPV may have a greater association with non-economic factors related to parent education than previously thought. Specifically, health knowledge and awareness may be significant contributors to educational disparities.