Informing Health Policies and Interventions to Increase Human Papillomavirus Vaccination among Adolescents for Cancer Prevention in the United States

Abstract

While a safe and highly effective vaccine exists to prevent up to 90% of cancers caused by human papillomavirus (HPV), vaccination rates in the United States (US) remain substantially below public health targets. Achieving optimal HPV vaccination requires a comprehensive understanding of the multi-level barriers to vaccination to inform development of new policies and interventions to increase vaccination. This dissertation examines household, state, and federal factors potentially influencing HPV vaccination to inform evidence-based policy. Specifically, this research: (1) examines the relationship between household language and HPV vaccination by race and ethnicity; (2) assesses the impact of state-level school-entry vaccination mandates on HPV vaccination uptake; and (3) evaluates the association between Medicaid spending per child and HPV vaccination coverage.