HPV and Other Vaccination Rates in Texas: Association with Racial and Ethnic Distribution




DePlaza, Maya
Dudhia, Amil
Freguson, Samuel
Basha, Riyaz


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Presenter: Maya DePlaza

Authors: Maya DePlaza, Amil Dudhia, Sam Ferguson; Riyaz Basha,

Title: HPV and Other Vaccination Rates in Texas: Association with Racial and Ethnic Distribution

Background: Human Papilloma Virus (HPV) is a sexually transmitted disease responsible for ~70% of cervical cancer worldwide and can result in genital warts, anal, penile, and oropharyngeal cancers. Since the adoption of HPV vaccines, high-risk HPV incidences have decreased by 50%1. Vaccination is recommended from ages 11-26 and requires 3 doses to be up to date. While vaccination rates have increased, racial and ethnic minorities are less likely to complete the series, with rates of initiation and completion particularly low amongst African American adolescents2.

Objective: This project examined the association between rates of HPV and other regularly recommended vaccines at the national, state-wide, and county level with consideration given to racial and ethnic distribution.

Methods: Data was collected from the Centers of Disease Control and Prevention (CDC) and the National Immunization survey. Vaccination rates were compared between HPV, Tdap, and MenACWY vaccines at the national, state-wide, and county level3. Racial and ethnic makeup was also compared in these regions4.

Results: When compared to the Tdap and MenACWY vaccines, vaccination rates for HPV (UTD and ≥1 dose) were significantly lower across national, state-wide, and county levels. The national vaccination rate for HPV UTD and ≥1 dose were 48.6% and 65.5% while the rates for Tdap and MenACWY vaccinations were 88.7% and 85.1%. Additionally, Texas had an overall lower vaccination rate of 39.7%, 57.8% and 83.2% for HPV UTD, HPV ≥1 dose, and Tdap, respectively. Texas county vaccination rates were lowest in Dallas County with HPV UTD at 35.7%, HPV ≥1 dose at 54.5%, and Tdap at 77%. Dallas county has the highest percentage of African American and Hispanic residents when compared to other major Texas counties, Texas, and national average. The non-white population in Dallas county makes up 48.5% while it is 32.3% and 28.2% at the state and nation level.

Conclusion: While HPV vaccine rates have increased since its induction in 2006, it is still among the lowest vaccines received across all populations. This study suggests that there is a correlation between vaccination rates and racial/ethnic distributions. African Americans and Hispanics at the national and county level were shown to have the lowest vaccine rates, especially African American girls. Further analysis is required to determine the source of such health disparities and further links to socioeconomic factors.


Jeudin P, et al. Race, ethnicity, and income factors impacting human papillomavirus vaccination rates. Clin Ther. 2014 Jan 1;36(1):24-37. doi: 10.1016/j.clinthera.2013.11.001. PMID: 24417783.

Hirth J. Disparities in HPV vaccination rates and HPV prevalence in the United States: a review of the literature. Hum Vaccin Immunother. 2019;15(1):146-155. doi: 10.1080/21645515.2018.1512453. Epub 2018 Sep 6. PMID: 30148974; PMCID: PMC6363146.

Boersma, Peter; Black, Lindsey. "Human Papillomavirus Vaccination Among Adults Aged 18−26.” DHHS Publication.

Center for Disease Control and Prevention. "Human Papillomavirus (HPV) Vaccination & Cancer Prevention.” CDC, July 2022, https://www.cdc.gov/vaccines/vpd/hpv/index.html