Cancer Prevention| Volume 29, ISSUE 1, P31-37, January 2019

Obesity and Disparities in Human Papillomavirus Vaccination for U.S. Adolescent Girls and Young Women

  • John A. Harris
    Correspondence to: John A. Harris, MD, MSc, Magee-Womens Hospital of UPMC, 300 Halket Street, Suite 2328, Pittsburgh, PA 15213. Phone: 412-641-1597; fax 412-641-1133.
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania

    Magee-Womens Research Institute and Foundation, Pittsburgh, Pennsylvania
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  • Alison A. Garrett
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania

    Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania
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  • Aletha Y. Akers
    The Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Published:November 13, 2018DOI:



      Obesity is recognized as a barrier to receiving women's preventive health services, including cervical and breast cancer screening. Little is known about whether obesity is associated with a lower incidence of human papillomavirus (HPV) vaccination, another important preventive care service for adolescent girls and young women. The objective of this study was to determine if adolescent girls and young women with obesity are less likely to receive HPV vaccination compared with individuals with normal weight.


      We examined whether HPV vaccination was associated with obesity status in women aged 9–30 years surveyed from 2009 to 2016 by the U.S. National Health and Nutrition Examination Survey. Results from logistic and linear regression models were adjusted for age, race, income, insurance status, self-reported health, and health care use, accounting for the weighted survey design.


      The final cohort included 5,517 women. Overall, 32.9% of participants reported vaccination, with a mean age at vaccination of 15.8 years. Adolescent girls and young women with obesity were less likely to report vaccination; the adjusted odds ratio of vaccination was 0.79 (p = .01) compared with normal weight women. Among those vaccinated, the age at vaccination was significantly older for women with obesity, 16.3 years compared with 15.2 years (p = .002), but there was no difference in the completion of the vaccination series rate by obesity.


      Adolescent girls and young women with obesity were less likely to report HPV vaccination and, if they were vaccinated, received the vaccination at a later age.
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      John A. Harris, MD, MSc, is an Assistant Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh, Pittsburgh, Pennsylvania.


      Alison A. Garrett MD is an Obstetrics and Gynecology Resident Physician at Magee-Women's Hospital of UPMC, Pittsburgh, Pennsylvania.


      Aletha Y. Akers is an Assistant Professor of Obstetrics and Gynecology and Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.