Sociodemographic Determinants of Parental Reporting Accuracy of Human Papillomavirus (HPV) Vaccination Status in Male and Female Adolescents: National Immunization Survey-Teen (NIS-Teen) 2012 Open Access

Abstract

Background: Vaccination for human papillomavirus (HPV) is an important preventative tool to reduce morbidity and mortality due to cervical cancer, other HPV-associated cancers, and genital warts. Many surveillance tools use parental report to assess vaccination status, thus it is important to understand the accuracy of these reports. The present study investigates sociodemographic and other factors that contribute to HPV vaccine reporting accuracy.

Methods: Data come from the 2012 National Immunization Survey-Teen (NISTeen), a nationally representative survey of vaccine coverage in adolescents aged 13-17. Parental report of HPV vaccination status was compared to the gold standard of provider reports from medical records. Concordance was examined as a function of various socioeconomic factors, in particular the teenager's race/ethnicity and gender. Additionally, association between reporting accuracy and time interval since vaccine series initiation was examined.

Results: A total of 17,138 participants were included in the present study, including 8,165 females and 8,973 males. Overall concordance between provider and parent report of vaccine series initiation was good, with a weighted kappa of 0.721, sensitivity of 0.819 (95% CI 0.798, 0.840) and a specificity of 0.900 (95% CI 0.891, 0.910). Reporting accuracy was found to be better for parents of male children compared with females (chi square = 9.83, p = 0.0074), as well as for non-Hispanic white teens as compared with non-Hispanic black, Hispanic, and other race/ethnicities (chi square = 44.29, p < 0.0001). Finally, time interval since vaccine series initiation was significantly associated with variation in reporting accuracy, with the lowest false negative reporting shown after three years since initiation (chi square = 12.85, p = 0.0051).

Conclusions: The present study shows higher rates of false negative than false positive parental reports overall, with poorest reporting accuracy in sociodemographically disadvantaged groups. This suggests HPV vaccine uptake may be higher than suggested by findings from studies using parental report. The finding of decreased false negative reporting with increased time interval since vaccine series initiation was unexpected, and further investigation is needed to better understand this relationship.

Table of Contents

I. Background/ Literature Review 1

II. Methods 10

III. Results 14

IV. Discussion 19

V. References 23

VI. Tables 26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	parental report HPV vaccine
Committee Chair / Thesis Advisor	Gazmararian, Julie A, Emory University
Committee Members	Shannon, Stokley, CDC Markowitz, Lauri, CDC
Partnering Agencies	CDC

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