Factors associated with human papillomavirus (HPV) non-vaccination among 14-year-old children in Canada

The purpose of this study is to identify factors associated with HPV non-vaccination among 14-year-olds in Canada. This study employed data from the 2021 Childhood National Immunization Coverage Survey. Data were collected between January and June 2022 across Canada's 10 provinces and three territories. Multivariate logistic regression analysis was conducted, to identify factors linked to HPV non-vaccination among 14-year-olds. HPV non-vaccination was found to be independently and significantly associated with the child being born outside of Canada (aOR = 2.61, 95 % CI: 1.20,5.70) and having a history of parental refusal, reluctance, or delay of at least one routine childhood vaccine other than HPV vaccine for their child (aOR = 3.26, 95 % CI: 1.87,5.66). Socioeconomic status-related factors such as household income, parent/guardian education, and the child's visible minority status were not found to be associated with HPV non-vaccination. Future research is needed to better understand the barriers to HPV vaccination among non-Canadian-born adolescents and to gain insight into the complex intersecting factors at the individual, interpersonal, organizational, and societal levels that contribute to HPV non-vaccination in this population. • Analyzed Canadian national survey data on human papillomavirus vaccine coverage. • Coverage among adolescents was below the 90 % national goal. • Non-vaccination was linked to being born outside the country. • Non-vaccination was linked to refusal, reluctance, or delay of childhood vaccines.