HPV vaccination in New York City: variation by population characteristics and nativity

Abstract Background Differences persist in human papillomavirus (HPV) vaccination rates by race, ethnicity, and nativity; however, research often aggregates populations, obscuring subgroup-level differences. We examined HPV vaccine uptake between and within racial and ethnic groups in a multiethnic adult population in New York City, with a focus on nativity. Methods Data were collected from the 2021–2022 Cancer Community Health Resources and Needs Assessment by the NYU Langone Health Perlmutter Cancer Center and 23 community partners. The analytic sample included 1,278 adults aged 18–45 years. Multinomial logistic regression models estimated the odds of individuals receiving no doses, one dose, more than one dose, or having unknown HPV vaccination status across six race and ethnicity groups: White; Hispanic; Black; SWANA (Southwest Asian and North African); Asian; and Other (including American Indian/Alaskan Native, Central Asian, Mixed, Native Hawaiian and Pacific Islander, and Unknown). An interaction term between race, ethnicity, and nativity was retained after significance testing ( p < 0.01). Models adjusted for socio-demographic covariates. Results Respondents were predominantly female (61%), born outside the US (65%), and insured (73%). Over half (53%) never received HPV vaccination, and 23% reported unknown vaccination status. Compared to United States (US)-born White individuals, SWANA (OR = 0.21, 95% CI: 0.06, 0.74) and White (OR = 0.35, 95% CI: 0.12, 0.96) individuals born outside the US had lower odds of receiving one dose versus no doses. The odds of receiving more than one dose versus no doses were lower among Asian (OR = 0.34, 95% CI: 0.17, 0.71), Black (OR = 0.39, 95% CI: 0.16, 0.95), SWANA (OR = 0.07, 95% CI: 0.02, 0.34), and White (OR = 0.08, 95% CI: 0.02, 0.30) individuals born outside the US compared to US-born White individuals. Asian individuals born outside the US had higher odds of unknown vaccination status versus no doses (OR = 2.82, 95% CI: 1.16, 6.83) compared with US-born White individuals. Conclusions These findings highlight the importance of disaggregated data for developing effective programs to improve HPV vaccination uptake.