Article Data

  • Views 701
  • Dowloads 158

Original Research

Open Access


  • Charlene Morrow1
  • Lili Ding1
  • Pamina Gorbach2
  • Emmanuel Chandler1
  • Marilyn Crumpton3
  • Jessica A. Kahn1

1Cincinnati Children’s Hospital Medical Center. University of Cincinnati College of Medicine, Cincinnati, OH

2University of California, Los Angeles, CA

3Cincinnati Health Department, Cincinnati, OH

DOI: 10.22374/jomh.v15i1.114 Vol.15,Issue 1,March 2019 pp.30-44

Published: 22 March 2019

*Corresponding Author(s): Jessica A. Kahn E-mail:

PDF (351.96 kB)


Background and Objective

Human papillomavirus (HPV) vaccination rates are suboptimal in young men, representing a missed op-portunity to prevent cancers caused by HPV. Data about factors associated with vaccination over time are important to design interventions that improve vaccination rates. The aims of this study were to determine HPV vaccine initiation and completion rates in young men 13–26 years of age recruited from clinical and community settings from 2013-2014 and 2016-2017, and to determine factors associated with vaccination.

Material and Methods

Men (N=747) were recruited from a hospital-based teen health center (THC), health department sexually transmitted disease clinic (HDSTD) and the general community. Participants completed a self-administered survey assessing demographic and behavioural factors. Vaccination status was determined using the electronic medical record and a statewide immunization registry. We determined vaccine initiation and completion rates, by recruitment site and year. We determined factors independently associated with vaccine initiation and completion, overall and stratified by recruitment year, using multivariable logistic regression.


Mean age was 21.2 years, 258 (34.5%) had initiated the vaccine series and 154 (20.8%) had completed it. Those recruited from the THC (vs. community and HDSTD) were more likely to initiate (71.3%, 23.2%, and 19.5%, respectively, p<.0001) and complete (50.7%, 11.7%, and 8.3%, p<.0001) the series. In multivariable analysis, variables associated with vaccine initiation were younger age (13–17 vs. 22–26 years: AOR 5.31), insurance plan (Private vs. Medicaid: OR 0.39; Medicaid vs. others: AOR 2.22), no cigarette smoking (no vs. yes: AOR 1.78) and recruitment site (THC vs. HDSTD: AOR 3.74; THC vs. community: AOR 3.01). Variables associated with vaccine completion were younger age (13–17 vs. 22-26 years: AOR 3.55; 18–21 vs. 22–26 years: AOR 4.26), insurance plan (Private vs. Medicaid: AOR 0.51; Medicaid vs. others: AOR 2.62), fewer lifetime female partners (1 vs. 2–10: AOR 2.55; 1 vs. 11+: AOR 2.23) and recruitment site (THC vs. HDSTD: AOR 4.99; THC vs. community: AOR 3.95). 


HPV vaccine initiation and completion rates were low among young men over the 6 years after vaccine recommendations for men. Men who reported behaviours that have been associated with a higher risk for HPV were less likely to be vaccinated. Interventions that improve access to a primary care medical home and insurance programs that cover vaccination costs may increase HPV vaccination rates in young men.


human papillomavirus; vaccination; adolescent; young men; urban 

Cite and Share

Charlene Morrow,Lili Ding,Pamina Gorbach,Emmanuel Chandler,Marilyn Crumpton,Jessica A. Kahn. RATES AND PREDICTORS OF HUMAN PAPILLOMAVIRUS VACCINATION AMONG YOUNG MEN RECRUITED FROM URBAN CLINICAL AND COMMUNITY SETTINGS. Journal of Men's Health. 2019. 15(1);30-44.


1. Markowitz LE, Dunne EF, Saraiya M, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2014;63:1–30.

2. Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Commit-tee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep 2011;60:1705–8.

3. Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination - up-dated recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep 2016;65:1405–8.

4. Walker TY, Elam-Evans LD, Singleton JA, et al. National, regional, state, and selected local area vac-cination coverage among adolescents aged 13-17 years 

- United States, 2016. MMWR Morb Mortal Wkly Rep 2017;66:874–82.

5. Williams WW, Lu PJ, O’Halloran A, et al. Surveillance of vaccination coverage among adult populations - United States, 2015. MMWR Surveill Summ 2017;66:1–28.

6. Ackerson B, Hechter R, Sidell M, et al. Human papil-lomavirus vaccine series completion in boys before and after recommendation for routine immunization. Vaccine 2017;35:897–902.

7. Reiter PL, McRee AL, Pepper JK, et al. Longitudinal predictors of human papillomavirus vaccination among a national sample of adolescent males. Am J Public Health 2013;103:1419–27.

8. Nanagas VC, Stolfi A, Nanagas MT, et al. Adolescent male human papillomavirus vaccination. Global Pediatr Health 2016;3:2333794x16642373.

9. Clarke MA, Coutinho F, Phelan-Emrick DF, et al. Predictors of human papillomavirus vaccination in a large clinical population of males aged 11 to 26 years in Maryland, 2012-2013. Cancer Epidemiol Biomarkers Prev 2016;25:351–8.

10. Sledge JA. The male factor: human papillomavirus (HPV) and HPV4 vaccine acceptance among african american young men. J Commun Health 2015;40:834–42.

11. Fuller KM, Hinyard L. Factors associated with HPV vaccination in young males. J Commun Health 2017;42:1127–32.

12. Thomas R, Higgins L, Ding L, et al. Factors associated With HPV vaccine initiation, vaccine completion, and accuracy of self-reported vaccination status among 13- to 

26- year-old men. Am J Men’s Health 2018;12:819–27.

13. Chandler E, Ding L, Gorbach P, et al. Epidemiology of any and vaccine-type anogenital human papillomavirus among 13-26-year-old young men after HPV vaccine introduction. J Adolesc Health 2018;63:43–9.

14. Kahn JA, Rosenthal SL, Jin Y, et al. Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstet Gynecol 2008;111:1103–10.

15. Mullins TL, Zimet GD, Rosenthal SL, et al. Adolescent perceptions of risk and need for safer sexual behaviours after first human papillomavirus vaccination. Arch Pediatr Adolesc Med 2012;166:82–8.

16. Feemster KA, Middleton M, Fiks AG, et al. Does intention to recommend HPV vaccines impact HPV vaccination rates? Hum Vaccines Immunother 2014;10:2519–26.

17. Lu PJ, Yankey D, Jeyarajah J, et al. Association of health insurance status and vaccination coverage among adoles-cents 13-17 years of age. J Pediatr 2018;195:256–62.e1.

18. Elam-Evans LD, Yankey D, Jeyarajah J, et al. National, regional, state, and selected local area vaccination cover-age among adolescents aged 13-17 years--United States, 2013. MMWR Morb Mortal Wkly Rep 2014;63:625–33.

Abstracted / indexed in

Science Citation Index Expanded Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Social Sciences Citation Index Social Sciences Citation Index contains over 3,400 journals across 58 social sciences disciplines, as well as selected items from 3,500 of the world’s leading scientific and technical journals. More than 9.37 million records and 122 million cited references date back from 1900 to present.

Current Contents - Social & Behavioral Sciences Current Contents - Social & Behavioral Sciences provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in the social and behavioral sciences.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

SCOPUS Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

DOAJ DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals.

CrossRef Crossref makes research outputs easy to find, cite, link, assess, and reuse. Crossref committed to open scholarly infrastructure and collaboration, this is now announcing a very deliberate path.

Portico Portico is a community-supported preservation archive that safeguards access to e-journals, e-books, and digital collections. Our unique, trusted process ensures that the content we preserve will remain accessible and usable for researchers, scholars, and students in the future.

Submission Turnaround Time