The association between state Medicaid expansion and human papillomavirus vaccination

•Medicaid expansion is associated with HPV vaccination among adolescents in the U.S.•Greater access to Medicaid may increase HPV vaccination in the U.S.•Medicaid is one of many state-level policies that affect vaccine uptake. Increased vaccination against human papillomavirus (HPV) is recommended to...

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Bibliographic Details
Published in:	Vaccine 2020-08, Vol.38 (38), p.5963-5965
Main Authors:	Hoff, Brandon M., Livingston, Melvin D., Thompson, Erika L.
Format:	Article
Language:	eng
Subjects:	Adolescent Age Alphapapillomavirus Anogenital Cross-Sectional Studies Disease control Editing Ethnicity Expansion Government programs Health insurance Human papillomavirus Humans Immunization Medicaid Papillomavirus Infections - epidemiology Papillomavirus Infections - prevention & control Papillomavirus Vaccines Parent educational background Policy Poverty Prevention Statistical analysis Studies Teenagers United States Vaccination Vaccines Writing
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Summary:	•Medicaid expansion is associated with HPV vaccination among adolescents in the U.S.•Greater access to Medicaid may increase HPV vaccination in the U.S.•Medicaid is one of many state-level policies that affect vaccine uptake. Increased vaccination against human papillomavirus (HPV) is recommended to reduce the incidence of anogenital and oropharyngeal cancers. This study aims to evaluate the impact of Medicaid expansion by states on HPV vaccination uptake among adolescents ages 13–17 in the United States. This study analyzed data from the National Immunization Survey (NIS) – Teen from 2011 to 2017 using a cross-sectional design. The adjusted difference-in-difference estimate of Medicaid expansion on HPV vaccine initiation was statistically significant (β = 0.031, 95% CI [0.016, 0.046]). There were significant increases in HPV vaccination after states expanded their Medicaid program. The largest increase occurred in those individuals below the federal poverty level and a modest increase occurred in those above the federal poverty level but below $75,000 of annual family income. Further research should be conducted to analyze the combined effect of multiple policies on HPV vaccination.
ISSN:	0264-410X 1873-2518