The Association between Health Insurance and HPV Vaccination among American Adults

Despite of the efforts of public health agencies in the United States, the coverage of Human Papilloma Virus (HPV) vaccination remains low and research on the impact of health insurance on vaccination attitudes are limiting. We therefore set out to assess the impact of health insurance on HPV vaccination in the United States. We analyzed the data from the National Health Interview Survey (NHIS) in 2016 with total participants (n=33,672). The NHIS is a survey of civilian non-institutionalized population in the United States conducted by the Centre for Disease Control and Prevention (CDC). Variables collected included HPV vaccination (dependent variable), health insurance (independent variable). Confounders such as: demographic characteristics (sex, race, marital status, work status and class of workers), difficulty of affordable health insurance smoking status, pap smear test etc. The study used bivariate regression analysis to determine the relationship between the health insurance and HPV vaccination. Though being insured increased the odds of HPV vaccination by 22% (95%CI: 0.92-1.61), this association was not significant. After adjusting for sex, race, marital status, work status, class of work, health promotion, pap smear, and health information from the internet, the odds of HPV vaccination increased by 42% in participants with health insurance [AOR (95%CI): 1.12-1.89)]. Though there was an association between health insurance and HPV vaccination, this association was not significant. Factors such as sex, race, marital status, health promotion and PAP smear test was found to influence HPV vaccination. More studies must be done on the impact of Medicare and Medicaid on HPV vaccination and uptake.