Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)

ObjectivesAs the first socio-demographic profiling of HPV vaccines in Chinese cities, this study assesses equity implications through compositional analysis of covered populations, with multilevel examination of vaccine-type selection determinants.MethodUtilizing HPV vaccination data obtained from t...

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Main Authors: Jing Xiang, Xuan Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1428267/full
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author Jing Xiang
Xuan Sun
author_facet Jing Xiang
Xuan Sun
author_sort Jing Xiang
collection DOAJ
description ObjectivesAs the first socio-demographic profiling of HPV vaccines in Chinese cities, this study assesses equity implications through compositional analysis of covered populations, with multilevel examination of vaccine-type selection determinants.MethodUtilizing HPV vaccination data obtained from the Jinnan Center for Disease Control and Prevention (CDC) spanning from 2018 to 2023, we conducted a retrospective analysis. Hierarchical logistic regression was employed to model the joint effects of age, ethnicity, occupation, and urban–rural residence on vaccination behaviors. Vaccine type preference was categorized as bivalent, quadrivalent, or nonavalent.ResultThree key disparities were revealed in the analysis. Age-stratified access revealed the highest proportion of recipients among women aged 33–38 years (29.6%) and 39–44 years (21.9%), contrasting with less than 1% participation in the 9–14 year-old cohort. Educationally, 87.3% held at least a bachelor’s degree, compared to 12.7% with below-college education (χ2 = 6048.89, p < 0.001). Clear urban–rural divide, with 99.7% of recipients in urban areas and just 0.3% in rural areas (χ2 = 76.79, p < 0.001). Vaccine-type selection showed socioeconomic patterns, with nonavalent vaccines preferred by urban professionals (OR = 1.577, 95% CI: 1.16–2.142) and those with incomes above 5000 yuan (OR = 1.958, 95% CI: 0.26–3.527).ConclusionDemonstrating Hart’s Inverse Care Law, Tianjin’s program disproportionately immunizes socioeconomically secure urbanites. We propose: (1) school-based mandates for pre-sexual debut cohorts; (2) rural vaccination-social insurance integration; (3) domestic 9-valent vaccine development with needs-based subsidies. These evidence-based reforms are critical for achieving equitable 90% coverage by 2030.
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spelling doaj-art-4d75e953b32c439eba4fd0ad9fbec4662025-08-20T03:05:01ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.14282671428267Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)Jing Xiang0Xuan Sun1Gynecology Department, Nankai University Hospital, Tianjin, ChinaZhou Enlai School of Government, Nankai University, Tianjin, ChinaObjectivesAs the first socio-demographic profiling of HPV vaccines in Chinese cities, this study assesses equity implications through compositional analysis of covered populations, with multilevel examination of vaccine-type selection determinants.MethodUtilizing HPV vaccination data obtained from the Jinnan Center for Disease Control and Prevention (CDC) spanning from 2018 to 2023, we conducted a retrospective analysis. Hierarchical logistic regression was employed to model the joint effects of age, ethnicity, occupation, and urban–rural residence on vaccination behaviors. Vaccine type preference was categorized as bivalent, quadrivalent, or nonavalent.ResultThree key disparities were revealed in the analysis. Age-stratified access revealed the highest proportion of recipients among women aged 33–38 years (29.6%) and 39–44 years (21.9%), contrasting with less than 1% participation in the 9–14 year-old cohort. Educationally, 87.3% held at least a bachelor’s degree, compared to 12.7% with below-college education (χ2 = 6048.89, p < 0.001). Clear urban–rural divide, with 99.7% of recipients in urban areas and just 0.3% in rural areas (χ2 = 76.79, p < 0.001). Vaccine-type selection showed socioeconomic patterns, with nonavalent vaccines preferred by urban professionals (OR = 1.577, 95% CI: 1.16–2.142) and those with incomes above 5000 yuan (OR = 1.958, 95% CI: 0.26–3.527).ConclusionDemonstrating Hart’s Inverse Care Law, Tianjin’s program disproportionately immunizes socioeconomically secure urbanites. We propose: (1) school-based mandates for pre-sexual debut cohorts; (2) rural vaccination-social insurance integration; (3) domestic 9-valent vaccine development with needs-based subsidies. These evidence-based reforms are critical for achieving equitable 90% coverage by 2030.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1428267/fullHPV vaccinesvaccine equitysocio-economic statusmultivariable logistic regressionurban–rural disparities
spellingShingle Jing Xiang
Xuan Sun
Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
Frontiers in Public Health
HPV vaccines
vaccine equity
socio-economic status
multivariable logistic regression
urban–rural disparities
title Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
title_full Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
title_fullStr Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
title_full_unstemmed Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
title_short Socioeconomic disparities in HPV vaccine uptake: multivariable analysis of vaccination data from Tianjin (2018–2023)
title_sort socioeconomic disparities in hpv vaccine uptake multivariable analysis of vaccination data from tianjin 2018 2023
topic HPV vaccines
vaccine equity
socio-economic status
multivariable logistic regression
urban–rural disparities
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1428267/full
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