Visualizing Immunization Registry Data to Identify Places With Low Rates of HPV Vaccination Initiation in a Rural State

Vaccination against human papillomavirus (HPV) protects against cancer and other diseases associated with the virus. Currently, the Advisory Committee on Immunization Practices recommends that boys and girls aged 11 and 12 receive a 2-dose vaccination series. Despite this recommendation, uptake of the HPV vaccine is low in comparison with uptake of other vaccines given at the same age (4). Some studies using national survey data identified rural residence as a risk factor for delayed HPV vaccination or no vaccination (5). However, national surveys often do not include enough rural children to adequately examine this risk factor. In this study, we used data from Iowa’s robust state immunization registry to examine the relationship between location and HPV vaccination initiation.