AUTHOR=Xiang Jing , Sun Xuan 

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

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1428267

DOI=10.3389/fpubh.2025.1428267

ISSN=2296-2565

ABSTRACT=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.