Background Human papillomavirus (HPV) vaccination is a critical cancer prevention tool, yet uptake among young adults in the United States remains suboptimal. Understanding sociodemographic factors influencing vaccine uptake is essential to reducing HPV-related cancer disparities. Objective This study examined factors influencing HPV vaccine uptake among US young adults using the Social Ecological Model framework, focusing on individual-, interpersonal-, community-, and societal-level predictors. Methods A cross-sectional analysis was conducted using data from the 2022 National Health Interview Survey, including a weighted sample of 15 014 592 young adults aged 18 to 26 years. Multivariable logistic regression models examined associations between vaccination status and multilevel predictors, including healthcare access, internet use, gender, health status, race/ethnicity, and education. Results Having a usual healthcare provider significantly increased vaccination odds (odds ratio OR, 1.99; P < .01), as did using the internet for health information (OR, 1.70; P < .01). Males had lower odds than females (OR, 0.41; P < .001). Unexpectedly, higher education was associated with lower vaccination odds, with graduate degree holders having the lowest odds (OR, 0.22; P < .05). Hispanic individuals showed higher odds compared with non-Hispanic Whites (OR, 1.40; P < .05). Conclusions HPV vaccine uptake is influenced by factors across multiple ecological levels. The inverse relationship between education and vaccination highlights the complexity in vaccination decision-making among young adults. Implications Oncology nurses should implement multilevel interventions, including systematic vaccination protocols, targeted male outreach, culturally tailored programs, and digital strategies, with specialized messaging for highly educated adults emphasizing universal cancer prevention benefits.
Kyei et al. (Mon,) studied this question.