Association Between a Mother's Cervical Cancer Screening and Child's Human Papillomavirus (HPV) Vaccination Status.

Objectives: To investigate the association between maternal cervical cancer (CC) screening status and child human papillomavirus (HPV) vaccination uptake. To understand if child sex or social deprivation index (SDI) modify this association. Methods: We used a national cohort of children linked to at least one parent using electronic health record (EHR) data from a network of community health centers across the United States. We used SDI scores and child sex as moderating variables. We performed the analysis (1) for the whole sample (with SDI and child sex added as covariates), (2) stratified by SDI quartile (with child sex added as a covariate), and (3) stratified by SDI quartile and child sex, to examine whether associations vary by SDI quartile and by child sex. Results: N = 52,919 linked mother–child pairs. Mother's receipt of CC screening was positively associated with the linked child's odds of receiving HPV vaccination [adjusted odds ratio (AOR) 1.39, 95% confidence interval (CI) 1.32, 1.47]. Neither sex or SDI modified this association. There were no significant differences in odds of HPV vaccination in children between SDI quartiles or between male and female children. Conclusions for Practice: An effective way to improve rates of HPV vaccination among children and adolescents may be to target attention towards increasing CC screening rates among mothers. Further, focusing resources and efforts on CC screenings and care of both mothers and their children may be more worthwhile than isolated efforts targeting HPV vaccination for children and adolescents. Significance: What is already known on this subject?: Human papillomavirus (HPV) vaccination reduces risk of cervical cancer. HPV vaccination rates are lower among children than other vaccination rates. Mothers' healthcare visits are associated with their child's healthcare visits. What does this study add?: Children of mothers up-to-date on cervical cancer screening have higher odds of HPV vaccination than children of mothers who have not received recommended cervical cancer screenings. These findings suggest that interventions that focus on cervical cancer screenings and care of both mothers and their children may help to increase HPV rates among children. Multigenerational approaches to cervical cancer prevention may be an important part of the elimination of this cancer. [ABSTRACT FROM AUTHOR]