Socioeconomic Disparities in HPV Vaccine Uptake: Multivariable Analysis of Vaccination Data from Tianjin (2018-2023)

Jing Xiang ¹ Xuan Sun ^2*

• ¹ Gynecology Department, Nankai University Hospital, Nankai University, Tianjin, China
• ² Zhou Enlai School of Government, Nankai University, Tianjin, China

Objectives: As the first socio-demographic profiling of HPV vaccinees in Chinese cities, this study assesses equity implications through compositional analysis of covered populations, with multilevel examination of vaccine-type s election determinants.Method: Utilizing 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 employ ed to model the joint effects of age, ethnicity, occupation, and urban-rural resi dence on vaccination behaviors. Vaccine type preference was categorized as bi valent, quadrivalent, or nonavalent.Result:Three key disparities were revealed in the analysis.Age-stratified a ccess 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% particip ation in the 9-14 year-old cohort. Educationally, 87.3% held at least a bachelo r'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 a nd just 0.3% in rural areas (χ² = 76.79, p < 0.001).Vaccine-type selection s howed socioeconomic patterns, with nonavalent vaccines preferred by urban pr ofessionals (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).: Demonstrating Hart's Inverse Care Law, Tianjin's program di sproportionately immunizes socioeconomically secure urbanites. We propose: 1) school-based mandates for pre-sexual debut cohorts; 2) rural vaccination-socia l insurance integration; 3) domestic 9-valent vaccine development with needs-b 3 ased subsidies. These evidence-based reforms are critical for achieving equitab le 90% coverage by 2030.