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Obscured inequity: How focusing on rates of disparities can conceal inequities in the reasons why adolescents are unvaccinated

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  • Elizabeth M Anderson

Abstract

Traditional sociodemographic disparities in adolescent vaccination initiation for the HPV, Tdap, and MenACWY vaccines have declined in the United States of America. This decline raises the question of whether inequities in access have been successfully addressed. This paper synthesizes research on the resource barriers that inhibit vaccination alongside research on vaccine hesitancy where parents actively refuse vaccination. To do so, I classify the primary reason why teens are unvaccinated in the National Immunization Survey-Teen 2012–2022 into three categories: resource failure, agentic refusal, and other reasons. I use three non-exclusive subsamples of teens who are unvaccinated against the HPV (N = 87,163), MenACWY (N = 54,726), and Tdap (N = 10,947) vaccines to examine the relative importance of resource failure reasons and agentic refusal reasons for non-vaccination across time and teens’ sociodemographic characteristics. Results indicate that resource failure reasons continue to explain a substantial portion of the reasons why teens are unvaccinated and disproportionately affect racially/ethnically and economically marginalized teens. Thus, even as sociodemographic inequalities in rates of vaccination have declined, inequities in access remain consequential.

Suggested Citation

  • Elizabeth M Anderson, 2023. "Obscured inequity: How focusing on rates of disparities can conceal inequities in the reasons why adolescents are unvaccinated," PLOS ONE, Public Library of Science, vol. 18(11), pages 1-19, November.
    • Handle: RePEc:plo:pone00:0293928
    DOI: 10.1371/journal.pone.0293928
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    References listed on IDEAS

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    1. Polonijo, Andrea N. & Carpiano, Richard M., 2013. "Social inequalities in adolescent human papillomavirus (HPV) vaccination: A test of fundamental cause theory," Social Science & Medicine, Elsevier, vol. 82(C), pages 115-125.
    2. Carpiano, Richard M. & Fitz, Nicholas S., 2017. "Public attitudes toward child undervaccination: A randomized experiment on evaluations, stigmatizing orientations, and support for policies," Social Science & Medicine, Elsevier, vol. 185(C), pages 127-136.
    3. Mingfeng Lin & Henry C. Lucas & Galit Shmueli, 2013. "Research Commentary ---Too Big to Fail: Large Samples and the p -Value Problem," Information Systems Research, INFORMS, vol. 24(4), pages 906-917, December.
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