{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T09:37:44Z","timestamp":1793957864195,"version":"4.8.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["RP210130"],"award-info":[{"award-number":["RP210130"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The purpose of this study was to compare regional HPV vaccination rates and trends among the Texas Medicaid population of adolescents in 2019 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We constructed 3 annual cross-sectional cohorts from Texas Medicaid data from 2019 to 2021, including a total of 1\u2009531\u2009301 individuals contributing 2\u2009757\u2009577 person-years of adolescents aged 9-18 for this analysis. The primary outcome was an observed HPV vaccine dose during the study period. We conducted multivariable logistic regression to estimate the odds of HPV vaccination based on region and the socio-demographic predictor variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, the HPV vaccination incidence rate was 13.1% for Medicaid adolescent clients in Texas. The 2020 and 2021 cohorts were significantly less likely to be vaccinated for HPV than the 2019 cohort. Regional variation was detected for adolescents. Significant differences were observed in both age cohorts by sex, race\/ethnicity, urbanicity, and cohort year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Declines in HPV vaccination after the COVID-19 pandemic among Texas Medicaid-insured adolescents are of urgent concern if HPV-related cancers are to be prevented. Furthermore, regional differences are apparent throughout Texas, which may contribute to an unequal burden of future disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261432414","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T04:52:08Z","timestamp":1774673528000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Regional Differences and Trends Within Texas in HPV Vaccination Among Medicaid-insured Adolescents"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7115-0001","authenticated-orcid":false,"given":"Erika L.","family":"Thompson","sequence":"first","affiliation":[{"name":"Kate Marmion School of Public Health, University of Texas at San Antonio, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Shan","sequence":"additional","affiliation":[{"name":"University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-2978","authenticated-orcid":false,"given":"Kirsten Y.","family":"Eom","sequence":"additional","affiliation":[{"name":"Kate Marmion School of Public Health, University of Texas at San Antonio, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9956-6566","authenticated-orcid":false,"given":"Miranda E.","family":"Cano","sequence":"additional","affiliation":[{"name":"Kate Marmion School of Public Health, University of Texas at San Antonio, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-0927","authenticated-orcid":false,"given":"Yong-Fang","family":"Kuo","sequence":"additional","affiliation":[{"name":"University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Centers for Disease Control and Prevention. Cancers Linked with HPV Each Year. 2025. Accessed December 11 2025. https:\/\/www.cdc.gov\/cancer\/hpv\/cases.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/cancer\/hpv\/statistics\/cases.htm"},{"key":"e_1_3_2_3_2","unstructured":"Centers for Disease Control and Prevention. HPV Vaccination. 2024. Accessed January 20 2026. https:\/\/www.cdc.gov\/hpv\/vaccines\/index.html"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6549a5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7430a1"},{"key":"e_1_3_2_6_2","unstructured":"Garza O Green D Grubbs S Halbrook S. Young Texans: Demographic Overview. 2020. Accessed December 11 2025. https:\/\/comptroller.texas.gov\/economy\/fiscal-notes\/archive\/2020\/feb\/texans.php"},{"key":"e_1_3_2_7_2","unstructured":"Centers for Disease Control and Prevention. Vaccination Coverage among Adolescents (13 \u2013 17 Years). TeenVaxView. 2024. Accessed December 11 2025. https:\/\/www.cdc.gov\/teenvaxview\/interactive\/index.html"},{"key":"e_1_3_2_8_2","unstructured":"Texas Department of State Health Services. Overview of ImmTrac2. 2025. Accessed December 11 2 2025. https:\/\/www.dshs.texas.gov\/sites\/default\/files\/commprep\/preparedness\/PCC\/handouts\/Disaster-Overview-of-ImmTrac2-04.08.2025.pdf"},{"key":"e_1_3_2_9_2","unstructured":"Annie E. Casey Foundation. Kids Count Data Center. Medicaid Enrollment (Birth to Age 18) in Texas. 2025. Accessed December 11 2025. https:\/\/datacenter.aecf.org\/data\/tables\/8528-medicaid-enrollment-birth-to-age-18#detailed\/2\/any\/false\/1096 2545 1095 2048 574 1729 37 871 870 573\/any\/17213 17214"},{"key":"e_1_3_2_10_2","unstructured":"Cancer Prevention and Research Institute of Texas. Prevention. 2025. Accessed December 11 2025. https:\/\/cprit.texas.gov\/our-programs\/prevention"},{"key":"e_1_3_2_11_2","unstructured":"Texas Health and Human Services. Public Health Regions. 2025. Accessed December 11 2025. https:\/\/www.dshs.texas.gov\/regional-local-health-operations\/public-health-regions"},{"key":"e_1_3_2_12_2","volume-title":"SAS Software","author":"SAS Institute Inc","year":"2025","unstructured":"SAS Institute Inc. SAS Software, version 9.4. SAS Institute Inc; 2025."},{"key":"e_1_3_2_13_2","unstructured":"Texas Health Institute. The Cancer Prevention and Research Institute of Texas Prevention Program\u2019s First Ten Years: A Comprehensive Assessment. Phase II Summary Report. 2025. Accessed December 11 2025. https:\/\/cprit.texas.gov\/media\/3627\/cprit-prev-program-comprehensive-assessment.pdf"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2023.2217257"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.09.073"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1981842"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261432414","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319261432414","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261432414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:23:57Z","timestamp":1777508637000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319261432414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":15,"alternative-id":["10.1177\/21501319261432414"],"URL":"https:\/\/doi.org\/10.1177\/21501319261432414","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"article-number":"21501319261432414"}}