Comparison of Medical Service Use and Human Papillomavirus Vaccination Rates Among Somali and White/Non-Hispanic Girls

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This study aimed to determine if there is a relationship between medical use patterns and human papillomavirus (HPV) vaccination rates among a previously studied population of Somali and white/non-Hispanic girls in Rochester, MN.

Materials and Methods

With the use of a previously identified group of Somali and white/non-Hispanic girls with known HPV vaccination status, the number, type, and age at provider visits were abstracted. Abstraction was blinded to vaccination status and ethnic designation. χ2 and Student t tests were performed for descriptive analysis of parametric data. For nonparametric data, Wilcoxon rank sum test was performed.


Somali girls had fewer provider visits (median = 7, interquartile range [IQR] = 3–12.25) compared with white/non-Hispanic girls (median = 12, IQR = 6–18) (p < .001). Among those who completed the HPV vaccine series, Somali girls had more well-child visits (median = 2, IQR = 1–2) compared with the white/non-Hispanic group (median = 1, IQR = 1–2) (p = .028). There was no difference in the number of emergency department visits or inpatient hospitalization between groups.


White/non-Hispanic girls had higher HPV vaccine completion rates and more provider visits. However, this increase in number of encounters is due to an increase in specialty visits. This is unlikely to account for the increase in HPV vaccination completion rates. Community-based research will likely provide greater insight into the cause(s) of reduced vaccine rates among Somali adolescent girls.

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