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Visualizing Immunization Registry Data to Identify Places With Low Rates of HPV Vaccination Initiation in a Rural State


The map shows the smoothed covariate-adjusted rates for initiation of the human papillomavirus vaccination among adolescents aged 13 to 15 in zip code tabulation areas in Iowa in 2016. The adjusted rates are categorized into the following ranges: 19.0% to 33.2%, 33.3% to 47.5%, 47.6% to 61.8%, and 61.9% to 76.0%. The map shows no clear association between vaccination initiation rates and location.


Covariate-adjusted initiation rates for human papillomavirus vaccination in zip code tabulation areas (ZCTAs) among adolescents aged 13 to 15, Iowa, 2016. Rates were spatially smoothed to account for small populations. The state-level mean vaccination rate for all ZCTAs was 47.9% (range, 0%–100%; standard deviation, 16.2%). All ZCTAs have initiation rates below the Healthy People 2020 target of 80% completion. Urban ZCTAs are indicated in black outlines. Vaccination initiation rates exhibit no clear association with location. Data sources: Iowa Department of Public Health (1), US Census Bureau (2), and US Department of Agriculture, Economic Research Service (3). Abbreviation: ZCTA, zip code tabulation area.

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