Table 2 Determinants of HPV vaccine refusal

Individual-level characteristics

Income quintiles ^*

  1^st (low)

21,357 (51.6)

1.24 (1.20, 1.29)

1.13 (1.09, 1.17)

  2^nd

25,689 (47.3)

1.04 (1.01, 1.08)

1.01 (0.98, 1.05)

  3^rd (reference)

30,823 (46.2)

1.00

1.00

  4^th

32,495 (48.3)

1.09 (1.05, 1.12)

1.12 (1.08, 1.15)

  5^th (high)

30,803 (49.7)

1.15 (1.11, 1.18)

1.21 (1.17, 1.25)

Vaccination history

Refusal of mandatory vaccines

  No (reference)

139,887 (48.5)

1.00

1.00

  Yes

4,160 (78.8)

3.95 (3.66, 4.26)

2.23 (2.07, 2.40)

Refusal of optional vaccines

  No (reference)

83,600 (34.8)

1.00

1.00

  Yes

60,447 (69.4)

4.25 (4.16, 4.35)

3.96 (3.87, 4.05)

Health care utilization

Hospitalizations

  ≤1 (reference)

110,167 (48.3)

1.00

1.00

  2-4

29,350 (49.5)

0.95 (0.93, 0.98)

0.94 (0.91, 0.97)

  ≥4

4,530 (52.6)

1.13 (1.07, 1.20)

0.96 (0.90, 1.03)

Emergency department visits

  None (reference)

48,413 (50.7)

1.00

1.00

  1-4

69,796 (48.9)

0.93 (0.91, 0.95)

1.03 (1.01, 1.06)

  5-12

21,229 (47.9)

0.89 (0.87, 0.92)

1.02 (0.98, 1.06)

  ≥13

4,609 (47.3)

0.87 (0.82, 0.93)

0.99 (0.93, 1.06)

Outpatient physician visits

  ≤42

36,861 (55.3)

1.55 (1.46, 1.64)

1.45 (1.35, 1.55)

  43-116

74,797 (47.9)

1.15 (1.09, 1.22)

1.24 (1.17, 1.32)

  117-206

26,794 (46.1)

1.07 (1.01, 1.14)

1.12 (1.05, 1.19)

  ≥207 (reference)

5,595 (44.4)

1.00

1.00

Medical history

Congenital anomalies

  No (reference)

139,324 (49.3)

1.00

1.00

  Yes

4,723 (50.2)

1.04 (0.98, 1.10)

1.03 (0.97, 1.10)

Viral diseases

  No (reference)

48,977 (52.4)

1.00

1.00

  Yes

95,070 (47.8)

0.83 (0.81, 0.85)

0.96 (0.94, 0.99)

Cardiovascular disease

  No (reference)

117,427 (49.5)

1.00

1.00

  Yes

26,620 (48.5)

0.96 (0.93, 0.98)

1.03 (1.00, 1.06)

Obesity

  No (reference)

137,783 (49.5)

1.00

1.00

  Yes

6,264 (45.0)

0.83 (0.79, 0.88)

0.87 (0.83, 0.92)

Autism

  No (reference)

143,448 (49.3)

1.00

1.00

  Yes

599 (64.3)

1.85 (1.57, 2.19)

1.60 (1.34, 1.90)

Mental illness

  No (reference)

99,459 (49.2)

1.00

1.00

  Yes

44,588 (49.5)

1.01 (0.99, 1.04)

1.04 (1.01, 1.07)

Neurological disorder

  No (reference)

131,075 (49.3)

1.00

1.00

  Yes

12,972 (49.7)

1.01 (0.98, 1.05)

1.06 (1.02, 1.10)

Down’s syndrome

  No (reference)

143,408 (49.3)

1.00

1.00

  Yes

639 (60.6)

1.58 (1.35, 1.85)

1.37 (1.16, 1.63)

Health unit-level characteristics

Index of area deprivation (quartiles)

  1^st (low) (reference)

93,093 (49.8)

1.00

1.00

  2^nd

21,249 (48.9)

0.97 (0.94, 0.99)

1.02 (0.99, 1.06)

  3^rd

18,482 (49.2)

0.98 (0.95, 1.01)

1.01 (0.97, 1.05)

  4^th (high)

11,223 (46.4)

0.87 (0.84, 0.91)

0.82 (0.79, 0.86)