Sociodemographic correlates of human papillomavirus vaccination and its association with hematological and metabolic parameters: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2011–2023
Introduction: Safety concerns contribute to human papillomavirus (HPV) vaccine hesitancy; however, population-representative evidence on routine hematologic and metabolic laboratory markers as indirect safety signals in adults remains limited.
Objective: We examined associations between HPV vaccination and selected laboratory parameters in the National Health and Nutrition Examination Survey (NHANES).
Methods: We conducted a cross-sectional analysis of adults (≥20 years) in NHANES 2011–2023 with complete HPV vaccination history and laboratory data. Survey weighted generalized linear regression models evaluated associations of vaccination status (and dose) with hematologic and metabolic parameters, adjusting for age, sex, race/ethnicity, educational attainment, and poverty index (and other prespecified covariates where available).
Results: Among 13,859 participants, 1,663 reported HPV vaccination. Vaccinated participants were younger and more often female. In fully adjusted models, most routine hematologic and lipid parameters showed no meaningful association with vaccination. Platelet count was higher in vaccinated participants (unadjusted difference: 10.97×103/μL; 95% confidence interval [CI]: 6.36–15.58; Model 3: p = 0.019) and showed a dose-related trend among participants aged ≤35 years (p = 0.027). In metabolic analyses, HPV vaccination was associated with higher vitamin B12 (β = 36.38; 95% CI: 13.56–59.19) and slightly lower 25-hydroxyvitamin D measures (β = −3.07; 95% CI: −5.62–−0.52).
Conclusion: In this nationally representative sample, HPV vaccination was not associated with large differences in most routine hematologic and metabolic measures. Modest differences observed in a limited number of biomarkers are indirect and observational and do not establish causality or clinical adverse events; longitudinal studies incorporating vaccination timing and clinical outcomes are warranted.
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