Koya Deepika L, Hill Elizabeth G, Darden Paul M
Health Services Research/Academic Generalist Fellowship Program and the Department of Internal Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Public Health. 2008 May;98(5):832-8. doi: 10.2105/AJPH.2007.116046. Epub 2008 Apr 1.
We sought to examine trends in hepatitis B virus (HBV) vaccination among high-risk adults and assess the potential effect vaccinated adolescents have on these trends as they age.
We used data from the National Health Interview Survey 2000, 2002, and 2004 to examine trends in HBV vaccination among high-risk adults aged 18 to 49 years and in age subgroups (18-29, 30-39, and 40-49 years). We investigated temporal differences in vaccination rates for the 18- to 29-year-old cohort with model-based linear contrasts constructed from a logistic regression model with age and survey year as predictors.
There was a significant increasing trend in vaccination prevalence across the 3 survey years (32.6%, 35.3%, and 41.4%; trend test, P=.001). We found that respondents aged 18 to 29 years were more likely to be vaccinated in 2004 than in 2000, after adjusting for relevant confounders (odds ratio=1.73; 95% confidence interval=1.14, 2.6); there was no significant increase in vaccination for the other cohorts.
A cohort effect, in which successfully vaccinated adolescents have reached young adulthood, contributes significantly to recent trends showing improved HBV vaccination among high-risk adults.
我们试图研究高危成年人中乙型肝炎病毒（HBV）疫苗接种的趋势，并评估已接种疫苗的青少年随着年龄增长对这些趋势的潜在影响。
我们使用了2000年、2002年和2004年美国国家健康访谈调查的数据，来研究18至49岁高危成年人以及年龄亚组（18 - 29岁、30 - 39岁和40 - 49岁）中HBV疫苗接种的趋势。我们通过构建以年龄和调查年份为预测因素的逻辑回归模型得出的基于模型的线性对比，研究了18至29岁队列疫苗接种率的时间差异。
在这3个调查年份中，疫苗接种率呈现出显著的上升趋势（分别为32.6%、35.3%和41.4%；趋势检验，P = 0.000）。我们发现，在调整相关混杂因素后，2004年18至29岁的受访者比2000年更有可能接种疫苗（优势比 = 1.73；95%置信区间 = 1.14，2.6）；其他队列的疫苗接种率没有显著增加。
一种队列效应，即成功接种疫苗的青少年已步入青年期，对近期高危成年人中HBV疫苗接种情况改善的趋势有显著贡献。
