Keating Katie M, Brewer Noel T, Gottlieb Sami L, Liddon Nicole, Ludema Christina, Smith Jennifer S
School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27516, USA.
J Adolesc Health. 2008 Oct;43(4 Suppl):S61-7. doi: 10.1016/j.jadohealth.2008.06.015.
Potential barriers to widespread vaccination of adolescent girls against human papillomavirus (HPV) infection are poorly understood. We provide an overview of potential barriers to provision of HPV vaccine and empirical data on the concerns of medical practices that may inhibit HPV vaccine provision.
We conducted phone interviews with medical practices in rural areas in southeastern North Carolina with high rates of cervical cancer to assess 10 potential concerns about HPV vaccine provision.
Concerns most commonly reported by medical practices (N = 71) were inadequate reimbursement (68%), high cost of the vaccine to patients (66%), and burden of determining insurance coverage (66%). Practices that were not providing the vaccine reported more concerns about HPV vaccine provision on average than practices providing the vaccine (6.0 vs. 4.5 concerns, p < .05).
Medical practices' concerns about the HPV vaccine may be barriers to stocking it and, thus, to providing it to adolescents. Even providers who stock the vaccine reported concerns. Research is needed to address ways to ameliorate these medical practices' concerns and also to understand other potential barriers to vaccine coverage.
人们对广泛接种人乳头瘤病毒（HPV）疫苗的潜在障碍了解甚少。我们概述了HPV疫苗接种的潜在障碍，并提供了有关可能阻碍HPV疫苗接种的医疗行为的实证数据。
我们对北卡罗来纳州东南部农村地区宫颈癌发病率较高的医疗机构进行了电话访谈，以评估对HPV疫苗接种的10个潜在担忧。
医疗机构（N = 71）最常报告的担忧是报销不足（68%）、疫苗对患者成本高（66%）以及确定保险覆盖范围的负担（66%）。未提供疫苗的医疗机构平均比提供疫苗的医疗机构对HPV疫苗接种的担忧更多（6.0个担忧与4.5个担忧，p < 0.05）。
医疗机构对HPV疫苗的担忧可能是库存疫苗以及向青少年提供疫苗的障碍。即使是库存疫苗的提供者也表示担忧。需要开展研究以解决减轻这些医疗机构担忧的方法，并了解疫苗接种覆盖的其他潜在障碍。
