Department of Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan 48109-5456, USA.
J Adolesc Health. 2010 Sep;47(3):242-8, 248.e1-248.e6. doi: 10.1016/j.jadohealth.2009.12.009. Epub 2010 Feb 11.
To develop a model of adolescent (HPV) human papillomavirus vaccine utilization that explored future HPV vaccination rates, with and without a school mandate, for the vaccine at middle school entry.
A dynamic, population-based, compartmental model was developed that estimated over a 50-year time horizon HPV vaccine uptake among female adolescents living in the United States. The model incorporated data on parental attitudes about this vaccine and adolescent health care utilization levels.
Without a mandate, our model predicted that 70% coverage, a lower threshold value used in many previous modeling studies of HPV vaccination, would not be achieved until a mean of 23 years after vaccine availability. Maximal coverage of 79% was achieved after 50 years. With a school mandate in place, utilization increased substantially, with 70% vaccination coverage achieved by year 8 and maximal vaccination coverage, 90%, achieved by year 43.
Our results suggest that vaccine utilization is likely to be low for several years, though strong school mandates might improve HPV vaccine uptake. These results affect the interpretation of previous modeling studies that estimated the potential clinical effects of HPV vaccination under assumptions of very high vaccine utilization rates.
开发一种青少年（HPV）人乳头瘤病毒疫苗利用模型，探索在没有和有学校授权的情况下，该疫苗在中学入学时的未来 HPV 疫苗接种率。
开发了一种动态的、基于人群的、隔室模型，该模型估计了美国生活的女性青少年在 50 年内 HPV 疫苗接种的情况。该模型结合了关于这种疫苗的父母态度和青少年医疗保健利用率的数据。
在没有授权的情况下，我们的模型预测，在疫苗供应后平均 23 年，才能达到 70%的覆盖率，这是许多之前 HPV 疫苗接种建模研究中使用的较低阈值。50 年后，覆盖率达到了 79%的最大值。有了学校授权，利用率大大提高，70%的疫苗接种覆盖率在第 8 年达到，最大接种覆盖率 90%在第 43 年达到。
我们的结果表明，疫苗的利用率可能在几年内都很低，尽管强有力的学校授权可能会提高 HPV 疫苗的接种率。这些结果影响了对 HPV 疫苗接种潜在临床效果的假设接种率非常高的先前建模研究的解释。
