19-26 岁女性 HPV 疫苗未接种的原因及未来接种意愿。
Reasons for non-vaccination against HPV and future vaccination intentions among 19-26 year-old women.
机构信息
Department of Pediatrics, Indiana University School of Medicine, 410 W, 10th Street, HS 1001, Indianapolis, IN 46202, USA.
出版信息
BMC Womens Health. 2010 Sep 1;10:27. doi: 10.1186/1472-6874-10-27.
BACKGROUND
Despite CDC recommendations regarding universal catch-up vaccination against human papillomavirus (HPV), only about ten percent of young adult women in the United States have been vaccinated. The purpose of this study was to better understand reasons for non-vaccination among insured 19-26 year-old women and to evaluate future vaccination intentions.
METHODS
We used an administrative claims database from a large US managed care plan to identify women aged 19-26 for receipt of a mailed survey. From a sample of 1,375 women with no evidence of HPV vaccination from June 1, 2006 through April 30, 2007, 222 completed surveys were received, of which 185 were eligible for this analysis. The main outcome measures were unvaccinated women's attitudes and vaccine awareness, likelihood of future action regarding the vaccine, and reasons for inaction.
RESULTS
Among the 185 non-vaccinees, 25.4% were married, 83.2% were white, and 89.2% had a college or higher level education. The vaccine was described as very important by 32.4% of subjects, and 30.1% had discussed the vaccine with a doctor and received a doctor's recommendation. Half or fewer of respondents were "very" or "extremely" likely to discuss the vaccine with their doctor (50.0%), do additional research on the vaccine (42.6%), ask a doctor to get the vaccine (37.5%), or make an appointment to get the vaccine (27.8%), while 48.0% were "somewhat", "very", or "extremely" likely to do nothing to get the vaccine. Among the latter, reasons for taking no action included being married or in a monogamous relationship (54.9%), belief that the vaccine is too new (35.4%), not having enough information about the vaccine (31.7%), concerns about side effects (24.4%), and uncertainty about insurance coverage (24.4%).
CONCLUSIONS
Educational interventions may be needed to enhance HPV vaccination rates among 19-26 year-old women, particularly regarding information about vaccine safety, vaccine efficacy, insurance coverage, and the value of vaccination to women in monogamous relationships.
背景
尽管美国疾病控制与预防中心（CDC）建议对所有青少年进行人乳头瘤病毒（HPV）疫苗的补种，但在美国，只有大约 10%的年轻成年女性接受了这种疫苗接种。本研究的目的是更好地了解已参保的 19-26 岁女性未接种疫苗的原因，并评估其未来接种疫苗的意愿。
方法
我们使用一家大型美国管理式医疗计划的行政索赔数据库，来确定在 2006 年 6 月 1 日至 2007 年 4 月 30 日期间未接受 HPV 疫苗接种的 19-26 岁女性。从 1375 名女性中随机抽取 222 名完成了邮寄调查，其中 185 名符合本分析的条件。主要的观察指标为未接种疫苗的女性的态度和疫苗意识、未来针对疫苗的行动可能性，以及未采取行动的原因。
结果
在 185 名未接种疫苗的女性中，25.4%已婚，83.2%为白人，89.2%具有大学或更高学历。32.4%的女性认为疫苗非常重要，30.1%曾与医生讨论过疫苗并获得医生的推荐。只有一半或更少的受访者非常有可能（50.0%）或极有可能（50.0%）与医生讨论疫苗、进一步研究疫苗（42.6%）、请医生接种疫苗（37.5%）或预约接种疫苗（27.8%），而 48.0%的人可能会选择什么也不做（48.0%）。在后者中，不采取任何行动的原因包括已婚或处于一夫一妻制关系（54.9%）、认为疫苗太新（35.4%）、对疫苗信息了解不足（31.7%）、对副作用的担忧（24.4%）和对保险覆盖范围的不确定性（24.4%）。
结论
可能需要开展教育干预措施来提高 19-26 岁女性的 HPV 疫苗接种率，特别是要加强对疫苗安全性、疫苗效力、保险覆盖范围以及对一夫一妻制关系中女性的疫苗价值的信息。
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