School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90095, USA.
Cancer Epidemiol Biomarkers Prev. 2011 Jul;20(7):1463-72. doi: 10.1158/1055-9965.EPI-11-0267. Epub 2011 May 20.
The introduction of human papillomavirus (HPV) vaccines represents a breakthrough in the primary prevention of cervical cancer. However, little is known about vaccination uptake and correlates among low-income, ethnic minority, and immigrant populations in the U.S. who may benefit most from the vaccine.
Telephone interviews (N = 490) were conducted in six languages between January and November 2009 among mothers of vaccine-eligible girls (ages 9-18) using the Los Angeles County Department of Public Health, Office of Women's Health service referral hotline. HPV and vaccine awareness, knowledge, beliefs, barriers, and daughter's vaccine receipt were assessed.
The sample consisted of low-income, uninsured, ethnic minority, and immigrant women. Only 29% of daughters initiated the vaccine and 11% received all three doses. No ethnic differences were observed in initiation or completion rates. Ethnic differences were observed in HPV awareness, perceived risk, and other vaccine-related beliefs. The strongest predictor of initiation was vaccine awareness (OR = 12.00). Daughter's age and reporting a younger acceptable age for vaccination were positively associated with initiation. Mothers of unvaccinated girls reported lacking information about the vaccine to make a decision (66%) and not knowing where they could obtain the vaccine (74%).
Vaccination rates in this sample were lower than state and national estimates, and were associated with low levels of vaccine awareness. Interventions, including culturally targeted messaging, may be helpful for enhancing HPV-vaccine knowledge, modifying vaccine-related beliefs and increasing uptake.
Our findings provide valuable guidance for developing interventions to address suboptimal HPV vaccination in high-risk groups.
人乳头瘤病毒（HPV）疫苗的引入是宫颈癌一级预防的一个突破。然而，在美国，对于那些可能从疫苗中受益最大的低收入、少数民族和移民群体，对于疫苗接种率和相关因素知之甚少。
2009 年 1 月至 11 月期间，使用洛杉矶县公共卫生部妇女健康办公室服务转介热线，以 6 种语言对符合疫苗接种条件女孩（9-18 岁）的母亲进行了电话访谈（N=490）。评估了 HPV 和疫苗的知晓率、知识、信念、障碍以及女儿的疫苗接种情况。
样本由低收入、没有保险、少数民族和移民妇女组成。只有 29%的女儿接种了疫苗，11%的女儿接种了全部 3 剂。在起始率和完成率方面没有观察到种族差异。在 HPV 知晓率、感知风险和其他疫苗相关信念方面观察到了种族差异。起始接种的最强预测因素是疫苗知晓率（OR=12.00）。女儿的年龄和报告的更年轻的可接受接种年龄与起始接种呈正相关。未接种疫苗的女孩的母亲报告说缺乏做出决定所需的疫苗信息（66%），也不知道在哪里可以获得疫苗（74%）。
在该样本中，接种率低于州和全国的估计值，且与疫苗知晓率低有关。包括有针对性的文化信息传递在内的干预措施可能有助于提高 HPV 疫苗知识，改变疫苗相关信念，并增加接种率。
我们的研究结果为制定干预措施提供了有价值的指导，以解决高危人群中 HPV 疫苗接种率不理想的问题。
