Herman Deleeck Centre for Social Policy, Antwerp University, St Jacobstraat 2, 2000 Antwerpen, Belgium.
BMC Public Health. 2011 Jun 14;11:470. doi: 10.1186/1471-2458-11-470.
We investigated dynamic patterns and predictors of HPV vaccination initiation in Flanders (Belgium) by girls aged 12 to 18, between 2007 and 2009, the period immediately after the introduction of the HPV vaccines on the Belgian market. During this period the initiative for vaccination was taken by the girl, her family or the general practitioner/pediatrician/gynecologist.
We used a Cox regression model with time constant and time varying predictors to model hazard rates of HPV vaccination initiation. The sample existed of 117,151 female members of the National Alliance of Christian Mutualities, the largest sickness fund in Flanders.
The study showed that the hazard of HPV vaccination initiation was higher (1) for older girls, (2) for girls with a more favorable socio-economic background, (3) under more generous reimbursement regimes (with this effect being more pronounced for girls with weak socioeconomic backgrounds), (4) for girls that were informed personally about the reimbursement rules.
When the initiative for HPV vaccination lies with the girls, their families or the physicians (no organized setting) the uptake of the vaccines is affected by both individual and organizational factors.
我们调查了 2007 年至 2009 年期间，即 HPV 疫苗在比利时市场推出后立即，12 至 18 岁女孩在佛兰德斯（比利时）接种 HPV 疫苗的动态模式和预测因素。在此期间，接种疫苗的主动权掌握在女孩、她的家人或全科医生/儿科医生/妇科医生手中。
我们使用具有时间常数和时变预测因子的 Cox 回归模型来对 HPV 疫苗接种启动的风险率进行建模。样本由佛兰德斯最大的疾病基金——基督教互助联盟的 117151 名女性成员组成。
研究表明，HPV 疫苗接种启动的风险更高（1）对于年龄较大的女孩，（2）对于社会经济背景较好的女孩，（3）对于报销制度更慷慨的女孩（对于社会经济背景较弱的女孩，这种影响更为明显），（4）对于那些个人被告知报销规则的女孩。
当 HPV 疫苗接种的主动权掌握在女孩、她们的家人或医生（没有组织环境）手中时，疫苗的接种情况受到个人和组织因素的影响。
