Public Health Ontario, Canada.
Vaccine. 2013 Jan 21;31(5):757-62. doi: 10.1016/j.vaccine.2012.11.090. Epub 2012 Dec 13.
In 2007, Ontario implemented a school-based human papillomavirus (HPV) vaccination program targeting grade 8 girls. Girls may complete the series in grade 9 (extended eligibility). Limitations in the existing provincial data sources for assessing HPV vaccine coverage in Ontario prompted the use of two surveys of Health Units (HUs) to calculate provincial vaccine coverage for the first three years of the vaccination program.
We surveyed Ontario's 36 HUs in March and November 2011 to obtain vaccine coverage information, including source of denominator data, and use of local information systems. The second survey was necessary in order to assess coverage including extended eligibility for the third year. HU-reported HPV vaccine coverage was compared to coverage estimates obtained from two provincial systems: the Immunization Records Information System (IRIS) and the HPV reimbursement database, a system used to remunerate HUs for HPV vaccine doses administered.
100% of HUs participated in the two surveys. The provincial coverage estimates using HU-reported data were: 51% (2007-2008), 58% (2008-2009), and 59% (2009-2010) with large variation by HU. Coverage increased significantly over time. The number of HUs that were able to report on doses given as part of extended eligibility also increased over time (47% in 2007-2008 to 89% in 2009-2010; p=0.0008). Comparisons across the three data sources (survey, IRIS and reimbursement database) revealed significantly different coverage estimates. Class or school lists were the most common source of denominator data used by HUs (27/36, 75%), however independent schools were not included by all.
As not all HUs were able to report on HPV vaccine coverage including extended eligibility doses these findings likely underestimate the true coverage attained by Ontario's program. Although coverage is below the Canadian Immunization Committee benchmark of 80% within two years of program implementation, the upward trend in coverage is encouraging.
2007 年，安大略省实施了一项针对 8 年级女生的基于学校的人乳头瘤病毒（HPV）疫苗接种计划。女孩们可以在 9 年级（延长资格）完成系列接种。由于安大略省现有的省级数据来源存在限制，难以评估 HPV 疫苗的接种情况，因此使用了两项对卫生单位（HU）的调查来计算该疫苗接种计划实施的前三年的省级疫苗接种率。
我们在 2011 年 3 月和 11 月对安大略省的 36 个卫生单位进行了调查，以获取疫苗接种率信息，包括分母数据来源和当地信息系统的使用情况。为了评估第三年的延长资格接种情况，需要进行第二次调查。HU 报告的 HPV 疫苗接种率与从两个省级系统获得的估计数进行了比较：免疫记录信息系统（IRIS）和 HPV 报销数据库，该系统用于补偿 HUs 接种的 HPV 疫苗剂量。
100%的卫生单位参加了这两项调查。利用 HU 报告的数据得出的省级覆盖估计数分别为：2007-2008 年为 51%，2008-2009 年为 58%，2009-2010 年为 59%，HU 之间的差异很大。随着时间的推移，覆盖率显著增加。能够报告延长资格部分接种的 HUs 数量也随着时间的推移而增加（2007-2008 年为 47%，2009-2010 年为 89%；p=0.0008）。对三个数据源（调查、IRIS 和报销数据库）的比较显示，覆盖估计数存在显著差异。班级或学校名单是 HU 最常用的分母数据来源（36 个中有 27 个，占 75%），但并非所有独立学校都包括在内。
由于并非所有 HU 都能够报告包括延长资格剂量在内的 HPV 疫苗接种率，因此这些发现可能低估了安大略省计划实际达到的真实接种率。尽管在实施计划后的两年内，覆盖率低于加拿大免疫咨询委员会 80%的基准，但覆盖率呈上升趋势令人鼓舞。
