Primary Prevention Research and Evaluation Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
J Sch Health. 2013 Feb;83(2):119-26. doi: 10.1111/josh.12007.
There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs.
In July to August 2010, 5 programs were identified. Semistructured, in-depth telephone interviews were conducted with program representatives about practical aspects of planning and implementation, including configuration and effectiveness.
Most programs offered HPV vaccine as part of a broader effort to increase uptake of adolescent vaccines. Respondents stressed the importance of building partnerships with local school systems throughout all aspects of the planning and implementation phases. All programs offered HPV vaccine at no cost to students. Most did not have a mechanism to bill private insurance, and some found Medicaid reimbursements to be a challenge. Programs achieved modest rates of initiation of the 3-dose HPV vaccine series (median 10%); however, among those who initiated the series, completion rates were high (median 78%). HPV vaccine uptake was lowest for a program that offered only HPV vaccine.
Extramural programs may increase uptake of vaccines and decrease absenteeism due to noncompliance with vaccine requirements for school entry. Until extramural programs in the US receive better access to billing private insurers and Medicaid, sustainability of these programs relies on grant funding. Better integration of extramural school-located vaccine programs with existing local healthcare and other programs at schools is an area for growth.
在美国没有健康中心（即校外项目）的学校提供人乳头瘤病毒（HPV）疫苗的校址疫苗接种计划，对此类计划的评估很少。本文总结了从这些计划中吸取的经验教训。
2010 年 7 月至 8 月，确定了 5 个项目。对项目代表进行了半结构化、深入的电话访谈，内容涉及规划和实施的实际方面，包括配置和效果。
大多数项目将 HPV 疫苗作为增加青少年疫苗接种率的更广泛努力的一部分。受访者强调了在规划和实施阶段的所有方面与当地学校系统建立伙伴关系的重要性。所有项目都为学生提供 HPV 疫苗，不收取任何费用。大多数项目没有向私人保险公司收费的机制，有些项目发现医疗补助报销存在挑战。大多数项目启动了 3 剂 HPV 疫苗系列接种（中位数为 10%），但在开始接种系列疫苗的人群中，完成率很高（中位数为 78%）。仅提供 HPV 疫苗的项目 HPV 疫苗接种率最低。
校外项目可能会增加疫苗接种率，并减少因不符合入学疫苗要求而导致的缺勤率。在美国，校外项目获得更好的私人保险公司和医疗补助报销渠道之前，这些项目的可持续性依赖于赠款资金。更好地将校外学校所在地疫苗接种计划与现有地方医疗保健和学校的其他计划整合是一个需要发展的领域。
