Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania.
J Adolesc Health. 2013 Oct;53(4):498-505. doi: 10.1016/j.jadohealth.2013.07.022.
Increases in adolescent vaccine coverage are needed. The aim of this study was to identify population-level clinical and demographic factors associated with adolescent vaccination.
A retrospective analysis of data from the Michigan Care Improvement Registry (MCIR), a statewide immunization registry, was performed for 2006-2010. The sample included 1,252,655 adolescents aged 11-18 years. Vaccine coverage levels were calculated for tetanus-diphtheria-acellular pertussis (Tdap), meningococcal conjugate (MCV4), flu (seasonal influenza), and human papillomavirus, females only (HPV) vaccines. For the subset of adolescents enrolled in Medicaid, claims data were used to obtain information about the type of visits in which vaccines were administered.
As of 2010, statewide coverage levels for Tdap and MCV4 vaccines were 46.0% and 46.5%, respectively whereas only 15% of females had completed the HPV vaccine series. Only one in four female adolescents were up to date for all three of these vaccines. Statewide coverage among adolescents for flu vaccine during the 2009-2010 season was 8%. Age was the most significant predictor of HPV vaccination, whereas health care-associated factors (provider type and childhood immunization history) were the strongest predictors for the other three vaccines. Older adolescents were less likely to have received the flu vaccine but more likely to have receive HPV vaccine doses than younger adolescents. Among Medicaid-enrolled adolescents, most Tdap, MCV, and first-dose HPV vaccines, but only 29% of flu doses, were administered during preventive visits.
Noted variability in adolescent vaccine coverage by age, vaccine type, and health care-associated factors provides a framework for developing future outreach activities to increase adolescent vaccine use.
需要提高青少年疫苗接种率。本研究旨在确定与青少年疫苗接种相关的人群水平临床和人口统计学因素。
对密歇根州免疫登记处（MCIR）的 2006-2010 年数据进行回顾性分析。该样本包括 1252655 名 11-18 岁的青少年。计算了破伤风、白喉和无细胞百日咳（Tdap）、脑膜炎球菌结合（MCV4）、流感（季节性流感）和仅女性的人乳头瘤病毒（HPV）疫苗的疫苗覆盖率。对于参加医疗补助计划的青少年亚组，索赔数据用于获取疫苗接种类型的信息。
截至 2010 年，全州 Tdap 和 MCV4 疫苗覆盖率分别为 46.0%和 46.5%，而只有 15%的女性完成了 HPV 疫苗系列接种。只有四分之一的女性青少年同时接种了这三种疫苗。在 2009-2010 年流感季节，全州青少年流感疫苗接种率为 8%。年龄是 HPV 疫苗接种的最重要预测因素，而与医疗保健相关的因素（提供者类型和儿童免疫史）是其他三种疫苗的最强预测因素。年龄较大的青少年不太可能接种流感疫苗，但更有可能接种 HPV 疫苗剂量，而年龄较小的青少年则不然。在参加医疗补助计划的青少年中，大多数 Tdap、MCV 和第一剂 HPV 疫苗，但只有 29%的流感疫苗，是在预防接种期间接种的。
按年龄、疫苗类型和与医疗保健相关的因素观察到的青少年疫苗覆盖率的变化为制定未来提高青少年疫苗使用的推广活动提供了框架。
