Rachel C. Potter and Patricia A. Vranesich are with the Michigan Department of Community Health, Division of Immunizations, Lansing. Stefanie F. DeVita is with the University of Michigan School of Public Health, Ann Arbor. Matthew L. Boulton is with the University of Michigan School of Public Health and University of Michigan School of Medicine.
Am J Public Health. 2014 Aug;104(8):1526-33. doi: 10.2105/AJPH.2014.301910. Epub 2014 Jun 12.
We examined the effect of Michigan's new school rules and vaccine coadministration on time to completion of all the school-required vaccine series, the individual adolescent vaccines newly required for sixth grade in 2010, and initiation of the human papillomavirus (HPV) vaccine series, which was recommended but not required for girls.
Data were derived from the Michigan Care Improvement Registry, a statewide Immunization Information System. We assessed the immunization status of Michigan children enrolled in sixth grade in 2009 or 2010. We used univariable and multivariable Cox regression models to identify significant associations between each factor and school completeness.
Enrollment in sixth grade in 2010 and coadministration of adolescent vaccines at the first adolescent visit were significantly associated with completion of the vaccines required for Michigan's sixth graders. Children enrolled in sixth grade in 2010 had higher coverage with the newly required adolescent vaccines by age 13 years than did sixth graders in 2009, but there was little difference in the rate of HPV vaccine initiation among girls.
Education and outreach efforts, particularly regarding the importance and benefits of coadministration of all recommended vaccines in adolescents, should be directed toward health care providers, parents, and adolescents.
我们研究了密歇根州新的学校规定和疫苗同时接种对完成所有学校要求的疫苗系列、2010 年六年级新要求的个别青少年疫苗以及人乳头瘤病毒（HPV）疫苗系列接种的影响，HPV 疫苗系列推荐但不要求女孩接种。
数据来自密歇根州免疫信息系统，即全州范围的医疗改善登记处。我们评估了 2009 年或 2010 年入读六年级的密歇根州儿童的免疫状况。我们使用单变量和多变量 Cox 回归模型来确定每个因素与学校完成情况之间的显著关联。
2010 年入读六年级和首次青少年就诊时同时接种青少年疫苗与完成密歇根州六年级学生所需疫苗的接种显著相关。2010 年入读六年级的儿童在 13 岁时，新要求的青少年疫苗接种覆盖率高于 2009 年的六年级学生，但女孩 HPV 疫苗接种启动率差异不大。
应针对医疗保健提供者、家长和青少年开展教育和宣传工作，特别是关于同时接种所有推荐青少年疫苗的重要性和益处。
