Hechter Rulin C, Chao Chun R, Sidell Margo A, Sy Lina S, Ackerson Bradley K, Slezak Jeff M, Patel Nilesh J, Tseng Hung Fu, Jacobsen Steven J
Rulin C. Hechter, Chun R. Chao, Margo A. Sidell, Lina S. Sy, Jeff M. Slezak, Hung Fu Tseng, and Steven J. Jacobsen are with the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA. Bradley K. Ackerson is with the Department of Pediatrics, South Bay Medical Center, Harbor City, CA. Nilesh J. Patel is with the Department of Pediatrics, Los Angeles Medical Center, Los Angeles, CA.
Am J Public Health. 2015 Dec;105(12):2549-56. doi: 10.2105/AJPH.2015.302840. Epub 2015 Oct 15.
We examined the trends and correlates of quadrivalent human papillomavirus vaccine (HPV4) initiation in insured boys during the periods before and after routine use recommendation.
We grouped data from electronic medical records of boys aged 9 to 17 years from the Kaiser Permanente Southern California prepaid health plan into 3 open cohorts: permissive use: 2009 to 2010; anal cancer indication added: 2010 to 2011; and routine use: 2011 to 2013. We estimated adjusted risk ratios (ARRs) between demographics and vaccination initiation using Poisson regression.
HPV4 initiation increased across cohorts--1.6%, 3.4%, and 18.5%--with the greatest increase among boys aged 11 to 12 years in cohort 3. Initiation was associated with receiving influenza vaccination in the previous year in all cohorts (cohort 3: ARR = 1.48; 95% confidence interval [CI] = 1.46, 1.51) and with non-White race/ethnicity following routine recommendation (cohort 3, non-Hispanic Black: ARR = 1.18; 95% CI = 1.08, 1.30; Hispanic: ARR = 1.23; 95% CI = 1.17, 1.29; Asian/Pacific Islanders: ARR = 1.16; 95% CI = 1.11, 1.20).
Routine use recommendation increased the uptake of HPV4 in boys. System-level interventions to encourage providers to routinely recommend HPV4 vaccination may help increase HPV4 uptake in boys.
我们研究了在四价人乳头瘤病毒疫苗（HPV4）常规使用建议前后，参保男孩开始接种该疫苗的趋势及其相关因素。
我们将来自南加州凯撒医疗集团预付费健康计划中9至17岁男孩电子病历的数据分为3个开放队列：允许使用阶段：2009年至2010年；增加肛门癌适应症阶段：2010年至2011年；常规使用阶段：2011年至2013年。我们使用泊松回归估计人口统计学特征与疫苗接种起始之间的调整风险比（ARR）。
各队列中HPV4起始接种率均有所上升，分别为1.6%、3.4%和18.5%，其中队列3中11至12岁男孩的接种率增幅最大。在所有队列中，前一年接种流感疫苗与起始接种HPV4相关（队列3：ARR = 1.48；95%置信区间[CI] = 1.46，1.51），在常规建议发布后，非白人种族/族裔与起始接种相关（队列3，非西班牙裔黑人：ARR = 1.18；95% CI = 1.08，1.30；西班牙裔：ARR = 1.23；95% CI = 1.17，1.29；亚裔/太平洋岛民：ARR = 1.16；95% CI = 1.11，1.20）。
常规使用建议提高了男孩对HPV4的接种率。鼓励医护人员常规推荐HPV4疫苗接种的系统层面干预措施，可能有助于提高男孩对HPV4的接种率。
