McRee Annie-Laurie, Maslow Gary R, Reiter Paul L
1 University of Minnesota, Minneapolis, MN, USA.
2 Duke University School of Medicine, Durham, NC, USA.
Clin Pediatr (Phila). 2017 May;56(5):451-460. doi: 10.1177/0009922816661330. Epub 2016 Jul 28.
We examined vaccination coverage among youth with special health care needs (YSHCN) using data from parents of adolescents (11-17 years) who responded to a statewide survey in 2010-2012 (n = 2156). Using a validated screening tool, we identified 29% of adolescents as YSHCN. Weighted multivariable logistic regression assessed associations between special health care needs and receipt of tetanus booster, meningococcal, and human papillomavirus (HPV) vaccines. Only 12% of youth had received all 3 vaccines, with greater coverage for individual vaccines (tetanus booster, 91%; meningococcal, 32%; HPV, 26%). YSHCN had greater odds of HPV vaccination than other youth (33% vs 23%, OR = 1.70, 95% CI = 1.16-2.50) but vaccination coverage was similar ( P ≥ .05) for other outcomes. In subgroup analyses, HPV vaccination also differed depending on the number and type of special health care needs identified. Findings highlight low levels of vaccination overall and missed opportunities to administer recommended vaccines among all youth, including YSHCN.
我们利用2010 - 2012年对全州范围内一项调查做出回应的青少年（11 - 17岁）家长的数据，研究了有特殊医疗需求的青少年（YSHCN）的疫苗接种覆盖率（n = 2156）。我们使用一种经过验证的筛查工具，确定29%的青少年为YSHCN。加权多变量逻辑回归评估了特殊医疗需求与破伤风加强疫苗、脑膜炎球菌疫苗和人乳头瘤病毒（HPV）疫苗接种之间的关联。只有12%的青少年接种了全部3种疫苗，个别疫苗的接种覆盖率更高（破伤风加强疫苗，91%；脑膜炎球菌疫苗，32%；HPV疫苗，26%）。YSHCN接种HPV疫苗的几率高于其他青少年（33%对23%，OR = 1.70，95%CI = 1.16 - 2.50），但其他疫苗接种结果的覆盖率相似（P≥0.05）。在亚组分析中，HPV疫苗接种情况也因所确定的特殊医疗需求的数量和类型而异。研究结果突出表明，包括YSHCN在内的所有青少年总体疫苗接种水平较低，且错过接种推荐疫苗的机会。
