Burdette Amy M, Webb Noah S, Hill Terrence D, Jokinen-Gordon Hanna
Department of Sociology and Pepper Institute for Aging and Public Policy, Florida State University, USA.
Department of Sociology and Pepper Institute for Aging and Public Policy, Florida State University, USA.
Public Health. 2017 Jan;142:167-176. doi: 10.1016/j.puhe.2016.07.009. Epub 2016 Sep 1.
Although racial and ethnic differences in HPV vaccination initiation are well established, it is unclear whether these disparities have changed over time. The role of health provider recommendations in reducing any racial and ethnic inequalities is also uncertain. This study addresses these gaps in the literature.
Repeated cross-sectional design.
Using data from the National Immunization Survey-Teen (2008-2013), we estimated a series of binary logistic regressions to model race-specific trends in (1) provider recommendations to vaccinate against HPV and (2) HPV vaccine initiation for males (n = 56,632) and females (n = 77,389).
Provider recommendations to vaccinate and HPV vaccination uptake have increased over time for adolescent males and females and across all racial and ethnic groups. Among girls, minority youths have seen a sharper increase in provider recommendations and HPV vaccination uptake than their White counterparts. Among boys, minority teens maintain higher overall rates of HPV vaccine uptake, however, Hispanics have lagged behind non-Hispanic Whites in the rate of increase in provider recommendations and HPV vaccinations.
Our results suggest that racial and ethnic disparities in provider recommendations and HPV vaccinations have waned over time among males and females. While these trends are welcomed, additional interventions are warranted to increase overall rates of vaccination across race, ethnicity, and gender.
尽管人乳头瘤病毒（HPV）疫苗接种起始方面的种族和民族差异已得到充分证实，但尚不清楚这些差异是否随时间发生了变化。医疗服务提供者的建议在减少任何种族和民族不平等方面的作用也不确定。本研究填补了文献中的这些空白。
重复横断面设计。
利用国家青少年免疫调查（2008 - 2013年）的数据，我们估计了一系列二元逻辑回归模型，以模拟针对男性（n = 56,632）和女性（n = 77,389）的以下情况的种族特异性趋势：（1）医疗服务提供者建议接种HPV疫苗；（2）HPV疫苗接种起始情况。
随着时间的推移，青少年男性和女性以及所有种族和民族群体中，医疗服务提供者建议接种疫苗的比例和HPV疫苗接种率都有所上升。在女孩中，少数族裔青少年医疗服务提供者建议接种疫苗的比例和HPV疫苗接种率的增长幅度高于白人同龄人。在男孩中，少数族裔青少年的HPV疫苗总体接种率较高，然而，西班牙裔在医疗服务提供者建议接种疫苗的比例和HPV疫苗接种率的增长速度上落后于非西班牙裔白人。
我们的结果表明，随着时间的推移，男性和女性在医疗服务提供者建议接种疫苗和HPV疫苗接种方面的种族和民族差异已经减弱。虽然这些趋势是值得欢迎的，但仍需要额外的干预措施来提高不同种族、民族和性别的总体疫苗接种率。
