Desiante F, Russo C, Giorgino A, Caputi G, Battista T, Cipriani R, Conversano M
Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy.
Italian Society of Hygiene, Preventive Medicine and Public Health (SItI), Vaccine Strategies Apulian Working Group.
J Prev Med Hyg. 2017 Sep;58(3):E225-E230.
A promising approach to increase teenager's adherence to immunization against HPV is the administration of vaccinations within the school facilities. The Local Health Unit of Taranto experienced two different vaccine strategy proposals in the twelve-year-olds: the first one was the usual active call strategy in the outpatient clinic, while the second one provided the involvement of the schools in the area. The aim of the study is to evaluate the results of the proposed vaccination strategies in both sexes and in towns of different sizes in order to identify an effective path for achieving vaccine coverage improvement.
To estimate the number of anti-HPV vaccine doses administered in adolescents of the 2003 cohort, we used the computerized vaccination system data of the Apulia Region. Then, once analyzed, the data for anti-HPV vaccine were broken down by gender, vaccine strategy and size of the town of residence. Analyses performed by using STATA SE 14.
The multiple logistic regression points out that, females (OR = 3.2; p < 0.01), living in small towns (OR = 1.3; p < 0.01) and school vaccination strategy (OR = 2; p < 0.01) increase the likelihood of completing the anti-HPV vaccine cycle in adolescents. The comparative assessment of anti-HPV coverage strategies, suggests that school vaccination has resulted in significantly better outcomes than outpatient clinic one, for all the groups considered (overall 72.3% vs 55.6%).
The involvement of school institutes can define a winning organizational model to get a wider adolescent's adherence to immunization programs, especially in bigger towns. The school vaccination strategy could improve anti-HPV vaccine adherence also in males, who perceives a lower HPV-related diseases risk than females.
在学校设施内进行疫苗接种是提高青少年对人乳头瘤病毒（HPV）免疫接种依从性的一种有前景的方法。塔兰托地方卫生单位在12岁儿童中经历了两种不同的疫苗接种策略方案：第一种是门诊诊所常见的主动宣传策略，而第二种则让该地区的学校参与其中。本研究的目的是评估所提议的疫苗接种策略在不同性别和不同规模城镇中的效果，以确定提高疫苗接种覆盖率的有效途径。
为了估计2003年出生队列青少年中抗HPV疫苗的接种剂量数量，我们使用了普利亚地区的计算机化疫苗接种系统数据。然后，一旦对数据进行分析，抗HPV疫苗的数据就会按性别、疫苗接种策略和居住城镇规模进行分类。使用STATA SE 14进行分析。
多元逻辑回归指出，女性（比值比[OR]=3.2；p<0.01）、居住在小城镇（OR=1.3；p<0.01）以及采用学校疫苗接种策略（OR=2；p<0.01）会增加青少年完成抗HPV疫苗接种周期的可能性。对抗HPV疫苗接种覆盖率策略的比较评估表明，对于所有考虑的群体而言，学校疫苗接种的效果明显优于门诊诊所疫苗接种（总体为72.3%对55.6%）。
学校机构的参与可以确定一种成功的组织模式，以提高青少年对免疫计划的依从性，尤其是在较大的城镇。学校疫苗接种策略还可以提高男性对抗HPV疫苗的依从性，男性认为与HPV相关疾病的风险低于女性。
