Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329-4027, USA; Synergy America, Inc., 6340 Sugarloaf Parkway, Suite 200, Duluth, GA 30097, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329-4027, USA.
Vaccine. 2018 May 3;36(19):2567-2573. doi: 10.1016/j.vaccine.2018.03.083. Epub 2018 Apr 9.
Human papillomavirus (HPV) vaccination has been routinely recommended at age 11-12 years in the United States for females since 2006 and males since 2011. Coverage can be estimated using self/parent-reported HPV vaccination collected in the National Health and Nutrition Examination Survey (NHANES) for a wider age range than other national surveys. We assessed vaccination coverage in 2015-2016, temporal trends by age, and the validity of self/parent-reported vaccination status.
Participants aged 9-59 years completed an interview collecting demographic and vaccination information. Weighted coverage was estimated for two-year NHANES cycles by age group for 2007-2008 to 2015-2016 for females (N = 14318) and 2011-2012 to 2015-2016 for males (N = 7847). Temporal trends in coverage were assessed from 2007-2008 to 2011-2012 for females and from 2011-2012 to 2015-2016 for both sexes. Sensitivity and specificity of self/parent-reported vaccination were assessed using provider-verified vaccination records from a pilot study in 14-29 year-olds.
In 2015-2016, ≥1 dose coverage among females was highest in 14-19 (54.7%) and 20-24 (56.0%) year-olds and lower in successively older age groups. Among males, ≥1 dose coverage was highest in 14-19 year-olds (39.5%) and lower at older ages. Coverage was similar in 9-13 year-old females and males. Between 2007-2008 and 2011-2012, there were increases among females younger than 30 years. Between 2011-2012 and 2015-2016, there were increases among female age groups including 20-39 year-olds; male coverage increased among ages 9-13, 14-19, and 20-24 years. Self/parent-reported receipt of ≥1 dose had a sensitivity and specificity of 87.0% and 83.3%. Performance was lower for 3 doses.
While overall HPV vaccination coverage remains low, it is higher in females than males, except in 9-13 year-olds. There have been increases in coverage among many age groups, but coverage has stalled in younger females. Adequate validity was demonstrated for self/parent-reported vaccination of ≥1 dose, but not 3 doses, in a pilot study.
自 2006 年以来，美国已将 HPV 疫苗接种常规推荐给 11-12 岁的女性，自 2011 年以来推荐给 11-12 岁的男性。可以使用全国健康和营养检查调查（NHANES）中自我/父母报告的 HPV 疫苗接种情况来估计接种率，其涵盖的年龄范围比其他国家调查更广。我们评估了 2015-2016 年的接种率、按年龄的时间趋势以及自我/父母报告的疫苗接种状况的有效性。
9-59 岁的参与者完成了一项访谈，收集了人口统计学和疫苗接种信息。对于女性（N=14318），2007-2008 至 2015-2016 年和男性（N=7847），2011-2012 至 2015-2016 年，根据年龄组对两年一次的 NHANES 周期进行了加权覆盖估计。从 2007-2008 年到 2011-2012 年，对女性的接种率进行了时间趋势评估，从 2011-2012 年到 2015-2016 年，对男女均进行了时间趋势评估。在 14-29 岁的试点研究中，使用提供者核实的疫苗接种记录评估了自我/父母报告的疫苗接种的敏感性和特异性。
在 2015-2016 年，14-19 岁（54.7%）和 20-24 岁（56.0%）女性的≥1 剂接种率最高，而年龄较大的女性接种率较低。在男性中，≥1 剂接种率在 14-19 岁的最高（39.5%），年龄较大的接种率较低。9-13 岁的女性和男性接种率相似。在 2007-2008 年至 2011-2012 年期间，30 岁以下女性的接种率有所增加。在 2011-2012 年至 2015-2016 年期间，包括 20-39 岁女性在内的各个年龄段的接种率均有所增加；9-13 岁、14-19 岁和 20-24 岁的男性接种率增加。自我/父母报告的≥1 剂接种的敏感性和特异性分别为 87.0%和 83.3%。对于 3 剂，性能较低。
尽管 HPV 疫苗接种的总体覆盖率仍然较低，但女性的覆盖率高于男性，9-13 岁的女性除外。许多年龄组的接种率有所增加，但年轻女性的接种率停滞不前。在试点研究中，自我/父母报告的≥1 剂接种具有足够的有效性，但 3 剂接种的有效性则不足。
