Yiu Yin, Fayson Shannon, Smith Holly, Matrka Laura
1 Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Ann Otol Rhinol Laryngol. 2019 Apr;128(4):309-315. doi: 10.1177/0003489418821695. Epub 2018 Dec 29.
: To investigate vaccine compliance and clinical outcomes after implementation of an initiative to provide the human papillomavirus (HPV) vaccine to all patients with recurrent respiratory papillomatosis (RRP).
: A retrospective review was performed of all adult patients treated for RRP from 2012 to 2017. Rates of HPV vaccination were evaluated before and after December 2015, when a program was established to increase compliance by educating patients and providing financial assistance toward vaccine administration. Paired sample analyses were conducted to compare intersurgical intervals (ISIs) and number of procedures per year pre- and post-vaccination.
: Fourteen patients with RRP completed the HPV vaccine series, with 11 patients undergoing vaccination after the initiative began. The pre-initiative vaccination rate of all patients with RRP was 9.7%; post-initiative rates improved to 43.8% ( P = .004; odds ratio, 7.26). Of vaccinated patients, there were significant differences between mean pre-vaccine ISI (3.5 months) and post-vaccine ISI (12.8 months; P = .0021), as well as between number of surgical procedures performed per year before and after vaccination (2.7 vs 0.81; P = .014). After vaccination, 5 patients demonstrated no evidence of papilloma regrowth for >12 months.
: Initiatives focused on patient education and financial support can successfully boost HPV vaccination rates in an RRP patient cohort. Our research mirrors prior findings that HPV vaccination is correlated with an increase in time between procedures and a decrease in number of procedures needed per year-factors that can dramatically reduce the disease burden on patients coping with RRP.
调查实施一项向所有复发性呼吸道乳头状瘤病（RRP）患者提供人乳头瘤病毒（HPV）疫苗的倡议后的疫苗接种依从性和临床结果。
对2012年至2017年期间接受RRP治疗的所有成年患者进行回顾性研究。评估2015年12月之前和之后的HPV疫苗接种率，当时设立了一个项目，通过对患者进行教育并为疫苗接种提供经济援助来提高依从性。进行配对样本分析以比较疫苗接种前后的手术间隔时间（ISI）和每年的手术次数。
14例RRP患者完成了HPV疫苗系列接种，其中11例患者在该倡议开始后接种。所有RRP患者在倡议前的疫苗接种率为9.7%；倡议后的接种率提高到43.8%（P = 0.004；优势比，7.26）。在接种疫苗的患者中，疫苗接种前的平均ISI（3.5个月）与疫苗接种后的平均ISI（12.8个月；P = 0.0021）之间存在显著差异，疫苗接种前后每年进行的手术次数也存在显著差异（2.7次对0.81次；P = 0.014）。接种疫苗后，5例患者在超过12个月的时间里没有乳头状瘤再生的迹象。
专注于患者教育和经济支持的倡议可以成功提高RRP患者队列中的HPV疫苗接种率。我们的研究反映了先前的研究结果，即HPV疫苗接种与手术间隔时间的增加和每年所需手术次数的减少相关，这些因素可以显著减轻RRP患者的疾病负担。
