利用退伍军人事务医疗中心(VAMC)的数据来确定 HPV 疫苗接种的错失机会。
Using Veterans Affairs Medical Center (VAMC) data to identify missed opportunities for HPV vaccination.
机构信息
a James J Peters VA Medical Center , Bronx , NY , USA.
b Icahn School of Medicine at Mount Sinai , New York , NY , USA.
出版信息
Hum Vaccin Immunother. 2019;15(7-8):1878-1883. doi: 10.1080/21645515.2018.1559684. Epub 2019 Feb 20.
Despite high HPV prevalence and low vaccination rates in the military, HPV vaccination is not required upon military service initiation. Given that national HPV vaccination rates remain low among people age 19-26 years, military service may represent an opportune time for intervention. The purpose of this study was to quantify the rate of HPV vaccination among young patients entering primary care at a single Veterans Affairs Medical Center (VAMC). Vaccination rates among veterans age ≤ 26 years old at first primary care visit were identified from the institutional data warehouse. Among 1,258 eligible patients, most were male (n = 782). The HPV vaccine initiation rate was 21.2%. Overall, 10.4% of patients received at least 1 HPV vaccine prior to initiating care at the VA (25.2% females and 1.4% males). An additional 10.8% of patients received their first HPV vaccine upon initiating care at the VA. Median age of first HPV vaccination was 21.4 years among patients that initiated the vaccine in the military versus 24.8 years among those that initiated vaccination at the VA. In conclusion, this study demonstrated low HPV vaccination rates both prior to transitioning to VA primary care and once receiving care at the VA. Additionally, among veterans that had not received vaccination upon initiating care at the VA, older age at vaccination was observed. Older age at vaccination may reduce HPV vaccine effectiveness given higher risk of exposure. Addition of HPV to the list of mandated vaccines upon military service initiation should be considered.
尽管军队中的 HPV 感染率很高,疫苗接种率却很低,但在开始兵役时并不要求接种 HPV 疫苗。鉴于全国范围内 19-26 岁人群的 HPV 疫苗接种率仍然很低,军队服役可能是一个进行干预的合适时机。本研究的目的是量化在一家退伍军人事务医疗中心(VAMC)接受初级保健的年轻患者中 HPV 疫苗接种率。从机构数据仓库中确定了在首次接受初级保健时年龄≤26 岁的退伍军人的疫苗接种率。在 1258 名符合条件的患者中,大多数是男性(n=782)。HPV 疫苗接种启动率为 21.2%。总体而言,在开始接受 VA 护理之前,有 10.4%的患者至少接种了 1 剂 HPV 疫苗(女性为 25.2%,男性为 1.4%)。另有 10.8%的患者在开始接受 VA 护理时首次接种了 HPV 疫苗。在开始接种疫苗的患者中,中位数年龄为 21.4 岁,在开始在 VA 接受护理的患者中,中位数年龄为 24.8 岁。总之,本研究表明,在过渡到 VA 初级保健之前和开始在 VA 接受护理时,HPV 疫苗接种率都很低。此外,在那些开始在 VA 接受护理时未接种疫苗的退伍军人中,观察到接种疫苗的年龄较大。接种疫苗的年龄较大可能会降低 HPV 疫苗的有效性,因为暴露的风险更高。应该考虑在兵役开始时将 HPV 添加到强制性疫苗清单中。