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为什么美国青少年人乳头瘤病毒疫苗接种率低?一项关于疫苗接种障碍的研究。

Why human papilloma virus vaccination coverage is low among adolescents in the US? A study of barriers for vaccination uptake.

作者信息

Sriram Shyamkumar, Ranganathan Radhika

机构信息

Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, USA.

出版信息

J Family Med Prim Care. 2019 Mar;8(3):866-870. doi: 10.4103/jfmpc.jfmpc_107_19.

Abstract

INTRODUCTION

Cervical cancer and Human papillomavirus (HPV) affects women, men, and children of all races, ethnicities, and backgrounds. The objective of this study is to examine the association between adolescent (13-17 years) HPV vaccination uptake and the key factors influencing the uptake rates of HPV vaccination.

MATERIALS AND METHODS

The 2016 NIS-Teen data, an annual survey conducted by the CDC to monitor vaccination uptake in the United States is used for this study. Multivariable logistic regression model was used to estimate the relationship between various factors and HPV vaccine uptake.

RESULTS

Male adolescents were 0.26 times less likely to get the HPV vaccines; adolescents covered by private health insurance were 0.18 times less likely to get HPV vaccines; Hispanic adolescents were 1.47 times more likely, adolescents from other races including Asians were 1.75 times more likely to get vaccinated for HPV compared to non-Hispanic white adolescents. Adolescents from the low-income families were 1.21 times more likely to get vaccinated for HPV; adolescents from North-eastern regions of the United States were 1.62 times more likely to get vaccinated; adolescents who were not recommended for vaccination by the family physicians were 0.43 times less likely to get HPV vaccination; adolescents who did not have any safety concerns and concerns about side effects were 3.24 times more likely to get the HPV vaccine; adolescents from households that did have not orthodox religious beliefs were 13.67 times more likely to get vaccinated.

CONCLUSIONS

Vaccination uptake rates are low for adolescents in the US and the results of this study identified important barriers which need to be addressed in order to improve vaccine uptake rates among the target groups which are less likely to get vaccinated. Also, knowing the sociodemographic and community level factors associated with HPV vaccination uptake status, health planners can better plan strategies to improve HPV vaccination in their local settings.

摘要

引言

宫颈癌和人乳头瘤病毒(HPV)影响着所有种族、民族和背景的女性、男性及儿童。本研究的目的是探讨青少年(13至17岁)HPV疫苗接种率与影响HPV疫苗接种率的关键因素之间的关联。

材料与方法

本研究使用了2016年美国国家免疫调查-青少年数据,这是美国疾病控制与预防中心开展的一项年度调查,用于监测美国的疫苗接种情况。采用多变量逻辑回归模型来估计各种因素与HPV疫苗接种之间的关系。

结果

男性青少年接种HPV疫苗的可能性比女性青少年低0.26倍;参加私人医疗保险的青少年接种HPV疫苗的可能性比未参保青少年低0.18倍;西班牙裔青少年接种HPV疫苗的可能性比非西班牙裔白人青少年高1.47倍,包括亚裔在内的其他种族青少年接种HPV疫苗的可能性比非西班牙裔白人青少年高1.75倍。来自低收入家庭的青少年接种HPV疫苗的可能性高1.21倍;来自美国东北部地区的青少年接种疫苗的可能性高1.62倍;未被家庭医生建议接种疫苗的青少年接种HPV疫苗的可能性低0.43倍;对疫苗安全性和副作用没有任何担忧的青少年接种HPV疫苗的可能性高3.24倍;来自没有正统宗教信仰家庭的青少年接种疫苗的可能性高13.67倍。

结论

美国青少年的疫苗接种率较低,本研究结果确定了一些重要障碍,为提高目标群体(即不太可能接种疫苗的群体)的疫苗接种率,这些障碍需要得到解决。此外,了解与HPV疫苗接种状况相关的社会人口统计学和社区层面因素后,卫生规划者可以更好地制定策略,以改善当地的HPV疫苗接种情况。

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