Baylor College of Medicine, United States.
Department of Medical Education, Dell Medical School at The University of Texas at Austin, United States.
Vaccine. 2020 May 22;38(25):4119-4124. doi: 10.1016/j.vaccine.2020.03.059. Epub 2020 Apr 27.
HPV vaccination rates remain low in the United States despite efforts to increase them, although rates vary geographically both at the state and regional level within the United States. This study examines differences in teen HPV vaccination rates and associated sociodemographic factors among six regions in Texas to understand potential variation insmaller regions. These differences may inform planning of local public health interventions aimed at increasing vaccination uptake in teens.
We analyzed sociodemographic and vaccination data for a total of 2256 teens 13-17 years old from six regions in Texas using the 2017 National Immunization Survey--Teen (NIS-Teen). We used survey-weighted chi-squared tests to compare demographic characteristics and HPV vaccination initiation and series completion across regions and multivariable robust Poisson regression models to examine the association between region of residence and HPV vaccination outcomes.
Rates of initiation and completion of the HPV vaccine series varied significantly between six regions in Texas and were both highest in El Paso County and lowest in Dallas County (initiation 82.8% vs52.5%, P < 0.001; completion 51.3% vs 30.2%, P < 0.001). Adjusted multivariable log binomial regression models demonstrated that teens in Dallas county were significantly less likely to initiate the HPV vaccine series than teens in Travis county (RR = 0.79, 95% CI: (0.65, 0.95), P = 0.01).
HPV vaccination uptake varied significantly between six regions in Texas, highlighting the importance of closely examining local regions in public health planning efforts. Intervention efforts should consider the variation in sociodemographic characteristics as well as policy at the regional level to best improve vaccination rates in communities across the nation.
尽管美国一直在努力提高 HPV 疫苗接种率，但接种率仍然很低，而且在美国各州和地区层面上，接种率存在地域差异。本研究旨在分析德克萨斯州六个地区青少年 HPV 疫苗接种率的差异及其相关社会人口学因素，以了解较小地区的潜在差异。这些差异可能为规划旨在提高青少年疫苗接种率的地方公共卫生干预措施提供信息。
我们使用 2017 年全国免疫调查-青少年（NIS-Teen）的数据，对来自德克萨斯州六个地区的 2256 名 13-17 岁青少年的社会人口学和疫苗接种数据进行了分析。我们使用加权卡方检验比较了六个地区的人口统计学特征以及 HPV 疫苗接种起始率和系列完成率，使用多变量稳健泊松回归模型检验了居住地与 HPV 疫苗接种结果之间的关系。
德克萨斯州六个地区 HPV 疫苗接种起始率和完成率差异显著，埃尔帕索县最高（起始率 82.8%，完成率 51.3%），达拉斯县最低（起始率 52.5%，完成率 30.2%）（均 P<0.001）。调整后的多变量对数二项式回归模型显示，达拉斯县青少年接种 HPV 疫苗系列的可能性明显低于特拉维斯县青少年（RR=0.79，95%CI：0.65，0.95），P=0.01）。
德克萨斯州六个地区 HPV 疫苗接种率差异显著，这突出表明在公共卫生规划工作中仔细检查地方区域非常重要。干预措施应考虑社会人口学特征以及区域层面的政策差异，以最大限度地提高全国社区的疫苗接种率。
