Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts; and
Division of Pharmacoepidemiology and Pharmacoeconomics, Departments of Medicine and.
Pediatrics. 2020 Oct;146(4). doi: 10.1542/peds.2019-3557. Epub 2020 Sep 14.
The human papillomavirus (HPV) vaccine was recommended in 2006 for girls and in 2011 for boys. The Healthy People 2020 goal for 2-dose HPV vaccination coverage is 80% by age 15 for girls and boys. We used nationwide population-based data to describe trends in HPV vaccination in children.
We conducted a cohort study nested within the MarketScan health care database between January 2003 and December 2017. Children were followed from the year they turned 9 until HPV vaccination, insurance disenrollment, or the end of the year when they turned 17, whichever came first. We estimated the cumulative incidence of at least 1- and 2-dose HPV vaccination, stratified by birth year, sex, and state. In secondary analyses, we evaluated the association between state-level vaccination policies and HPV vaccination coverage.
This study included 7 837 480 children and 19.8 million person-years. The proportion of 15-year-old girls and boys with at least a 1-dose HPV vaccination increased from 38% and 5% in 2011 to 57% and 51% in 2017, respectively; the proportion with at least a 2-dose vaccination went from 30% and 2% in 2011 to 46% and 39% in 2017, respectively. By 2017, 2-dose HPV vaccination coverage varied from 80% in Washington, District of Columbia, among girls to 15% in Mississippi among boys and was positively correlated with legislation for HPV vaccine education and pediatrician availability.
Despite the increasing trends in uptake, HPV vaccine coverage among commercially insured children in the United States remains behind target levels, with substantial disparities by state.
人乳头瘤病毒（HPV）疫苗于 2006 年推荐给女孩，2011 年推荐给男孩。“健康人民 2020 年”目标是到 2020 年，9-15 岁女孩和男孩 HPV 疫苗接种率达到 80%。我们使用全国性基于人群的数据来描述儿童 HPV 疫苗接种的趋势。
我们在 2003 年 1 月至 2017 年 12 月期间，在 MarketScan 健康护理数据库中进行了一项嵌套队列研究。儿童从年满 9 岁开始进行随访，直到接种 HPV 疫苗、保险退保或年满 17 岁的当年年底，以先到者为准。我们按出生年份、性别和州分层，估计至少接种 1 剂和 2 剂 HPV 疫苗的累积发病率。在二次分析中，我们评估了州级疫苗接种政策与 HPV 疫苗接种覆盖率之间的关系。
这项研究纳入了 7837480 名儿童和 1980 万人年。2011 年，15 岁女孩和男孩中至少接种 1 剂 HPV 疫苗的比例分别从 38%和 5%增加到 57%和 51%；至少接种 2 剂 HPV 疫苗的比例分别从 30%和 2%增加到 46%和 39%。到 2017 年，女孩 HPV 疫苗接种率从华盛顿特区的 80%到密西西比州的 15%不等，男孩接种率从 2%到 20%不等，与 HPV 疫苗教育立法和儿科医生可及性呈正相关。
尽管接种率呈上升趋势，但美国商业保险儿童 HPV 疫苗接种覆盖率仍低于目标水平，各州之间存在显著差异。
