Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
Am J Prev Med. 2021 Apr;60(4):478-487. doi: 10.1016/j.amepre.2020.08.032. Epub 2020 Dec 24.
Human papillomavirus-vaccinated cohorts, irrespective of age, will likely reduce their subsequent screening requirements, thus opening opportunities for global cost reduction and program sustainability. The determinants of uptake and completion of a 3-dose human papillomavirus vaccination program by adult women in a European context were estimated.
This was an intervention study.
SETTING/PARTICIPANTS: Study participants were women aged 25-45 years, attending opportunistic or population-based cervical cancer screening in Belgium, Denmark, Finland, France, Germany, Slovenia, Spain, Sweden, and the United Kingdom between April 2016 and May 2018.
Study participants completed a questionnaire on awareness and attitudes on adult female human papillomavirus vaccination and were invited to receive free human papillomavirus vaccination.
Main outcome measures were acceptance, uptake, and completion of vaccination schedule. Determinants of vaccine uptake were explored using multilevel logistic models in 2019.
Among 3,646 participants, 2,748 (range by country=50%-96%) accepted vaccination, and 2,151 (range=30%-93%) received the full vaccination course. The factors associated with higher vaccine acceptance were previous awareness of adult female (OR=1.22, 95% CI=1.00, 1.48) and male (OR=1.59, 95% CI=1.28, 1.97) vaccination. Women in stable relationships (OR=0.56, 95% CI=0.45, 0.69) or with higher educational level (OR=0.76, 95% CI=0.63, 0.93) were more likely to refuse vaccination. Recruitment by postal invitation versus personal invitation from a healthcare professional resulted in lower vaccine acceptance (OR=0.13, 95% CI=0.02, 0.76). Vaccination coverage of >70% of adolescent girls in national public programs was of borderline significance in predicting human papillomavirus vaccine uptake (OR=3.23, 95% CI=0.95, 10.97). The main reasons for vaccine refusal were vaccine safety concerns (range=30%-59%) and the need for more information on human papillomavirus vaccines (range=1%-72%). No safety issues were experienced by vaccinated women.
Acceptance and schedule completion were largely dependent on recruitment method, achieved coverage of national vaccination programs, and personal relationship status. Knowledge of benefits and safety reassurance may be critical to expanding vaccination target ages. Study results suggest that there are no major opinion barriers in adult women to human papillomavirus vaccination, especially when vaccination is offered face to face in healthcare settings.
EudraCT Number 2014-003177-42.
无论年龄大小，接种人乳头瘤病毒疫苗的人群都可能会减少后续的筛查需求，从而为全球降低成本和保持项目可持续性提供机会。本研究旨在评估欧洲背景下，成年女性接种 3 剂人乳头瘤病毒疫苗的接种率和完成率的决定因素。
这是一项干预研究。
地点/参与者：研究对象为年龄在 25-45 岁之间，于 2016 年 4 月至 2018 年 5 月在比利时、丹麦、芬兰、法国、德国、斯洛文尼亚、西班牙、瑞典和英国接受机会性或人群为基础的宫颈癌筛查的女性。
研究参与者完成了一份关于成年女性人乳头瘤病毒疫苗接种意识和态度的问卷，并被邀请接受免费的人乳头瘤病毒疫苗接种。
主要观察指标为接种的接受率、接种率和接种完成率。2019 年，采用多水平逻辑模型探讨了疫苗接种率的决定因素。
在 3646 名参与者中，2748 名（各国范围为 50%-96%）接受了疫苗接种，2151 名（范围为 30%-93%）完成了全程疫苗接种。更高的疫苗接种接受率与之前对成年女性（OR=1.22，95%CI=1.00，1.48）和男性（OR=1.59，95%CI=1.28，1.97）疫苗接种的认识有关。处于稳定关系（OR=0.56，95%CI=0.45，0.69）或具有更高教育水平（OR=0.76，95%CI=0.63，0.93）的女性更有可能拒绝接种疫苗。通过邮政邀请与通过医疗保健专业人员的个人邀请进行招募会导致疫苗接种接受率降低（OR=0.13，95%CI=0.02，0.76）。国家公共计划中青少年女孩接种率>70%对人乳头瘤病毒疫苗接种有一定的预测作用（OR=3.23，95%CI=0.95，10.97）。疫苗接种的主要拒绝原因是疫苗安全性问题（范围 30%-59%）和对人乳头瘤病毒疫苗更多信息的需求（范围 1%-72%）。接种疫苗的女性没有出现任何安全问题。
接受和完成接种计划在很大程度上取决于招募方法、国家疫苗接种计划的实施程度以及个人的关系状况。对益处和安全性的了解可能对扩大疫苗接种目标年龄至关重要。研究结果表明，成年女性对人乳头瘤病毒疫苗接种没有主要的意见障碍，特别是当面对面在医疗保健环境中提供疫苗接种时。
EudraCT 编号 2014-003177-42。
