Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
J Pediatr. 2021 Jul;234:149-157.e3. doi: 10.1016/j.jpeds.2021.03.002. Epub 2021 Mar 6.
To evaluate among pediatricians and family physicians human papillomavirus (HPV) vaccination recommendation practices for 11- to 12-year-old youth; report parental refusal/deferral of HPV vaccination; and report barriers to HPV vaccination changed over time.
We surveyed nationally representative networks of pediatricians and family physicians in 2008, 2010, 2013-2014, and 2018. Male vaccination questions were not asked in 2008; barriers and parental vaccine refusal questions were not asked in 2010.
Response rates were 80% in 2008 (680/848), 72% in 2010 (609/842), 70% in 2013-2014 (582/829), and 65% in 2018 (588/908). The proportion of physicians strongly recommending HPV vaccination for 11- to 12-year-old patients increased from 53% in 2008 to 79% in 2018 for female patients and from 48% in 2014 to 76% in 2018 for male patients (both P < .0001). The proportion of physicians indicating ≥50% of parents refused/deferred HPV vaccination remained steady for female patients (24% in 2008 vs 22% in 2018, P = .40) and decreased for male patients (42% in 2014 vs 28% in 2018, P < .001). Physician barriers to providing HPV vaccination were rare and decreased over time. Increasing numbers of physicians reported perceived parental barriers of vaccine safety concerns (5% "major barrier" in 2008 vs 35% in 2018, P < .0001) and moral/religious concerns (5% in 2008 vs 25% in 2018, P < .0001).
Between 2008 and 2018, more primary care physicians reported recommending HPV vaccination for adolescents, fewer reported barriers, and more physicians reported parents who had vaccine safety or moral/religious concerns.
评估儿科医生和家庭医生对 11 至 12 岁青少年接种人乳头瘤病毒（HPV）疫苗的推荐实践；报告父母拒绝/推迟 HPV 疫苗接种的情况；并报告 HPV 疫苗接种障碍随时间的变化。
我们于 2008 年、2010 年、2013-2014 年和 2018 年调查了全国代表性的儿科医生和家庭医生网络。2008 年未询问男性疫苗接种问题；2010 年未询问障碍和父母疫苗拒绝问题。
2008 年的回应率为 80%（680/848），2010 年为 72%（609/842），2013-2014 年为 70%（582/829），2018 年为 65%（588/908）。强烈建议为 11 至 12 岁患者接种 HPV 疫苗的医生比例从 2008 年的 53%增加到 2018 年的女性患者 79%和 2014 年的男性患者 48%增加到 2018 年的 76%（均 P<.0001）。表示≥50%的父母拒绝/推迟 HPV 疫苗接种的医生比例对女性患者保持稳定（2008 年为 24%，2018 年为 22%，P=.40），对男性患者下降（2014 年为 42%，2018 年为 28%，P<.001）。提供 HPV 疫苗接种的医生障碍很少，并且随着时间的推移而减少。越来越多的医生报告称，他们认为父母的疫苗安全问题（2008 年的 5%“主要障碍”与 2018 年的 35%，P<.0001）和道德/宗教问题（2008 年的 5%与 2018 年的 25%，P<.0001）是障碍。
2008 年至 2018 年间，越来越多的初级保健医生报告称推荐青少年接种 HPV 疫苗，报告的障碍减少，更多的医生报告称父母对疫苗安全性或道德/宗教问题存在担忧。
