人乳头瘤病毒（HPV）疫苗在青春期到成年期的过渡接种。
Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood.
机构信息
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA; UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Drive South Drive, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
UCLA Arthur Ashe Student Health & Wellness Center, University of California, Los Angeles, 221 Westwood Plaza, Los Angeles, CA 90095, USA.
出版信息
Vaccine. 2021 Jun 8;39(25):3435-3444. doi: 10.1016/j.vaccine.2021.04.019. Epub 2021 May 13.
PURPOSE
Young adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch-up vaccination is currently recommended up through age 26, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university.
METHODS
We conducted semi-structured interviews (n = 27) and four focus groups with female and male undergraduate and graduate students (n = 18) and semi-structured interviews with health care providers (n = 6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination.
RESULTS
Many young adults cited their parents' views and recommendations from medical providers as influential on their decision-making process. Students perceived that cervical cancer prevention was a main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine's benefits for males and expressed some concerns about the safety and side effects of a vaccine perceived as new. Logistical barriers to vaccination included uncertainty over vaccination status and insurance coverage for the vaccine, and concerns about balancing the vaccine schedule with school obligations. Providers' vaccine recommendations were impacted by health system factors, including clinical infrastructure, processes for recommending and documenting vaccination, and office visit priorities. Suggested vaccination promotion strategies included improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure.
CONCLUSIONS
Although college may be an opportune time to reach young adults for HPV vaccination, obstacles including navigating parental influence and independent decision-making, lack of awareness of vaccination status, and numerous logistical and system-level barriers may impede vaccination during this time.
目的
青年期的特点是医疗决策、保险覆盖范围和性风险的变化。虽然人乳头瘤病毒（HPV）疫苗现在已获准用于 45 岁以下的成年人，并且目前建议在 26 岁之前补种疫苗，但年轻人的疫苗接种率仍然很低。本研究探讨了在一所大型公立大学学生健康中心接受护理的年轻人对 HPV 疫苗接种的看法。
方法
我们对 27 名女性和男性本科生和研究生（n=18）进行了半结构化访谈和 4 次焦点小组讨论，对医疗保健提供者（n=6）进行了半结构化访谈。访谈和焦点小组探讨了对 HPV 感染风险的看法、HPV 疫苗的益处，以及 HPV 疫苗接种的动机和障碍。
结果
许多年轻人表示，父母的观点和医疗服务提供者的建议对他们的决策过程有影响。学生们认为，预防宫颈癌是 HPV 疫苗的主要益处，而性活动是 HPV 感染的风险因素。学生们通常缺乏关于疫苗对男性益处的知识，并对被认为是新的疫苗的安全性和副作用表示一些担忧。接种疫苗的实际障碍包括对疫苗接种状况和疫苗保险的不确定性，以及担心疫苗接种时间表与学校义务之间的平衡。疫苗接种建议受到卫生系统因素的影响，包括临床基础设施、推荐和记录疫苗接种的流程以及就诊优先级。建议的疫苗接种推广策略包括改善校园外展工作的时间安排和信息传递，并加强临床基础设施。
结论
尽管大学可能是为年轻人接种 HPV 疫苗的一个合适时机，但包括父母影响和独立决策、缺乏疫苗接种状况的认识、以及众多实际和系统层面的障碍等障碍可能会阻碍这个时期的疫苗接种。
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