Department of Health Services Administration, Xavier University, Cincinnati, OH 45207, USA.
Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
Vaccine. 2022 Feb 23;40(9):1352-1360. doi: 10.1016/j.vaccine.2021.12.039. Epub 2022 Jan 31.
To characterize counties in GA by quantifying administered doses of the HPV and Tdap vaccines collected by the state health department immunization registry and indicators of Health Department (HD) clinic access.
Using a cross sectional study design, secondary data were collected from public health data sources for the years 2016 to 2018 for 159 counties of Georgia. The study population was male and female adolescents aged 13-17. The number of administered HPV and Tdap vaccine doses were modeled in relation to number of private and public HD clinics, number of HD clinics registered in the VFC program and the availability of public transportation using Poisson regression, negative binomial regression, and Bayesian spatial analysis.
Choropleth maps showed similar clustering patterns between administered doses of the HPV vaccine and Tdap vaccine and increased counts of administered vaccine doses in counties with both public and private clinics. Administered doses of HPV and Tdap vaccines were found to exhibit spatial dependence across counties. Accounting for spatial dependence, the availability of public transit had a significant positive effect on administered HPV vaccine doses, while the number of private HD clinics had a significant positive effect on administered Tdap vaccine doses.
Maps at the county level show vaccination variability, clustering patterns and provide additional insights on the access to health care. Bayesian spatial models are needed to accurately identify and estimate factors associated with administering doses of the HPV and Tdap vaccines. Future work is needed to further examine the utilization of HPV vaccination services among urban groupings.
通过量化州卫生部门免疫登记处收集的 HPV 和 Tdap 疫苗接种剂量以及卫生部门（HD）诊所可及性的指标，对佐治亚州的县进行特征描述。
使用横断面研究设计，从 2016 年至 2018 年的公共卫生数据来源中收集佐治亚州 159 个县的二级数据。研究人群为 13-17 岁的男性和女性青少年。使用泊松回归、负二项回归和贝叶斯空间分析，将 HPV 和 Tdap 疫苗接种剂量数量与私人和公共 HD 诊所数量、登记在 VFC 计划中的 HD 诊所数量以及公共交通的可用性进行建模。
地域分布图显示 HPV 疫苗和 Tdap 疫苗接种剂量之间存在相似的聚类模式，并且在既有公共诊所又有私人诊所的县，接种疫苗的数量也有所增加。HPV 和 Tdap 疫苗的接种剂量在各县之间存在空间依赖性。考虑到空间依赖性，公共交通的可用性对 HPV 疫苗接种剂量有显著的正向影响，而私人 HD 诊所的数量对 Tdap 疫苗接种剂量有显著的正向影响。
县级地图显示了疫苗接种的可变性、聚类模式，并提供了有关医疗保健可及性的额外见解。需要贝叶斯空间模型来准确识别和估计与 HPV 和 Tdap 疫苗接种剂量相关的因素。未来需要进一步研究城市群体中 HPV 疫苗接种服务的利用情况。
