Department of Health Services Administration, Xavier University, Cincinnati, OH.
Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
Ann Epidemiol. 2022 Jun;70:74-78. doi: 10.1016/j.annepidem.2022.03.008. Epub 2022 Mar 28.
Vaccinations are reported at the state level, but services are delivered at the county level through health departments (HD). This research contributes statistical models to predict county level HPV vaccination.
Using a cross sectional study design, secondary data were analyzed for the years 2016-2018 for all counties of GA. Study population was male and female adolescents aged 13-17 who received the tetanus, diphtheria and pertussis (Tdap) vaccine. The number of administered HPV vaccine doses and HPV vaccination coverage rate were modeled using indicators of HD clinic access, age, sex, race/ethnicity, socioeconomic status, education, median household income, health insurance, and urban/rural residence.
By county the number of administered HPV vaccine doses showed a statistically significant positive association with indicators of HD clinic access: public transit and the number of HD private clinics. HPV vaccination coverage showed a statistically significant negative association with White race and rural residency.
Examining Tdap vaccinated adolescents conservatively predicted HPV vaccination and controlled for multiple confounders such as vaccination ineligibility, vaccine exemption, and vaccine opposition. Within this population, public health professionals and clinicians could use these statistical models to target HPV vaccination efforts among non-Hispanic whites and rural communities at the county level.
疫苗接种情况在州一级报告，但服务通过卫生部门在县一级提供。本研究为预测县一级 HPV 疫苗接种提供了统计模型。
使用横断面研究设计，对 2016 年至 2018 年佐治亚州所有县的数据进行了二次分析。研究人群为接受破伤风、白喉和百日咳（Tdap）疫苗的 13-17 岁男性和女性青少年。使用 HD 诊所可及性、年龄、性别、种族/族裔、社会经济地位、教育、家庭中位数收入、医疗保险以及城乡居住等指标，对管理 HPV 疫苗剂量数和 HPV 疫苗接种率进行建模。
按县划分，管理 HPV 疫苗剂量数与 HD 诊所可及性指标（公共交通和 HD 私人诊所数量）呈显著正相关。HPV 疫苗接种率与白人种族和农村居住呈显著负相关。
对 Tdap 接种青少年的保守预测保守地预测了 HPV 疫苗接种情况，并控制了多种混杂因素，如疫苗接种不合格、疫苗豁免和疫苗反对。在这一人群中，公共卫生专业人员和临床医生可以使用这些统计模型，在县一级针对非西班牙裔白人和农村社区开展 HPV 疫苗接种工作。
