Boyce Thomas G, Christianson Ben, Hanson Kayla E, Dunn Denise, Polter Elizabeth, VanWormer Jeffrey J, Williams Charnetta L, Belongia Edward A, McLean Huong Q
Marshfield Clinic Research Institute, Marshfield, WI, USA.
Minnesota Department of Health, St. Paul, MN, USA.
Vaccine X. 2022 Jun 11;11:100180. doi: 10.1016/j.jvacx.2022.100180. eCollection 2022 Aug.
Studies have shown that adolescent vaccination rates with human papillomavirus (HPV) and quadrivalent meningococcal conjugate (MenACWY) vaccines are lower in rural areas of the U.S. than in urban areas. We sought to determine factors associated with vaccine acceptance in these two settings.
We conducted a cross-sectional survey of 536 parents or guardians of teens age 13 through 15 years in select rural and urban counties of Minnesota and Wisconsin. We collected information on demographic variables, receipt of adolescent vaccines, and attitudes toward HPV vaccine in particular. Multivariable logistic regression models were used to assess associations between covariates and outcomes of interest (HPV vaccine receipt and MenACWY receipt).
Of the 536 respondents, 267 (50%) resided in a rural county. Most respondents were female (78%) and non-Hispanic White (88%). About half (52%) of teens of the surveyed parents received the three vaccines recommended specifically for adolescents: 90% received tetanus-diphtheria-acellular pertussis (Tdap), 84% received MenACWY, and 60% received one or more doses of HPV vaccine. Rural and urban parents surveyed differed on several covariates relating to teen's health services, parent's demographics, and household characteristics. Parent's perception of the importance that their healthcare providers placed on vaccination with HPV and MenACWY were independently associated with receipt of each of those vaccines (odds ratio [OR] 6.37, 95% confidence interval [CI] 2.90-13.96 and OR 2.15, 95% CI 1.07-4.31, respectively). Parents of vaccinated teens were less likely to report concerns about potential harm from the HPV vaccine or having heard stories about health problems caused by the HPV vaccine.
Teen receipt of HPV vaccine and MenACWY appears to be influenced by parents' perception of vaccine importance, provider recommendations, and concerns regarding potential harm from the HPV vaccine. Continued education of providers and parents of the importance of adolescent vaccinations is warranted.
研究表明，美国农村地区人乳头瘤病毒（HPV）疫苗和四价脑膜炎球菌结合疫苗（MenACWY）的青少年接种率低于城市地区。我们试图确定这两种情况下与疫苗接受度相关的因素。
我们对明尼苏达州和威斯康星州部分农村和城市县的536名13至15岁青少年的父母或监护人进行了横断面调查。我们收集了人口统计学变量、青少年疫苗接种情况以及对HPV疫苗的态度等信息。使用多变量逻辑回归模型评估协变量与感兴趣的结果（HPV疫苗接种和MenACWY疫苗接种）之间的关联。
在536名受访者中，267人（50%）居住在农村县。大多数受访者为女性（78%）且是非西班牙裔白人（88%）。在接受调查的父母的青少年中，约一半（52%）接种了专门为青少年推荐的三种疫苗：90%接种了破伤风-白喉-无细胞百日咳疫苗（Tdap），84%接种了MenACWY，60%接种了一剂或多剂HPV疫苗。接受调查的农村和城市父母在与青少年健康服务、父母人口统计学和家庭特征相关的几个协变量上存在差异。父母对医疗保健提供者对HPV和MenACWY疫苗接种重视程度的看法与接种这两种疫苗独立相关（优势比[OR]分别为6.37，95%置信区间[CI]为2.90 - 13.96和OR 2.15，95% CI为1.07 - 4.31）。接种疫苗的青少年的父母不太可能报告对HPV疫苗潜在危害的担忧或听说过HPV疫苗导致健康问题的故事。
青少年对HPV疫苗和MenACWY疫苗的接种似乎受到父母对疫苗重要性的看法、提供者的建议以及对HPV疫苗潜在危害的担忧的影响。有必要继续对提供者和父母进行青少年疫苗接种重要性的教育。
