Ryan Grace W, Perry Sarah S, Scherer Aaron, Charlton Mary E, Ashida Sato, Gilbert Paul A, Askelson Natoshia
Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City IA, 52242, United States.
Department of Biostatistics, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City IA, 52242, United States.
Vaccine X. 2022 Jul 9;11:100192. doi: 10.1016/j.jvacx.2022.100192. eCollection 2022 Aug.
Rates of human papillomavirus (HPV) vaccination remain low and missed opportunities for HPV vaccination are widespread. Researchers have identified factors related to HPV vaccination, but less is known about missed opportunities.
We used medical claims data from a large Midwestern insurance provider to explore relationships between adolescent and provider characteristics and missed opportunities for HPV vaccination. We stratified models by initiation status with adolescents who had received one or more HPV vaccinations in one group (n = 6,123) and adolescents with no record of an HPV vaccination in the other (n = 8,107).
There were significant differences in comparisons of all variables between initiators and non-initiators. Notably, non-initiators had lower rates of vaccination for HPV and other adolescent vaccinations, and fewer well-child visits. For all adolescents, birth year, having other recommended vaccines, and number of well-child visits were significantly associated with missed opportunities. Additionally, among initiators, pediatrician as a primary care provider and being in a rural area were significantly associated.
Overall, adolescents with greater healthcare utilization had more missed opportunities, indicating that, despite increased numbers of visits, providers are not taking advantage of these opportunities to vaccinate. Future research should prioritize developing a deeper understanding of why these missed opportunities are occurring and implementing new and existing strategies to prevent them. Reducing missed opportunities will help to prevent future HPV-related cancers and the significant morbidity and mortality that they can cause.
人乳头瘤病毒（HPV）疫苗接种率仍然很低，错过HPV疫苗接种的情况普遍存在。研究人员已经确定了与HPV疫苗接种相关的因素，但对于错过的机会了解较少。
我们使用了来自中西部一家大型保险提供商的医疗理赔数据，以探讨青少年和医疗服务提供者特征与错过HPV疫苗接种机会之间的关系。我们按起始状态对模型进行分层，一组为已接种一剂或多剂HPV疫苗的青少年（n = 6123），另一组为无HPV疫苗接种记录的青少年（n = 8107）。
起始者和未起始者在所有变量的比较上存在显著差异。值得注意的是，未起始者的HPV疫苗接种率和其他青少年疫苗接种率较低，健康儿童就诊次数也较少。对于所有青少年而言，出生年份、接种其他推荐疫苗以及健康儿童就诊次数与错过的机会显著相关。此外，在起始者中，以儿科医生作为初级保健提供者以及居住在农村地区与错过机会显著相关。
总体而言，医疗保健利用率较高的青少年错过的机会更多，这表明尽管就诊次数增加，但医疗服务提供者并未利用这些机会进行疫苗接种。未来的研究应优先深入了解这些错过机会的原因，并实施新的和现有的预防策略。减少错过的机会将有助于预防未来与HPV相关的癌症以及它们可能导致的重大发病率和死亡率。
