Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX, United States of America; Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX, United States of America.
Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX, United States of America.
Prev Med. 2022 Nov;164:107218. doi: 10.1016/j.ypmed.2022.107218. Epub 2022 Aug 23.
The Centers for Disease Control and Prevention (CDC) promotes taking a 'bundling approach' (i.e., administering Tetanus, diphtheria toxoids, and acellular pertussis [Tdap] and human papillomavirus [HPV] vaccines in the same way and on the same day) for adolescent vaccinations. Recent trends and patterns in Tdap-HPV vaccination bundling in the USA remain undocumented. In addition, the implications of bundling Tdap-HPV vaccination for HPV vaccine series completion remain unknown. To address these critical knowledge gaps, we performed a retrospective study using a nationwide sample of privately insured adolescents (Optum's de-identified Clinformatics® Data Mart Database). Tdap-HPV vaccination bundling (per 100 Tdap vaccination encounters) during 2014-2018 was estimated overall, for 50 states, and by adolescents' age, sex, and provider specialties. Survival model estimated the likelihood of series completion among 9-14-year-old adolescents. From 2014 to 2018, 560,806 adolescents received a Tdap vaccine of which 172,604 (30.8%) received the HPV vaccines on the same day. Tdap-HPV vaccination bundling (per 100 Tdap vaccinations) increased nationally, from 22.9 in 2014 to 39.1 in 2018 (P < 0.001); bundling was lowest in New York and New Jersey. The likelihood of receiving the Tdap and HPV vaccines bundled was higher for young and female adolescents. Adolescents who received their first HPV vaccine bundled with the Tdap vaccine were more likely to complete the series compared to those who received it alone (Hazards Ratio = 1.45; 1.43-1.48). HPV vaccination bundling has increased in recent years in the USA. The increased likelihood of HPV vaccine series completion provides important evidence supporting the adoption of same-day Tdap-HPV vaccine administration in clinical practice to boost HPV vaccination coverage.
疾病控制与预防中心（CDC）提倡采取“捆绑式方法”（即在同一次和同一天接种破伤风、白喉类毒素和无细胞百日咳[Tdap]和人乳头瘤病毒[HPV]疫苗）来进行青少年疫苗接种。美国最近 Tdap-HPV 疫苗接种捆绑的趋势和模式仍未记录在案。此外，Tdap-HPV 疫苗接种捆绑对 HPV 疫苗系列完成的影响仍不清楚。为了解决这些关键的知识空白，我们使用全国范围内私人保险青少年的样本（Optum 的去识别 Clinformatics® Data Mart 数据库）进行了回顾性研究。总体上、50 个州以及根据青少年的年龄、性别和提供者专业，估计了 2014-2018 年期间 Tdap-HPV 疫苗接种捆绑（每 100 次 Tdap 接种事件）的情况。生存模型估计了 9-14 岁青少年系列完成的可能性。从 2014 年到 2018 年，有 560806 名青少年接种了 Tdap 疫苗，其中 172604 名（30.8%）在同一天接种了 HPV 疫苗。全国范围内 Tdap-HPV 疫苗接种捆绑（每 100 次 Tdap 接种）从 2014 年的 22.9 增加到 2018 年的 39.1（P<0.001）；捆绑在纽约和新泽西州最低。年轻和女性青少年接受 Tdap 和 HPV 疫苗捆绑的可能性更高。与单独接种 Tdap 疫苗的青少年相比，同时接种 Tdap 和 HPV 疫苗的青少年更有可能完成系列接种（危害比=1.45；1.43-1.48）。近年来，美国的 HPV 疫苗接种捆绑有所增加。HPV 疫苗系列完成率的提高提供了重要证据，支持在临床实践中采用 Tdap-HPV 疫苗同日接种，以提高 HPV 疫苗接种覆盖率。
