Muthukrishnan Meera, Loux Travis, Shacham Enbal, Tiro Jasmin A, Arnold Lauren D
University of Texas Southwestern Medical Center, Department of Population and Data Sciences, USA.
Saint Louis University, College for Public Health and Social Justice, Department of Epidemiology and Biostatistics, USA.
Prev Med Rep. 2022 Aug 8;29:101942. doi: 10.1016/j.pmedr.2022.101942. eCollection 2022 Oct.
In the United States (US), an estimated 35,900 human papillomavirus (HPV)-related cancers are diagnosed annually. HPV vaccines are projected to eliminate ∼90% of these cancers. Routine vaccination is recommended at age 11-12 with "catch-up" vaccination through age 26 and shared clinical decision making for ages 27-45. However, vaccine uptake has been slow with many young adults remaining unvaccinated. This study examined barriers to HPV vaccination among individuals aged 18-35 years and assessed likelihood of future HPV vaccination. Age-eligible participants (n = 499) recruited through Facebook advertisements, Facebook posts, and clinics (6/2019-3/2020) completed an online survey. Descriptive statistics and bivariate analysis examined HPV vaccine barriers and intent. Logistic regression models examined predictors of HPV vaccine intent. Most (57.1%) reported they were not at all likely to get vaccinated for HPV in the future. Lower intent was associated with belief that the vaccine is not necessary (aOR: 0.134, 95% CI: 0.073, 0.246) and not safe (aOR: 0.312, 95% CI: 0.126, 0.773). Intent was positively associated with the belief that health insurance would not cover vaccination (aOR: 2.226, 95% CI: 1.070, 4.631). Provider recommendation was not significantly associated with vaccine intention. This study highlights challenges to HPV vaccine uptake for young adults. Though several successful interventions exist, most target adolescents and their parents or providers. Future steps should use this evidence to inform development of targeted interventions to increase HPV vaccine intention and uptake in adults, ultimately reducing the burden of HPV-related cancers.
在美国,估计每年有35900例与人乳头瘤病毒(HPV)相关的癌症被确诊。HPV疫苗预计可消除约90%的此类癌症。建议在11至12岁时进行常规接种,并在26岁之前进行“补种”,对于27至45岁的人群则需共同进行临床决策。然而,疫苗接种进展缓慢,许多年轻人仍未接种。本研究调查了18至35岁个体接种HPV疫苗的障碍,并评估了未来接种HPV疫苗的可能性。通过脸书广告、脸书帖子和诊所(2019年6月至2020年3月)招募的符合年龄要求的参与者(n = 499)完成了一项在线调查。描述性统计和双变量分析研究了HPV疫苗接种的障碍和意愿。逻辑回归模型研究了HPV疫苗接种意愿的预测因素。大多数人(57.1%)报告称他们未来完全不可能接种HPV疫苗。较低的接种意愿与认为疫苗不必要(调整后比值比:0.134,95%置信区间:0.073,0.246)和不安全(调整后比值比:0.312,95%置信区间:0.126,0.773)的信念相关。接种意愿与认为医疗保险不会覆盖疫苗接种的信念呈正相关(调整后比值比:2.226,95%置信区间:1.070,4.631)。医生的建议与疫苗接种意愿没有显著关联。本研究突出了年轻人接种HPV疫苗面临的挑战。尽管存在一些成功的干预措施,但大多数针对的是青少年及其父母或医生。未来的措施应利用这一证据,为制定有针对性的干预措施提供信息,以提高成年人接种HPV疫苗的意愿和接种率,最终减轻HPV相关癌症的负担。