Surveillance & Health Equity Science Research Program, American Cancer Society, Atlanta, GA, USA.
Interventions & Implementation, American Cancer Society, Atlanta, GA, USA.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2175555. doi: 10.1080/21645515.2023.2175555. Epub 2023 Feb 7.
Recent guidelines from the American Cancer Society stress HPV vaccination series initiation at the youngest opportunity, i.e., age 9 years. There are limited data on the association between initiating HPV vaccination at ages 9-10 years and up-to-date (UTD) status. In this study, we compare nationally representative UTD HPV vaccination rates between adolescents who initiated the series younger (ages 9-10 years) vs. older (≥ age 11 years). Five years of pooled data (2016-2020) from National Immunization Survey-Teen were used to estimate the UTD HPV vaccination prevalence among younger vs. older initiating 13-17-year-olds. Adjusted logistic regression models estimated prevalence ratios (aPRs), differences (aDs), and difference in differences (aDDs) in prevalence of being UTD to assess the overall association of age at initiation with being UTD and differences in sociodemographic predictors of being UTD among younger vs. older initiators. UTD prevalence for younger initiators was 93% compared with 72% among older initiators (aPR: 1.27,95%CI: 1.24,1.31). Among older initiators, UTD prevalence was significantly different by sex, insurance status, and current age; no such differences were observed among younger initiators. Results indicate that younger initiation is associated with a 27% higher UTD prevalence, highlighting the importance of promoting younger initiation, particularly among those with health-care barriers.
最近，美国癌症协会的指南强调应在最早的机会，即 9 岁时开始 HPV 疫苗系列接种。关于在 9-10 岁时开始接种 HPV 疫苗与最新（UTD）状态之间的关联，数据有限。在这项研究中，我们比较了在较年轻（9-10 岁）和较年长（≥11 岁）时开始接种系列疫苗的青少年中，全国代表性的 UTD HPV 疫苗接种率。使用来自国家免疫调查-青少年的 5 年（2016-2020 年）合并数据，来估计年轻（9-10 岁）和年长（≥11 岁）启动者中 13-17 岁青少年的 UTD HPV 疫苗接种流行率。调整后的逻辑回归模型估计了 UTD 流行率的比值比（aPR）、差异（aD）和差异差异（aDD），以评估年龄开始与 UTD 的总体关联，以及年轻和年长启动者之间 UTD 的社会人口预测因素的差异。年轻启动者的 UTD 流行率为 93%，而年长启动者为 72%（aPR：1.27，95%CI：1.24，1.31）。在年长启动者中，UTD 流行率在性别、保险状况和当前年龄方面存在显著差异；而在年轻启动者中则没有观察到这种差异。结果表明，年轻启动与 UTD 流行率提高 27%相关，这突出了促进年轻启动的重要性，尤其是在那些存在医疗保健障碍的人群中。
