Vielot Nadja, Lane Robyn M, Loefstedt Kaitlyn, Cunningham Jennifer, Everson Jason, Tiller Eli, Patel Sallie, Smith Jennifer
The University of North Carolina at Chapel Hill School of Medicine.
The University of North Carolina at Chapel Hill Gillings School of Global Public Health.
Res Sq. 2023 Jan 30:rs.3.rs-2326137. doi: 10.21203/rs.3.rs-2326137/v1.
While 9-valent human papillomavirus vaccination (HPV-9) is approved by the U.S. Food and Drug Administration for use in adolescents as young as age 9, providers typically recommend it at ages 11-12 per Centers for Disease Control and Prevention recommendations. Studies suggest that recommending HPV-9 at 9 or 10 years of age could increase up-to-date vaccination by age 13, which could benefit rural populations with reduced access to primary health care and lower HPV-9 coverage than urban areas. This pilot study aimed to assess the feasibility of earlier recommendation of HPV-9 in rural clinics. We conducted in-depth interviews with providers and staff from two primary care clinics in central North Carolina, to understand attitudes toward recommending HPV-9 to 9- and 10-year-olds. All interviewees agreed that HPV-9 was important for cancer prevention and should be recommended before the onset of sexual activity, and agreed that HPV-9 could be initiated before age 11 to improve timeliness and completion of the vaccination series. However, opinions were mixed on whether it should be initiated as young as 9-years-old. Two key informants recruited from two urban clinics described their experiences recommending HPV-9 to 9- and 10-year-olds, including a modified vaccination schedule that promotes HPV-9 during routine well-child visits, prior to pubertal onset, and alongside other recommended adolescent vaccines. Earlier recommendation and administration of HPV-9 is possible with minimal changes to current clinical practices and could increase convenience and acceptability of HPV-9 in under-vaccinated settings.
虽然九价人乳头瘤病毒疫苗（HPV-9）已获美国食品药品监督管理局批准，可用于9岁及以上的青少年，但根据疾病控制与预防中心的建议，医护人员通常建议在11至12岁接种。研究表明，在9岁或10岁时推荐接种HPV-9疫苗，可提高13岁时的疫苗接种率，这将惠及农村人口，因为他们获得初级卫生保健的机会较少，HPV-9疫苗接种率低于城市地区。这项试点研究旨在评估在农村诊所更早推荐接种HPV-9疫苗的可行性。我们对北卡罗来纳州中部两家初级保健诊所的医护人员和工作人员进行了深入访谈，以了解他们对向9岁和10岁儿童推荐接种HPV-9疫苗的态度。所有受访者都认为，HPV-9疫苗对预防癌症很重要，应该在开始性行为之前推荐接种，并且一致认为可以在11岁之前开始接种HPV-9疫苗，以提高疫苗接种系列的及时性和完成率。然而对于是否应该在9岁就开始接种，意见不一。从两家城市诊所招募的两名关键信息提供者描述了他们向9岁和10岁儿童推荐接种HPV-9疫苗的经历，包括一种经过调整的疫苗接种时间表，即在常规儿童健康检查期间、青春期开始之前以及与其他推荐的青少年疫苗一起接种HPV-9疫苗。只需对当前临床实践进行最小程度的改变，就可以更早地推荐和接种HPV-9疫苗，这可能会提高疫苗接种率较低地区HPV-9疫苗的便利性和可接受性。
