Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Adolesc Health. 2023 Sep;73(3):595-598. doi: 10.1016/j.jadohealth.2023.05.008. Epub 2023 Jun 29.
The Coronavirus Disease 2019 pandemic disrupted healthcare, but the impact on vaccination missed opportunities (MOs, vaccine-eligible visits without vaccination) is unknown. We evaluated pandemic-related trends in MOs at adolescent well-care visits for three vaccines: human papillomavirus; quadrivalent meningococcal conjugate; and tetanus, diphtheria, and acellular pertussis (Tdap).
We analyzed electronic health record data from 24 pediatric primary care practices in 13 states from 1/1/2018 to 12/31/2021. Segmented logistic regression estimated risk differences for MOs during the pandemic relative to prepandemic trends.
Among 106,605 well-care visits, we observed decreases in MOs prepandemic followed by an increase in MOs during the pandemic for all three vaccines. Relative to prepandemic, MOs increased for human papillomavirus (+15.9%, 95% confidence interval [CI]: 11.7%, 20.1%), meningococcal conjugate (+9.4%, 95% CI: 5.2%, 13.7%), and tetanus, diphtheria, and acellular pertussis (Tdap) (+ 8.2%, 95% CI: 4.3%, 12.1%).
Increases in vaccine MOs during the pandemic equaled or exceeded pre-pandemic decreases. Reducing MOs in adolescent well-care could raise vaccine coverage.
2019 年冠状病毒病大流行扰乱了医疗保健，但疫苗接种错失机会（即有疫苗接种资格但未接种疫苗的就诊）的影响尚不清楚。我们评估了三种疫苗（人乳头瘤病毒、四价脑膜炎球菌结合疫苗和破伤风、白喉和无细胞百日咳（Tdap））在青少年常规保健就诊中与大流行相关的错失机会趋势。
我们分析了来自 13 个州的 24 个儿科初级保健实践的电子健康记录数据，时间为 2018 年 1 月 1 日至 2021 年 12 月 31 日。分段逻辑回归估计了大流行期间相对于大流行前趋势的错失机会风险差异。
在 106605 次常规保健就诊中，我们观察到大流行前错失机会减少，随后所有三种疫苗的大流行期间错失机会增加。与大流行前相比，人乳头瘤病毒（HPV）（+15.9%，95%置信区间[CI]：11.7%，20.1%）、脑膜炎球菌结合疫苗（+9.4%，95% CI：5.2%，13.7%）和破伤风、白喉和无细胞百日咳（Tdap）（+8.2%，95% CI：4.3%，12.1%）的错失机会增加。
大流行期间疫苗错失机会的增加与大流行前的减少相等或超过。减少青少年常规保健中的错失机会可能会提高疫苗覆盖率。
