Hirth Jacqueline, Ostovar-Kermani Tiffany, Gutierrez Judith A, Thompson Erika L, Barnett Tracey E, Zoorob Roger
Department of Family and Community Medicine, Baylor College of Medicine, United States.
Department of Family and Community Medicine, Baylor College of Medicine, United States.
Vaccine. 2024 Apr 19;42(11):2827-2836. doi: 10.1016/j.vaccine.2024.03.050. Epub 2024 Mar 21.
Up-to-date (UTD) of the human papillomavirus (HPV) vaccine series has been low despite 2016 recommendations for 2 doses among initiators <15 years of age and 3 doses for 15+ year olds. This study examined how age at initiation affected the association between race/ethnicity and UTD among adolescent HPV vaccine initiators. We also examined how administration of other adolescent vaccines affected UTD.
A secondary analysis of The National Immunization Survey - Teen data between 2016 and 2020 was conducted. Characteristics associated with initiation of the vaccine series was examined and used to evaluate UTD among initiators. All data were weighted. Associations between characteristics and HPV vaccine initiation were examined using Rao Scott chi-square tests and univariable logistic regression. Multivariable binary logistic regression models stratified by race/ethnicity calculated the strength of association between independent variables and odds of initiation and UTD among initiators.
The final sample size was 99,719 with 67,855 (68.1 %) initiating HPV vaccination. Among HPV vaccine initiators, Hispanic and black adolescents had lower odds of UTD. However, 9-10-year-old initiators had increased odds (aOR: 5.71; 95 %CI: 3.78-8.63) of UTD compared to 12-year-old initiators. Increased odds of UTD among initiators younger than 12 years were found across racial/ethnic groups. Flu vaccination was associated with decreased odds of UTD among white (aOR: 0.76; 95 %CI:0.65-0.88) and black adolescents (aOR: 0.67; 95 %CI: 0.46-0.96).
Strong recommendations to ensure patients are UTD on the HPV vaccine series are essential to improving UTD among all adolescents and follow-up should occur when administering other vaccines to reduce missed opportunities.
尽管2016年建议15岁以下的初种者接种2剂人乳头瘤病毒（HPV）疫苗，15岁及以上者接种3剂，但HPV疫苗系列的全程接种率一直很低。本研究调查了初种年龄如何影响青少年HPV疫苗初种者的种族/族裔与全程接种之间的关联。我们还研究了其他青少年疫苗的接种情况如何影响全程接种。
对2016年至2020年的全国青少年免疫调查数据进行二次分析。研究了与疫苗系列初种相关的特征，并用于评估初种者的全程接种情况。所有数据均进行了加权处理。使用Rao Scott卡方检验和单变量逻辑回归分析特征与HPV疫苗初种之间的关联。按种族/族裔分层的多变量二元逻辑回归模型计算了自变量与初种者初种及全程接种几率之间的关联强度。
最终样本量为99,719，其中67,855人（68.1%）开始接种HPV疫苗。在HPV疫苗初种者中，西班牙裔和黑人青少年的全程接种几率较低。然而，与12岁的初种者相比，9至10岁的初种者全程接种几率增加（调整后比值比：5.71；95%置信区间：3.78 - 8.63）。在各种族/族裔群体中，12岁以下的初种者全程接种几率均有所增加。流感疫苗接种与白人青少年（调整后比值比：0.76；95%置信区间：0.65 - 0.88）和黑人青少年（调整后比值比：0.67；95%置信区间：0.46 - 0.96）的全程接种几率降低有关。
确保患者完成HPV疫苗系列全程接种的有力建议对于提高所有青少年的全程接种率至关重要，并且在接种其他疫苗时应进行随访，以减少错过接种机会的情况。
