Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Neil John Maclean Library, University of Manitoba, Winnipeg, MB, Canada.
Vaccine. 2024 Sep 17;42(22):125994. doi: 10.1016/j.vaccine.2024.05.042. Epub 2024 May 25.
Human papillomavirus (HPV) vaccination rates among females are lower than the World Health Organization target and vaccination rates specifically among adult females are even much lower.
We systematically evaluated individual socioeconomic and health-related characteristics associated with HPV vaccination initiation and vaccination series completion among adult females (PROSPERO: CRD42023445721). We performed a literature search on December 14, 2022, and supplemented the search on August 1, 2023. We pooled appropriate multivariable-adjusted results using an inverse variance random-effects model and expressed the results as odds ratios with associated 95 % confidence intervals. A point pooled significantly increased/decreased odds of 30-69 % was regarded to be strongly associated, and ≥ 70 % was very strongly associated.
We included 63 cross-sectional studies. There were strongly increased odds of vaccination initiation among White women compared with Black or Asian women, and those with higher education, health insurance, a history of sexually transmitted infection (STI), receipt of influenza vaccination in the preceding year, not married/cohabiting, not smoking, using contraception, and having visited a healthcare provider in the preceding year. We observed very strongly increased odds of vaccination initiation among those younger and having been born in the country of study. Similarly, there were strongly increased odds of completing the vaccination series for the same variables as initiating vaccination, except for higher education, prior STI, smoking and contraception use. Additional variables associated with strongly increased odds of vaccination series completion not seen in initiation were higher annual household income, being lesbian/bisexual, and having a primary care physician. We observed very strongly increased odds of vaccination series completion similar to vaccination initiation but including for White compared with Black women, higher education, and prior cervical cancer screening.
These individual characteristics may be the key to identifying women at increased risk of not being vaccinated against HPV and could inform targeted messaging to drive HPV vaccination.
女性人群中人类乳头瘤病毒（HPV）疫苗接种率低于世界卫生组织目标，而成年女性的 HPV 疫苗接种率则更低。
我们系统地评估了与成年女性 HPV 疫苗接种启动和接种系列完成相关的个体社会经济和健康相关特征（PROSPERO：CRD42023445721）。我们于 2022 年 12 月 14 日进行了文献检索，并于 2023 年 8 月 1 日进行了补充检索。我们使用逆方差随机效应模型对合适的多变量调整结果进行了汇总，并以相关的 95%置信区间表示结果，比值比（OR）。认为 30%-69%的点汇总具有显著增加/降低的几率是高度相关的，而≥70%的点汇总则是非常高度相关的。
我们纳入了 63 项横断面研究。与黑人或亚洲女性相比，白人女性接种疫苗的启动几率更高，具有更高的教育程度、医疗保险、性传播感染史、前一年接种流感疫苗、未婚/同居、不吸烟、使用避孕措施以及前一年接受过医疗保健提供者的访问。我们发现，与研究所在国出生的人群相比，年轻人群和接种疫苗的人群具有更高的接种启动几率。同样，对于与接种疫苗相同的变量，除了更高的教育程度、先前的性传播感染、吸烟和避孕措施使用之外，完成疫苗接种系列的几率也会大大增加。除了更高的年收入、同性恋/双性恋和有初级保健医生外，与接种疫苗系列完成相关的其他变量也具有高度增加的几率，但在接种疫苗启动中未观察到。我们观察到与接种疫苗启动类似的高度增加的接种疫苗系列完成几率，但包括白人女性与黑人女性相比、更高的教育程度和先前的宫颈癌筛查。
这些个体特征可能是确定未接种 HPV 疫苗的高危女性的关键，并且可以为有针对性的 HPV 疫苗接种宣传提供信息。
