Department of Epidemiology, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States.
The Joint Collaborative on Geospatial Analysis and Health, A Collaboration of The University of Texas Health Science Center at Houston School of Public Health and The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Front Public Health. 2024 Jun 25;12:1418526. doi: 10.3389/fpubh.2024.1418526. eCollection 2024.
HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates. We used geospatial analysis to identify areas with high and low vaccination rates and explored differences in neighborhood characteristics.
Using Anselin's Local Moran's I statistic, we conducted an ecological analysis of hot and cold spots of adolescent HPV vaccination coverage in Texas from 2017 to 2021. Next, we utilized a Mann-Whitney U test to compare neighborhood characteristics of vaccination coverage in hot spots versus cold spots, leveraging data from the Child Opportunity Index (COI) and American Community Survey.
In Texas, there are 64 persistent vaccination coverage hotspots and 55 persistent vaccination coverage cold spots. The persistent vaccination coverage hot spots are characterized by ZIP codes with lower COI scores, higher percentages of Hispanic residents, higher poverty rates, and smaller populations per square mile compared to vaccine coverage cold spots. We found a more pronounced spatial clustering pattern for male adolescent vaccine coverage than we did for female adolescent vaccine coverage.
In Texas, HPV vaccination coverage rates differ depending on the community's income level, with lower-income areas achieving higher success rates. Notably, there are also gender-based discrepancies in vaccination coverage rates, particularly among male adolescents. This knowledge can aid advocates in customizing their outreach initiatives to address these disparities.
HPV 是导致大多数宫颈癌、口咽癌、肛门癌、阴道癌和外阴癌的主要原因。HPV 疫苗的使用降低了宫颈癌的发病率，但德克萨斯州只有 49%的青少年接种了该疫苗。德克萨斯州的 HPV 疫苗接种率差异很大。我们使用地理空间分析来确定高接种率和低接种率的地区，并探讨了邻里特征的差异。
我们使用 Anselin 的局部 Moran's I 统计量，对 2017 年至 2021 年德克萨斯州青少年 HPV 疫苗接种覆盖率的热点和冷点进行了生态分析。接下来，我们利用曼-惠特尼 U 检验比较了热点和冷点的疫苗接种覆盖率的邻里特征，利用儿童机会指数（COI）和美国社区调查的数据。
在德克萨斯州，有 64 个持续的疫苗接种覆盖率热点和 55 个持续的疫苗接种覆盖率冷点。持续的疫苗接种覆盖率热点的特点是 COI 得分较低、西班牙裔居民比例较高、贫困率较高、每平方英里人口较少的邮政编码。我们发现，男性青少年疫苗接种覆盖率的空间聚类模式比女性青少年疫苗接种覆盖率更为明显。
在德克萨斯州，HPV 疫苗接种率因社区的收入水平而异，收入较低的地区接种率较高。值得注意的是，疫苗接种率也存在性别差异，尤其是在男性青少年中。这些知识可以帮助倡导者定制他们的外展计划，以解决这些差异。
