Office of the Chief Medical Health Officer, Vancouver Coastal Health, British Columbia V5Z 4C2, Canada.
Office of the Chief Medical Health Officer, Vancouver Coastal Health, British Columbia V5Z 4C2, Canada.
Vaccine. 2024 Aug 30;42(21):126147. doi: 10.1016/j.vaccine.2024.07.048. Epub 2024 Jul 26.
To identify sociodemographic factors associated with HPV vaccine uptake in a universal, in-school HPV vaccination program, among grade 6 and 9 students in the regional health authority of Vancouver Coastal Health (VCH), British Columbia (BC), Canada during the 2021/22 school year. VCH operates within the southwest corner of the province of BC serving a mix of urban and rural regions. HPV vaccine is offered in school to all grade 6 students using a two-dose series, with catch up immunizations offered to students in grade 9.
We conducted a cross-sectional study of grade 6 and 9 students enrolled in VCH schools for the 2021/22 school year, who also resided within the VCH region. We modelled the associations between sociodemographic explanatory variables (individual-level and group-level) and fully vaccinated outcome using a cross-classified (non-nested) multilevel model.
Among the 17,939 students eligible, 74 % were fully vaccinated for HPV. Immunization coverage was associated with grade, geographic area of residence, school category, social and material deprivation. We demonstrated that grade modified the association between material deprivation and being fully vaccinated. Grade 9 students, including those residing in more materially deprived neighbourhoods, had substantially higher odds (OR 2.01 [95 % CI 1.08, 3.75]) of being fully vaccinated relative to grade 6 students in the least materially deprived neighbourhoods.
Though publicly funded HPV vaccine is offered to all students in grade 6 and 9, in a space that maximizes programmatic access, sociodemographic factors associated with under-immunized populations were identified. This information can be leveraged for strategic targeting of resources to underimmunized schools or students to mitigate impacts. The repeat offering of HPV vaccine in an older grade (grade 9 in BC) is a key programmatic strategy to reach under-immunized populations and should be complemented by other creative approaches.
在加拿大不列颠哥伦比亚省温哥华沿海卫生局（VCH）的 2021/22 学年，对参加普遍的校内 HPV 疫苗接种计划的 6 年级和 9 年级学生，确定与 HPV 疫苗接种率相关的社会人口学因素。VCH 在不列颠哥伦比亚省西南部为城市和农村地区提供服务。HPV 疫苗在学校提供给所有 6 年级学生，采用两剂系列接种，为 9 年级学生提供补种免疫。
我们对参加 2021/22 学年 VCH 学校的 6 年级和 9 年级学生进行了一项横断面研究，这些学生也居住在 VCH 区域内。我们使用交叉分类（非嵌套）多水平模型，对社会人口学解释变量（个体水平和群体水平）与完全接种结果之间的关系进行建模。
在符合条件的 17939 名学生中，有 74%的人完全接种了 HPV 疫苗。免疫接种率与年级、居住地的地理位置、学校类别、社会和物质匮乏有关。我们表明，年级改变了物质匮乏与完全接种之间的关系。与居住在物质匮乏程度较低的社区的 6 年级学生相比，9 年级学生（包括那些居住在物质匮乏程度较高的社区的学生）完全接种疫苗的可能性要高得多（OR 2.01 [95%CI 1.08, 3.75]）。
尽管在最大程度上增加项目获得机会的空间内，为所有 6 年级和 9 年级学生提供了公共资助的 HPV 疫苗，但仍确定了与未免疫人群相关的社会人口学因素。可以利用这些信息有针对性地向免疫不足的学校或学生提供资源，以减轻影响。在不列颠哥伦比亚省，将 HPV 疫苗在更高年级（9 年级）重复接种是一项关键的项目策略，可用于覆盖未免疫人群，还应辅以其他创造性方法。
