Allen Jennifer D, Abuelezam Nadia N, Rose Raviv, Isakoff Katelin, Zimet Gregory, Fontenot Holly B
Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Ave, Medford, MA, 02155, USA.
Connell School of Nursing, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA.
BMC Public Health. 2024 Aug 8;24(1):2154. doi: 10.1186/s12889-024-18740-2.
The Advisory Committee on Immunization Practices issued a shared clinical decision-making (SCDM) recommendation for HPV vaccination in persons aged 27-45. Since expanded eligibility for the vaccine was issued, little information has been available about HPV vaccine behaviors and intentions among women in this age group.
We conducted a cross-sectional online survey among women aged 27-45 years recruited through a Qualtrics™ respondent panel (N = 324) to answer the following questions (1) What is the prevalence of HPV vaccination among a diverse sample of adult women aged 27-45 years? (2) What are the characteristics of those who have or have not previously been vaccinated? and (3) What factors are associated with the intention to obtain the HPV vaccine among those who had never been vaccinated? Multivariable logistic regression analyses estimated adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs).
Only 31.1% had at least one dose of the HPV vaccine. In multivariable analyses, those more likely to have been vaccinated were younger and were more likely to believe that the vaccine was effective. Of those unvaccinated or unsure, 54.8% indicated they were likely to get vaccinated in the future. Factors associated with future vaccine intention (compared to those not intending) included beliefs about vaccine testing, perceived likelihood of HPV infection, greater comfort in asking one's provider for vaccination, and prior negative healthcare experiences.
Our findings suggest that many women in this age group are interested in HPV vaccination. While the recommendation is for SCDM rather than routine vaccination for all women in this age group, efforts to promote informed decision-making among mid-adult women may include educating women about the rigorous vaccine testing and approval process, their risk factors for HPV infection, and encouraging them to engage in SCDM with their medical providers. Targeted efforts to reach women who have had negative experiences with healthcare may also be needed.
免疫实践咨询委员会发布了一项关于27至45岁人群人乳头瘤病毒（HPV）疫苗接种的共同临床决策（SCDM）建议。自扩大该疫苗的适用范围以来，关于这个年龄组女性的HPV疫苗接种行为和意愿的信息一直很少。
我们通过Qualtrics™受访者小组招募了324名27至45岁的女性进行横断面在线调查，以回答以下问题：（1）在27至45岁的成年女性多样化样本中，HPV疫苗接种率是多少？（2）以前接种过或未接种过疫苗的人的特征是什么？以及（3）在从未接种过疫苗的人中，哪些因素与接种HPV疫苗的意愿相关？多变量逻辑回归分析估计了调整后的优势比（AOR）和95%置信区间（95%CI）。
只有31.1%的人至少接种过一剂HPV疫苗。在多变量分析中，更有可能接种过疫苗的人年龄较小，并且更有可能认为疫苗有效。在未接种或不确定的人中，54.8%表示他们未来可能会接种疫苗。与未来接种疫苗意愿相关的因素（与无意愿者相比）包括对疫苗测试的信念、HPV感染的感知可能性、向医疗服务提供者咨询接种疫苗时更自在，以及以前的负面医疗经历。
我们的研究结果表明，这个年龄组的许多女性对HPV疫苗接种感兴趣。虽然该建议是关于SCDM，而不是针对这个年龄组所有女性的常规接种，但促进中年女性做出明智决策的努力可能包括教育女性了解严格的疫苗测试和审批过程、她们的HPV感染风险因素，并鼓励她们与医疗服务提供者进行SCDM。可能还需要有针对性地努力接触那些有过负面医疗经历的女性。
