Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA.
Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., P.O. Box 19024, Seattle, WA, 98109-1024, USA.
Matern Child Health J. 2024 Dec;28(12):2137-2146. doi: 10.1007/s10995-024-03998-0. Epub 2024 Oct 8.
To investigate the association between maternal cervical cancer (CC) screening status and child human papillomavirus (HPV) vaccination uptake. To understand if child sex or social deprivation index (SDI) modify this association.
We used a national cohort of children linked to at least one parent using electronic health record (EHR) data from a network of community health centers across the United States. We used SDI scores and child sex as moderating variables. We performed the analysis (1) for the whole sample (with SDI and child sex added as covariates), (2) stratified by SDI quartile (with child sex added as a covariate), and (3) stratified by SDI quartile and child sex, to examine whether associations vary by SDI quartile and by child sex.
N = 52,919 linked mother-child pairs. Mother's receipt of CC screening was positively associated with the linked child's odds of receiving HPV vaccination [adjusted odds ratio (AOR) 1.39, 95% confidence interval (CI) 1.32, 1.47]. Neither sex or SDI modified this association. There were no significant differences in odds of HPV vaccination in children between SDI quartiles or between male and female children.
An effective way to improve rates of HPV vaccination among children and adolescents may be to target attention towards increasing CC screening rates among mothers. Further, focusing resources and efforts on CC screenings and care of both mothers and their children may be more worthwhile than isolated efforts targeting HPV vaccination for children and adolescents.
研究母亲宫颈癌(CC)筛查状况与儿童人乳头瘤病毒(HPV)疫苗接种率之间的关联。了解儿童性别或社会剥夺指数(SDI)是否会改变这种关联。
我们使用了一个全国性的儿童队列,这些儿童通过美国社区卫生中心网络的电子健康记录(EHR)数据与至少一位家长相关联。我们使用 SDI 评分和儿童性别作为调节变量。我们进行了分析(1)在整个样本中(加入 SDI 和儿童性别作为协变量),(2)按 SDI 四分位分层(加入儿童性别作为协变量),以及(3)按 SDI 四分位分层和儿童性别,以检查关联是否因 SDI 四分位和儿童性别而有所不同。
共有 52919 对关联的母子对。母亲接受 CC 筛查与所关联儿童接受 HPV 疫苗接种的几率呈正相关[调整后的优势比(AOR)1.39,95%置信区间(CI)1.32,1.47]。性别或 SDI 均未改变这种关联。在 SDI 四分位数或男童和女童之间,HPV 疫苗接种的几率没有显著差异。
提高儿童和青少年 HPV 疫苗接种率的有效方法可能是将注意力集中在提高母亲的 CC 筛查率上。此外,将资源和努力集中在 CC 筛查以及母亲及其子女的护理上,可能比针对儿童和青少年的 HPV 疫苗接种的孤立努力更有价值。