Cunningham-Erves J, Sanderson M, Jin S W, Davis J, Brandt H M
Vanderbilt University Medical Center, Department of Public health Policy, 2525 West End Avenue, Nashville, TN 37203, USA.
Meharry Medical College, School of Medicine, Department of Family and Community Medicine, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208; USA.
Vaccine. 2025 Feb 6;46:126581. doi: 10.1016/j.vaccine.2024.126581. Epub 2024 Dec 7.
Geographical disparities exist in human papillomavirus (HPV) vaccination rates with Southern states having the lowest rates. Parental attitudes remain understudied in different Southern locations. We assessed factors related to HPV vaccination receipt among children aged 9-17 years in Tennessee, and if those factors differed by child's age and gender. A cross-sectional survey of 506 parents was performed via random digit dial from May to August 2022. A multivariable logistic regression model was used to estimate adjusted odds ratios and 95 % confidence intervals to predict sociodemographic and overall vaccine-related factors associated with HPV vaccine receipt or non-receipt (referent) for their child, and exploratory analyses to determine if those factors differed by child's age and gender. In adjusted logistic regression models, HPV vaccine receipt was significantly positively associated with the child's age (13-17 years) and the parent and child having had the influenza vaccine this season and the COVID-19 vaccine, and negatively associated with children who were male and had a parent employed part-time/unemployed/retired/student/disabled. Significant associations for HPV vaccine receipt were with increased levels of agreement of the parent having enough information for decision-making, belief the vaccine was beneficial, and increased levels of trust and perceived effectiveness of the vaccine. Increased levels of hesitancy and increased levels of agreement that the vaccine might cause infertility issues in the child, was unsafe, and natural immunity is better than vaccine immunity had negative associations with HPV vaccine receipt. All associations were more pronounced among older than younger children, and all but one association (overall vaccine trust) was more pronounced among males compared with females. Strategies to improve HPV vaccine uptake should be targeted to and/or include males and parents with children aged 9-12 years, and include education on the importance and process of protecting the body through HPV vaccination and vaccines in general.
人乳头瘤病毒（HPV）疫苗接种率存在地域差异，美国南部各州的接种率最低。不同南部地区的家长态度仍未得到充分研究。我们评估了田纳西州9至17岁儿童HPV疫苗接种情况的相关因素，以及这些因素是否因儿童年龄和性别而异。2022年5月至8月，通过随机数字拨号对506名家长进行了横断面调查。采用多变量逻辑回归模型估计调整后的优势比和95%置信区间，以预测与孩子HPV疫苗接种或未接种（对照）相关的社会人口统计学和总体疫苗相关因素，并进行探索性分析，以确定这些因素是否因孩子年龄和性别而异。在调整后的逻辑回归模型中，HPV疫苗接种与孩子的年龄（13至17岁）、家长和孩子本季度接种流感疫苗以及COVID-19疫苗呈显著正相关，与男性孩子以及家长为兼职/失业/退休/学生/残疾的孩子呈负相关。HPV疫苗接种的显著关联因素包括家长对决策有足够信息的认同度提高、认为疫苗有益、对疫苗的信任度和感知有效性提高。犹豫程度增加以及认为疫苗可能导致孩子不孕、不安全且自然免疫优于疫苗免疫的认同度增加与HPV疫苗接种呈负相关。所有关联在年龄较大的孩子中比年龄较小的孩子中更为明显，除了一个关联（总体疫苗信任）外，所有关联在男性中比女性中更为明显。提高HPV疫苗接种率的策略应针对9至12岁孩子的男性和家长，或纳入他们，并包括关于通过HPV疫苗及一般疫苗保护身体的重要性和过程的教育。
