Cernasev Alina, Oyedeji Oluwafemifola, Springer Cary M, Hagemann Tracy M, Hohmeier Kenneth C, Kintziger Kristina W
Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, USA.
Internal Medicine Residency Program, North Knoxville Medical Center, 7565 Dannaher Dr., Powell, TN 37849, USA.
Vaccines (Basel). 2024 Dec 12;12(12):1405. doi: 10.3390/vaccines12121405.
Human papillomavirus (HPV) remains the most prevalent sexually transmitted infection in the United States (U.S.). By the age of 45, over 80% of Americans will contract HPV, which creates a significant public health concern. Despite the availability of effective vaccines, low vaccination uptake continues to be a challenge, particularly in Tennessee. Additionally, the Advisory Committee on Immunization Practices (ACIP) recently expanded recommendations for HPV vaccine usage to include adults aged 27-45, suggesting a population with the potential to experience a gap in preventative care. To understand the underlying factors that may hinder Tennesseans from receiving the HPV vaccine, we conducted a cross-sectional survey from 29 June to 17 August 2023 among adults aged 18 to 45 in Tennessee. The survey was developed and informed by a scoping review regarding the various constructs and frameworks used in vaccine hesitancy and our previous qualitative work. Using theory-based instruments and previous qualitative data, this study aimed to determine the underlying factors that may hinder Tennesseans from receiving the HPV vaccine, focusing on those adults within the recently approved age range of 27-45 years old. An Exploratory Factor Analysis of 2011 participants ultimately included five factors, which explain 70.3% of the variability. These were Benefits/Trust, Perceived Susceptibility, Attitude/Behavioral Control, Perceived Barriers, and Perceived Severity. All Cronbach alphas were greater than 0.80, indicating that each factor was reliable. When stratifying by various demographics, our analysis found that race emerged as a significant factor ( = 0.002), while the interaction of race and vaccination status was not significant ( = 0.753). Black respondents had significantly lower levels of Benefits/Trust than White ( < 0.001) and Asian respondents ( = 0.030), with no significant differences between White and Asian respondents. These findings underscore the importance of researchers, healthcare professionals, public health officials, and policymakers in addressing these demographic differences to effectively increase vaccination rates and reduce HPV-associated cancer risks in Tennessee. Further studies are needed for targeted interventions to address these disparities.
人乳头瘤病毒（HPV）仍是美国最普遍的性传播感染。到45岁时，超过80%的美国人会感染HPV，这引发了重大的公共卫生问题。尽管有有效的疫苗，但疫苗接种率低仍是一项挑战，尤其是在田纳西州。此外，免疫实践咨询委员会（ACIP）最近扩大了HPV疫苗使用建议，将27至45岁的成年人纳入其中，这表明这一人群在预防保健方面可能存在差距。为了解可能阻碍田纳西州人接种HPV疫苗的潜在因素，我们于2023年6月29日至8月17日对田纳西州18至45岁的成年人进行了一项横断面调查。该调查是根据一项关于疫苗犹豫中使用的各种结构和框架的范围审查以及我们之前的定性研究制定的。本研究使用基于理论的工具和之前的定性数据，旨在确定可能阻碍田纳西州人接种HPV疫苗的潜在因素，重点关注最近批准的27至45岁年龄范围内的成年人。对2011名参与者进行的探索性因素分析最终包括五个因素，这些因素解释了70.3%的变异性。它们分别是益处/信任、感知易感性、态度/行为控制、感知障碍和感知严重性。所有克朗巴哈系数均大于0.80，表明每个因素都是可靠的。在按各种人口统计学特征分层时，我们的分析发现种族是一个显著因素（P = 0.002），而种族与疫苗接种状况的相互作用不显著（P = 0.753）。黑人受访者的益处/信任水平明显低于白人（P < 0.001）和亚洲受访者（P = 0.030），白人和亚洲受访者之间没有显著差异。这些发现强调了研究人员、医疗保健专业人员、公共卫生官员和政策制定者在解决这些人口统计学差异以有效提高田纳西州的疫苗接种率和降低HPV相关癌症风险方面的重要性。需要进一步研究以制定针对性干预措施来解决这些差异。
