青少年定期体检时的人乳头瘤病毒疫苗接种时机
Human papillomavirus vaccine administration opportunities at well visits in adolescents.
作者信息
Saxena Kunal, Ai Lei, Martino Amanda, Mohamed Aneesha Fathima Syed, Wang Dong, Zheng Yi, Oliver Kristin
机构信息
Outcomes Research, Merck & Co., Inc, 126 East Lincoln Avenue, Rahway, NJ, 07065, USA.
Departments of Environmental Medicine and Climate Science, Pediatrics Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
BMC Public Health. 2025 Jun 4;25(1):2084. doi: 10.1186/s12889-025-23235-9.
BACKGROUND
Despite the effectiveness of the human papillomavirus (HPV) vaccine, uptake in the United States (US) remains suboptimal, with only about half of US adolescents completing the HPV vaccine series before the recommended age of 13. Adolescents are more likely to be vaccinated at annual well visits, making these visits key opportunities to promote HPV vaccination and improve overall completion rates of the HPV vaccination series. Further, it has been suggested that HPV vaccine initiation at age 9 may increase overall adolescent coverage of HPV vaccine. This study aimed to describe patterns in HPV vaccine administration during adolescent well visits and quantify potential HPV vaccination opportunities at age 9.
METHODS
This retrospective descriptive analysis included adolescents aged 9-14 years with continuous enrollment from 2018 to 2022 in the MarketScan Commercial or the Multi-State Medicaid databases. We analyzed percentages of well visits and administered vaccines for each age cohort and calendar year. We assessed potential opportunities for HPV vaccination among adolescents at the 9-, 10-,11-, and 12-year well visits.
RESULTS
Most age 9 well visits showed no vaccine claims (89.0-91.7%) while claims for two and three concurrent vaccines at age 11 occurred in 22.2-37.2% of well visits, most often for meningococcal and Tdap vaccines. Claims for HPV vaccine initiation at 11 and 12 years remained suboptimal (17.9-24.3%). We identified several potential opportunities for HPV vaccination. Among adolescents who did not receive the HPV vaccine at their 9- or 10-year well visits, 34.8-36.9% did not have a well visit at 11 or 12 years. Among adolescents with an 11- and 12-year well visit, 20.6-30.0% had claims for vaccination, but not the HPV vaccine. Among adolescents with a well visit at 11 or 12 years who received one or more other vaccinations, but not the HPV vaccine, 40.6-46.1% had a well visit at 9 or 10 years and did not initiate the HPV vaccine then.
CONCLUSIONS
Routine HPV vaccination beginning at age 9 well visits could optimize opportunities to improve vaccine coverage.
背景
尽管人乳头瘤病毒（HPV）疫苗有效，但美国的疫苗接种率仍不理想，只有约一半的美国青少年在13岁的推荐年龄之前完成了HPV疫苗系列接种。青少年更有可能在年度健康检查时接种疫苗，这使得这些检查成为促进HPV疫苗接种和提高HPV疫苗系列总体完成率的关键机会。此外，有人提出9岁开始接种HPV疫苗可能会提高青少年HPV疫苗的总体接种率。本研究旨在描述青少年健康检查期间HPV疫苗接种模式，并量化9岁时潜在的HPV疫苗接种机会。
方法
这项回顾性描述性分析纳入了2018年至2022年在MarketScan商业数据库或多州医疗补助数据库中持续登记的9至14岁青少年。我们分析了每个年龄组和日历年的健康检查百分比和接种疫苗情况。我们评估了9岁、10岁、11岁和12岁健康检查时青少年中HPV疫苗接种的潜在机会。
结果
大多数9岁的健康检查没有疫苗接种记录（89.0% - 91.7%），而11岁时同时接种两种和三种疫苗的记录出现在22.2% - 37.2%的健康检查中，最常见的是脑膜炎球菌疫苗和破伤风、白喉、无细胞百日咳联合疫苗（Tdap）。11岁和12岁开始接种HPV疫苗的记录仍然不理想（17.9% - 24.3%）。我们确定了几个HPV疫苗接种的潜在机会。在9岁或10岁健康检查时未接种HPV疫苗的青少年中，34.8% - 36.9%在11岁或12岁时没有进行健康检查。在11岁和12岁进行健康检查的青少年中，20.6% - 30.0%有疫苗接种记录，但没有接种HPV疫苗。在11岁或12岁进行健康检查且接种了一种或多种其他疫苗但未接种HPV疫苗的青少年中，40.6% - 46.1%在9岁或10岁时进行了健康检查，但当时未开始接种HPV疫苗。
结论
从9岁健康检查开始进行常规HPV疫苗接种可以优化提高疫苗接种率的机会。
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