Llavona-Ortiz Josheili Y, Fogel Benjamin, Scoy Lauren J Van, Pinto Casey N, Tuan Wen-Jan, Pradhan Sandeep, Calo William A
Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
University of Arizona Cancer Center, Tucson, AZ, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251359401. doi: 10.1177/10732748251359401. Epub 2025 Jul 19.
BackgroundCOVID-19 pandemic-related disruptions in primary care caused delays in in-person well visits for patients that were age-eligible to receive recommended preventive healthcare services. Vaccine schedules impacted by disruptions led to delays in administration of human papillomavirus (HPV), tetanus, diphtheria, and acellular pertussis (Tdap), and quadrivalent meningococcal (MenACWY) vaccines, but some studies report inconsistent findings. Our study sought to characterize changes in HPV vaccination patterns during the COVID-19 pandemic by birth cohorts in South Central Pennsylvania, compared to changes in Tdap and MenACWY vaccination.MethodsOur methodological approach consisted of survival analysis techniques, such as Kaplan-Meier survival curves and Cox proportional hazards models. Patient data were analyzed by separate birth cohorts and groups of birth cohorts, with a primary interest on younger birth cohorts during the COVID-19 pandemic.ResultsDemographic and vaccination data from 29 928 patients born between January 1, 2000 and December 31, 2014 were analyzed. Overall, 80.1% had been vaccinated against Tdap, 81.8% against meningitis, and 67.1% against HPV by the age of 17. The adjusted hazard ratio (aHR) for HPV vaccine initiation by age 12 was the highest for patients born between 2009 and 2010 (aHR = 2.52; 95% CI: 2.34, 2.70), when compared to patients born between 2000 and 2002. However, this observation was also accompanied by a slowed increase in uptake from 63.5% (birth cohort 2006-2008) to 65.2% (birth cohort 2009-2010). ConclusionUnderstanding changes in vaccination uptake by birth cohorts informs the efforts of researchers and primary care practitioners to identify best practices tailored to the vaccination gaps for each group.
背景
与2019冠状病毒病大流行相关的基层医疗中断，导致符合年龄条件的患者接受推荐的预防性医疗服务的面对面健康检查出现延迟。受干扰影响的疫苗接种计划导致人乳头瘤病毒（HPV）、破伤风、白喉和无细胞百日咳（Tdap）以及四价脑膜炎球菌（MenACWY）疫苗的接种延迟，但一些研究报告的结果并不一致。我们的研究旨在描述宾夕法尼亚州中南部在2019冠状病毒病大流行期间按出生队列划分的HPV疫苗接种模式的变化，并与Tdap和MenACWY疫苗接种的变化进行比较。
方法
我们的方法包括生存分析技术，如Kaplan-Meier生存曲线和Cox比例风险模型。患者数据按不同的出生队列和出生队列组进行分析，主要关注2019冠状病毒病大流行期间较年轻的出生队列。
结果
分析了2000年1月1日至2014年12月31日出生的29928名患者的人口统计学和疫苗接种数据。总体而言，到17岁时，80.1%的人接种了Tdap疫苗，81.8%的人接种了脑膜炎疫苗，67.1%的人接种了HPV疫苗。与2000年至2002年出生的患者相比，2009年至2010年出生的患者在12岁时开始接种HPV疫苗的调整后风险比（aHR）最高（aHR = 2.52；95% CI：2.34，2.70）。然而，这一观察结果还伴随着接种率从63.5%（2006 - 2008年出生队列）缓慢上升至65.2%（2009 - 2010年出生队列）。
结论
了解按出生队列划分的疫苗接种率变化，有助于研究人员和基层医疗从业者努力确定针对每组疫苗接种差距的最佳做法。
