2017-2022 年全国免疫调查的横断面分析：美国青少年中 HPV 疫苗接种启动和完成系列与社会人口统计学差异相关。
A Cross-Sectional Analysis of 2017-2022 National Immunization Survey: Sociodemographic Disparities Associated With Human Papillomavirus Vaccine Initiation and Completion Series Among US Adolescents.
机构信息
Department of Graduate Studies in Health and Rehabilitation Science, Youngstown State University, Youngstown, OH, USA.
Department of Criminal Justice and Consumer Sciences, Youngstown State University, Youngstown, OH, USA.
出版信息
Cancer Control. 2024 Jan-Dec;31:10732748241293674. doi: 10.1177/10732748241293674.
OBJECTIVE
The introduction of the Human Papillomavirus (HPV) vaccine has led to future decline in prevalence of HPV-causing cancers; however, disparities in early HPV vaccine uptake and coverage may contribute to persistent inequalities in HPV-related cancers in the United States. We assess the current trend of sociodemographic factors significantly associated with the initiation and Up To Date (UTD) HPV vaccine series among adolescents in the U.S.
METHODS
The retrospective National Immunization Survey-Teen data were analyzed for a cohort of adolescents aged 13-17 years who initiated HPV vaccine and completed the series from 2017 to 2022. A multivariable logistic regression estimated the correlation of sociodemographic variables to determine the odds of HPV vaccine initiation and completion as the outcomes.
RESULTS
There were 3.2% and 5% surge in HPV vaccine initiation and UTD, respectively, with teens' mean age of 14.98 over the years. The unvaccinated dropped by 5.6%, and those not UTD declined by 4.6% in the HPV vaccine series during this period. The proportion of teens who initiated and completed the vaccine series were mostly older female teens, non-Hispanics, regularly insured with private coverage, raised by educated older mothers, above poverty status, and living in the South. The adjusted multivariable logistic regression shows the odds of initiating and completing increases over the years, and older teens are more likely to initiate the HPV vaccine and complete the vaccine series. However, boys with non-Medicaid coverage/uninsured in the South have lower odds to initiate and complete the vaccine.
CONCLUSION
Improved HPV vaccine uptake and UTD were found in older females, insured with Medicaid, and from highly educated mothers in the Northeast. Findings underscore the importance of effective strategies to address current HPV vaccination disparities among identified teens with lower uptake and UTD that may reduce future burden of HPV-related cancers in the U.S.
目的
人乳头瘤病毒（HPV）疫苗的引入导致 HPV 引起的癌症患病率未来将下降；然而，美国 HPV 疫苗接种和覆盖率的早期差异可能导致 HPV 相关癌症的持续不平等。我们评估了与美国青少年 HPV 疫苗接种系列启动和最新（Up To Date，UTD）相关的社会人口因素的当前趋势。
方法
对 2017 年至 2022 年期间接种 HPV 疫苗并完成系列接种的 13-17 岁青少年的回顾性全国免疫调查-青少年数据进行了分析。多变量逻辑回归估计了社会人口变量的相关性，以确定 HPV 疫苗接种启动和完成的可能性作为结果。
结果
HPV 疫苗接种启动和 UTD 分别增长了 3.2%和 5%，青少年的平均年龄为 14.98 岁。在这段时间内，HPV 疫苗系列中的未接种人数下降了 5.6%，未完成 UTD 的人数下降了 4.6%。启动和完成疫苗系列的青少年中，大多数是年龄较大的女性青少年、非西班牙裔、定期投保私人保险、由受过教育的年长母亲抚养、处于贫困线以上，并且居住在南部。调整后的多变量逻辑回归显示，启动和完成的几率随着时间的推移而增加，年龄较大的青少年更有可能启动 HPV 疫苗接种并完成疫苗系列。然而，南方没有医疗保险/未参保的男孩启动和完成疫苗的几率较低。
结论
在东北部，接受过更多教育的母亲投保 Medicaid 的较年长女性、青少年 HPV 疫苗接种率和 UTD 有所提高。这些发现强调了必须制定有效的策略来解决当前 HPV 疫苗接种率较低和 UTD 率较低的青少年的差异，这可能会降低美国未来 HPV 相关癌症的负担。
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