期刊
PAPILLOMAVIRUS RESEARCH
卷 2, 期 -, 页码 128-132出版社
ELSEVIER
DOI: 10.1016/j.pvr.2016.06.002
关键词
HPV vaccine; Adolescent; Preventive medicine; Demographic factors; Registries
类别
资金
- Huntsman Cancer Institute Foundation
- Primary Children's Hospital Foundation
- Beaumont Foundation
- National Center for Advancing Translational Sciences of the National Institutes of Health [1ULTR001067, KL2TR001065]
Background: Human papillomavirus (HPV) vaccine 3-dose completion rates among adolescent females in the US are low. Missed opportunities impede HPV vaccination coverage. Methods: A population-based secondary data analysis of de-identified vaccination and demographic data from the Utah Statewide Immunization Information System (USIIS) was conducted. Records were included from 25,866 females ages 11-26 years at any time during 2008-2012 who received at least one of the following adolescent vaccinations documented in the USIIS: Tdap (Tetanus, Diphtheria, Pertussis), meningococcal, and/or influenza. A missed opportunity for HPV vaccination was defined as a clinical encounter where the patient received at least one adolescent vaccination, but not a HPV vaccine. Results: Of 47,665 eligible visits, there were 20,911 missed opportunities (43.87%). Age group, race/ethnicity, and rurality were significantly associated with missed opportunity (p < 0.0001). In a multi variable mixed-effects logistic regression model that included ethnicity, location and age, as fixed effects and subject as a random effect, Hispanics were less likely to have a missed opportunity than whites OR 0.59 (95% CI: 0.52-0.66), small rural more likely to have a missed opportunity than urban youth OR 1.8 (95% CI: 1.5-2.2), and preteens more likely than teens OR 2.4 (95% CI: 2.2-2.7). Conclusion: Missed clinical opportunities are a significant barrier to HPV vaccination among female adolescents. Interventions targeted at providers who serve patient groups with the highest missed opportunities are needed to achieve adequate protection from HPV-associated illnesses. Impact: This is one of the first studies to utilize state immunization information system data to assess missed opportunities for HPV vaccination. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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