Geographic Variation in Human Papillomavirus Vaccination Initiation and Completion Among Young Adults in the U.S.
Geographic Variation in Human Papillomavirus Vaccination Initiation and Completion Among Young Adults in the U.S.
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美国年轻人中人乳头瘤病毒疫苗接种开始和完成的地理差异
DOI：
10.1016/j.amepre.2020.09.005
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发表时间：
2021-03
影响因子：
5.5
通讯作者：
Kim M
中科院分区：
文献类型：
--
作者：
Adjei Boakye E;Babatunde OA;Wang M;Osazuwa-Peters N;Jenkins W;Lee M;Kim M
这项研究探讨了18-34岁男性和女性的人乳头瘤病毒疫苗接种开始和完成情况如何因地理区域而异。分析了2015-2017年行为风险因素监测系统的数据。所选州的地理区域被定义为南部、东北部和中西部/西部。人乳头瘤病毒疫苗接种开始定义为接受≥1剂，完成定义为接受≥3剂。加权多变量逻辑回归模型估计了地理区域和疫苗接种之间的关联，调整了社会人口统计学，健康和医疗保健因素。分析于2019年11月进行。共有18，078名成年人参与了这项研究，其中80%居住在南方。总体疫苗接种启动率为23.4%，完成率为11.0%。居住在东北部的人中启动率较高（38.6%），其次是中西部/西部（23.8%），南部最低（21.8%）（p<0.0001）。完成率与开始时的趋势相同。在调整后的模型中，与居住在东北部的成年人相比，居住在南方的人开始（AOR=0.47，95% CI=0.40，0.55）和完成（AOR=0.56，95% CI=0.46，0.68）人乳头瘤病毒疫苗接种的可能性较小。所有地区的人乳头瘤病毒疫苗接种率都很低，但南部地区的疫苗接种率明显较低。这表明有必要确定与南方人口具体相关的障碍，其中可能包括不同的教育和保险水平。这项工作尤其重要，因为许多南方州面临着人类乳头瘤病毒相关癌症的风险增加，如宫颈癌、口腔癌和咽癌。这项研究的摘要发表在第12届美国癌症研究协会会议上，会议主题是种族/民族少数群体和医疗服务不足人群的癌症健康差异科学，加利福尼亚州旧金山弗朗西斯科。
This study explores how human papillomavirus vaccination initiation and completion among men and women aged 18–34 years varies by geographic region. Data from the 2015–2017 Behavioral Risk Factor Surveillance System were analyzed. Geographic regions for the selected states were defined as South, Northeast, and Midwest/West. Human papillomavirus vaccination initiation was defined as receipt of ≥1 dose and completion as receipt of ≥3 doses. Weighted, multivariable logistic regression models estimated the association between geographic region and vaccine uptake, adjusting for sociodemographic, health, and healthcare factors. Analyses were performed in November 2019. A total of 18,078 adults were included in the study, 80% of whom resided in the South. The overall vaccination initiation rate was 23.4% and the completion rate was 11.0%. Initiation was higher among those who resided in the Northeast (38.6%), followed by Midwest/West (23.8%), and lowest for those in the South (21.8%) (p<0.0001). Completion rates followed the same trend as initiation. In the adjusted models, compared with adults residing in the Northeast, those living in the South were less likely to initiate (AOR=0.47, 95% CI=0.40, 0.55) and complete (AOR=0.56, 95% CI=0.46, 0.68) human papillomavirus vaccination. Human papillomavirus vaccine uptake was low for all regions, but vaccine uptake was significantly lower in the South region. This demonstrates the need to identify barriers specifically associated with the Southern population, which may include differing levels of education and insurance. Such work is especially pertinent as many Southern states face increased risk of human papillomavirus–associated cancers, such as cervix and oral cavity and pharynx cancers. The abstract of this study was presented at the 12th American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Under-served, San Francisco, CA.
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