Examining Future Adolescent Human Papillomavirus Vaccine Uptake, With and Without a School Mandate
Examining Future Adolescent Human Papillomavirus Vaccine Uptake, With and Without a School Mandate
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DOI：
10.1016/j.jadohealth.2009.12.009
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发表时间：
2010-09-01
影响因子：
7.6
通讯作者：
Mendez, David
中科院分区：
文献类型：
--
作者：
Dempsey, Amanda F.;Mendez, David
目的：建立青少年（HPV）人乳头瘤病毒疫苗使用模型，探讨未来HPV疫苗接种率，有无学校强制，在中学入学时接种疫苗。方法：建立了一个动态的、以人群为基础的区室模型，估计了生活在美国的女性青少年超过50年的HPV疫苗接种率。该模型纳入了父母对这种疫苗的态度和青少年保健利用水平的数据。结果：在没有强制要求的情况下，我们的模型预测70%的覆盖率（在许多先前的HPV疫苗接种建模研究中使用的较低阈值）要到疫苗可用后的平均23年才能实现。50年后达到79%的最大覆盖率。随着学校授权的实施，使用率大幅提高，到第8年疫苗接种覆盖率达到70%，到第43年达到最大疫苗接种覆盖率90%。结论：我们的研究结果表明，尽管强有力的学校指令可能会提高HPV疫苗的吸收率，但疫苗的使用率可能会在几年内很低。这些结果影响了先前的建模研究的解释，这些研究在假设非常高的疫苗使用率的情况下估计了HPV疫苗接种的潜在临床效果。(C) 2010年青少年健康和医学学会。版权所有。
Purpose: To develop a model of adolescent (HPV) human papillomavirus vaccine utilization that explored future HPV vaccination rates, with and without a school mandate, for the vaccine at middle school entry.Methods: A dynamic, population-based, compartmental model was developed that estimated over a 50-year time horizon HPV vaccine uptake among female adolescents living in the United States. The model incorporated data on parental attitudes about this vaccine and adolescent health care utilization levels.Results: Without a mandate, our model predicted that 70% coverage, a lower threshold value used in many previous modeling studies of HPV vaccination, would not be achieved until a mean of 23 years after vaccine availability. Maximal coverage of 79% was achieved after 50 years. With a school mandate in place, utilization increased substantially, with 70% vaccination coverage achieved by year 8 and maximal vaccination coverage, 90%, achieved by year 43.Conclusions: Our results suggest that vaccine utilization is likely to be low for several years, though strong school mandates might improve HPV vaccine uptake. These results affect the interpretation of previous modeling studies that estimated the potential clinical effects of HPV vaccination under assumptions of very high vaccine utilization rates. (C) 2010 Society for Adolescent Health and Medicine. All rights reserved.