Physicians' Human Papillomavirus Vaccine Recommendations, 2009 and 2011
Physicians' Human Papillomavirus Vaccine Recommendations, 2009 and 2011
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DOI：
10.1016/j.amepre.2013.07.009
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发表时间：
2014-01-01
影响因子：
5.5
通讯作者：
Giuliano, Anna R.
中科院分区：
文献类型：
--
作者：
Vadaparampil, Susan T.;Malo, Teri L.;Giuliano, Anna R.
背景：医生推荐是人类乳头瘤病毒(HPV)疫苗接种的关键预测因素。了解与推荐相关的因素对于努力增加目前次优疫苗的使用率非常重要。目的：本研究旨在检查医生分别在2009年和2011年，在疫苗许可后3年和5年为11-26岁的女性患者接种疫苗的建议。第二个目标是确定11岁和12岁儿童疫苗推荐相关因素的趋势。方法：从美国医学协会医师总档案中随机抽取具有全国代表性的家庭医学、儿科和妇产科医生样本(2009年为1538人，2011年为1541人)。一份邮寄的调查询问了医生关于患者和临床实践的特点、免疫支持以及HPV疫苗推荐的频率(“总是”=75%的时间与其他)。结果：2009年和2011年分别收到1013名合格医师(应答率68%)和928名(63%)合格医师的完整调查问卷。从2009年到2011年，对于11岁或12岁的患者，报告总是推荐HPV疫苗的医生比例显著增加(分别为35%和40%；p=0.03)，但对于13-17岁的患者(53%对55%；p=0.28)或18-26岁的患者(50%对52%；p=0.52)。医生专业、年龄和对疫苗接种的认知问题/障碍与两年内11岁或12岁患者的疫苗推荐有关。结论：结果表明，在两年期间，11岁或12岁女孩接种HPV疫苗的建议略有增加；然而，尽管国家建议普及免疫，但对所有年龄段的建议仍然是次优的。
Background: Physician recommendation is a key predictor of human papillomavirus (HPV) vaccine uptake. Understanding factors associated with recommendation is important for efforts to increase current suboptimal vaccine uptake.Purpose: This study aimed to examine physician recommendations to vaccinate female patients aged 11-26 years, in 2009 and 2011, at 3 and 5 years postvaccine licensure, respectively. A second aim was to identify trends in factors associated with vaccine recommendation for ages 11 and 12 years.Methods: Nationally representative samples of physicians practicing family medicine, pediatrics, and obstetrics and gynecology were randomly selected from the American Medical Association Physician Masterfile (n=1538 in 2009, n=1541 in 2011). A mailed survey asked physicians about patient and clinical practice characteristics; immunization support; and frequency of HPV vaccine recommendation ("always" >= 75% of the time vs other). Analyses were conducted in 2012.Results: Completed surveys were received from 1013 eligible physicians (68% response rate) in 2009 and 928 (63%) in 2011. The proportion of physicians who reported always recommending HPV vaccine increased significantly from 2009 to 2011 for patients aged 11 or 12 years (35% vs 40%, respectively; p=0.03), but not for patients aged 13-17 years (53% vs 55%; p=0.28) or 18-26 years (50% vs 52%; p=0.52). Physician specialty, age, and perceived issues/barriers to vaccination were associated with vaccine recommendation for patients aged 11 or 12 in both years.Conclusions: Results suggest a modest increase in recommendations for HPV vaccination of girls aged 11 or 12 years over a 2-year period; however, recommendations remain suboptimal for all age groups despite national recommendations for universal immunization.