Correlates for Completion of 3-Dose Regimen of HPV Vaccine in Female Members of a Managed Care Organization
Correlates for Completion of 3-Dose Regimen of HPV Vaccine in Female Members of a Managed Care Organization
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DOI：
10.4065/84.10.864
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发表时间：
2009-10-01
影响因子：
8.9
通讯作者：
Jacobsen, Steven J.
中科院分区：
文献类型：
--
作者：
Chao, Chun;Velicer, Chrstine;Jacobsen, Steven J.
目的：为了检查四价人乳头瘤病毒疫苗（HPV 4）3剂方案的完成率和相关性，因为不遵守方案可能会对疫苗效力产生不利影响。南加州凯萨医疗机构的女性成员，年龄在9岁至26岁之间，在2006年10月至2007年3月期间接受了第一剂HPV 4，并在12个月后保持健康计划成员资格，并随访方案完成情况。我们审查了以下内容：（1）人口统计学/社会经济地位，（2）初级保健医生特征，（3）历史卫生服务利用，（4）妇女的健康相关状况，和（5）选择的免疫相关状况，用于它们与2个年龄组中完成的相关性：9至17岁和18至26岁。多变量log-binomial回归用于直接估计相对危险度（RR）。结果：在34，193名启动HPV 4的女性中，9- 17岁组的完成率为41.9%，18- 26岁组为47.1%。黑人种族（RR，0.70; 95%置信区间[CI]，0.64-0.77）和较低的社区教育水平与较低的方案完成率相关。然而，那些在9至17岁的组谁是由国家补贴的计划Medi-Cal覆盖更有可能完成方案（RR，1.14; 95% CI，1.07-1.22）。住院史和急诊就诊史（每次就诊的RR，0.92; 95% CI，0.87-0.96; RR，0.96; 95% CI，0.94-0.98）和有儿科医生也是未完成研究的预测因素。性传播疾病的历史，异常巴氏试验结果，免疫相关的条件（例如，哮喘/感染）与方案completion.CONCLUSION：这些研究结果表明，当人乳头瘤病毒疫苗接种计划正在设计和评估，如种族或社会经济地位的因素，应予以考虑。马约临床学报2009;84（10）：864-870
OBJECTIVE: To examine the rate and correlates of completion of the quadrivalent human papillomavirus vaccine (HPV4) 3-dose regimen because nonadherence to the regimen may adversely affect vaccine efficacy.PARTICIPANTS AND METHODS: Female members of Kaiser Permanente Southern California who were 9 to 26 years old, received the first dose of HPV4 between October 2006 and March 2007, and maintained health plan membership 12 months afterward were Identified and followed up for regimen completion. We examined the following: (1) demographics/socioeconomic status, (2) primary care physician characteristics, (3) historical health service utilization, (4) women's health-related conditions, and (5) selected Immune-related conditions for their association with completion In 2 age groups: 9 to 17 years and 18 to 26 years. Multivariable log-binomial regression was used to directly estimate relative risk (RR).RESULTS: Of the 34,193 females who Initiated HPV4, the completion rate was 41.9% In the 9- to 17-year-old group and 47.1% In the 18- to 26-year-old group. Black race (RR, 0.70; 95% confidence interval [CI], 0.64-0.77) and lower neighborhood education level were associated with lower regimen completion. However, those in the 9- to 17-year-old group who were covered by the state-subsidized program Medi-Cal were more likely to complete the regimen (RR, 1.14; 95% Cl, 1.07-1.22). Historical hospitalizations and emergency department visits (RR, 0.92; 95% Cl, 0.87-0.96; and RR, 0.96; 95% Cl, 0.94-0.98 per visit, respectively) and having a pediatrician were also predictors of noncompletion. A history of sexually transmitted diseases, abnormal Papanicolaou test results, and Immune-related conditions (eg, asthma/infections) were not associated with regimen completion.CONCLUSION: These findings suggest that factors such as race or socioeconomic status should be considered when human papillomavirus vaccination programs are being designed and evaluated. Mayo Clin Proc. 2009;84(10):864-870