克服人类乳头瘤病毒疫苗接种的障碍

Paige A. Domurat, Bonnie L. Nickasch
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摘要

引言尽管人乳头瘤病毒(HPV)疫苗有助于预防某些类型的癌症,但HPV疫苗接种率仍然很低,选择让孩子接种HPV疫苗已成为一个有争议的话题。该质量改进项目的主要目标是,一旦患者有资格接种HPV疫苗,通过创建并向儿科诊所患者及其家人分发一体化的教育和提醒系统,提高HPV疫苗接种率。方法确定了提高HPV疫苗接种率的三个障碍:成本、缺乏知识和缺乏提供者建议。实施了一个传单系统来解决这些障碍。这份传单发给所有11-18岁的患者,并附有强烈的口头提供者建议。结果进行了单样本比例测试,以确定2018年、2019年和2020年不同系列完成率的显著性。从2018年到2019年,儿科诊所的HPV疫苗接种系列完成率显著提高。在新冠肺炎大流行期间实施这一传单制度期间,疫苗接种系列完成率下降,但这一下降在统计上并不显著。讨论随着对疫情的控制,预计定期就诊将恢复正常,因此疫苗接种率也将恢复。这项研究的发现可用于创建或修改任何接种HPV疫苗的诊所的现行做法。未来的研究和试验应该实施更长的时间,而不是在大流行期间,理想的情况是产生更具统计意义的结果。
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Overcoming Barriers to Human Papillomavirus Vaccination
Introduction Despite the human papillomavirus (HPV) vaccine's ability to help prevent certain types of cancer, rates of vaccination against HPV remain low, and choosing to have a child receive the HPV vaccine has become a controversial topic. The primary objective of this quality improvement project was to increase HPV vaccination rates through creating and distributing an all-in-one education and reminder system to pediatric clinic patients and their families once patients are eligible to receive the HPV vaccination. Methods Three barriers to increasing rates of HPV vaccination were identified: cost, lack of knowledge, and lack of provider recommendation. A flyer system was implemented that addressed these barriers. This flyer was given to all patients ages 11–18 years, with a strong verbal provider recommendation. Results One-sample proportion tests were run to determine significance in the differing series completion rates in 2018, 2019, and 2020. The pediatric clinic's HPV vaccination series completion rates increased significantly from 2018 to 2019. During the implementation of this flyer system, which occurred during the COVID-19 pandemic, the vaccination series completion rates decreased, but this decrease was not statistically significant. Discussion As control is gained over the pandemic, it is anticipated that regular provider visits will increase back to normal and therefore vaccination rates will recover as well. The findings from this study can be used to create or modify current practices in clinics anywhere that the HPV vaccination is administered. Future studies and trials should be implemented for a longer period, and not during a pandemic, ideally to yield more statistically significant results.
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