Intention choice of daughters′ free HPV vaccination scheme: an online survey among mothers of school-age girls in Suzhou city
-
摘要:
目的 对适龄9～15岁女生母亲的宫颈癌知识、人乳头瘤病毒（HPV）疫苗知识和对不同HPV疫苗免费供应方案的选择意愿进行调查，为卫生行政部门制定相关免疫接种策略提供依据。 方法 于2022年10月通过“苏州预防接种”官方微信公众服务号向苏州市9～15岁女生母亲推送自行设计的问卷进行在线网络调查。 结果 共1648人参与调查，回收有效问卷1484份。如果政府开展适龄女生双价HPV疫苗免费接种项目，4种HPV疫苗免费供应方案选择人数由多至少依次为：699人（47.10%）选择方案二（免费接种中标国产双价HPV疫苗或自费补差价接种其他疫苗的方案）、565人（38.07%）选择方案一（采用参照二针国产双价HPV疫苗价格的现金补贴方案）、161人（10.85%）选择方案三（免费接种中标国产双价HPV疫苗或全自费接种其他疫苗的方案）和59人（3.98%）选择方案四（保证供应但纯自费接种方案）。不同学历（χ2 = 53.77，P < 0.05）、家庭月收入（χ2 = 49.07，P < 0.05）和认知得分（χ2 = 8.19，P = 0.04）对HPV疫苗免费供应方案的选择差异有统计学意义。多元logistics回归模型结果显示，相较于方案四，家庭月收入 ≤5000元是选择方案一（OR = 5.65）、方案二（OR = 5.31）和方案三（OR = 14.34）的影响因素；选择方案一的影响因素还有家庭月收入10001～15000元（OR = 2.59）；方案三的影响因素还有月收入5001～10000元（OR = 2.60）。在4种方案中选择接种九价疫苗的人均占比最多，分别为94.16%（532/565）、83.26%（582/699）、55.28%（89/161）和98.31%（58/59）。 结论 苏州市9～15岁女生母亲选择方案二的人数最多，家庭月收入和学历是HPV疫苗免费供应方案选择的影响因素。所有接种方案中家长对九价疫苗的选择最多，应尽快推进国产高性价比的九价HPV疫苗的研发、生产与供应。 Abstract:Objective To investigate the knowledge on cervical cancer and human papillomavirus (HPV) vaccine, and intention choice of daughters′ free HPV vaccination scheme among mothers of school-age girls for providing evidence to administrative departments in developing relevant vaccination strategies. Methods Using convenient sampling and a self-designed questionnaire, we conducted an online survey among 1 648 mothers of girls aged 9 – 15 years through official WeChat website of Suzhou Vaccination during October 2022. The data collected from 1 484 eligible respondents were statistically analyzed. Results Of the 1 484 respondents for the four listed HPV vaccination schemes available to their daughters (including free domestic bivalent or subsidized HPV vaccine supplied by health administrative departments), 699 (47.10%) selected plan 2 (free domestic bivalent HPV vaccine or partially subsidized vaccination of other HPV vaccines); 565 (38.07%) selected plan 1 (with cash subsidy for other HPV vaccination according to the price of two-dose vaccination of domestic bivalent HPV vaccine); 161 (10.85%) selected plan 3 (free vaccination of domestic HPV vaccine or self-paid vaccination of other HPV vaccines); and 59 (3.98%) selected plan 4 (self-paid vaccination of all other HPV vaccines available). Nine-valent HPV vaccine was the most frequently selected vaccine reported by the four groups of respondents with different intention choice of the vaccination scheme, with the selecting ratios of 94.16%, 83.26%, 55.28%, and 98.31% for the respondents reporting the intention choice of vaccination plan 2, 1, 3, and 4, respectively. The respondents' intention choice of daughters′ free HPV vaccination scheme differed significantly by educational background (χ2 = 53.77, P < 0.05), monthly household income (χ2 = 49.07, P < 0.05), and the score of cognition on cervical cancer and HPV vaccine (χ2 = 8.19, P = 0.04). The results of multivariate logistic regression model showed that compared to those with a monthly household income of ≥ 20 001 (Chinese Yuan), the respondents with a monthly household income of ≤ 5 000 were more likely to select the plan 1 (odds ratio [OR] = 5.65), plan 2 (OR = 5.31), and plan 3 (OR = 14.34) other than the plan 4; the respondents with a monthly household income of 10 001 – 15 000 were likely to select the plan 3 (OR = 2.59) other than the plan 4; and the respondents with a monthly family income of 5 001 – 10 000 were more likely to select the plan 3 (OR = 2.60) other than the plan 4. Conclusion In Suzhou city, about one half of the mothers of school-age girls intend to select free domestic bivalent vaccine or partially subsidized vaccination of other vaccines for their daughters′ free HPV vaccination scheme, with nine-valent HPV vaccine being the most frequently selected vaccine, and the intention choice is mainly influenced by maternal monthly household income and education background. -
表 1 苏州市9～15岁女生母亲对HPV疫苗免费供应方案选择的单因素分析
Table 1. Age-, education-, household income-, and relevant knowledge-specific intention choice of free HPV vaccination scheme among 1 484 mothers of girls aged 9 – 15 years in Suzhou city
项目 方案一（n = 565） 方案二（n = 699） 方案三（n = 161） 方案四（n = 59） χ2 值 P 值 人数 构成比（%） 人数 构成比（%） 人数 构成比（%） 人数 构成比（%） 年龄（岁） 8.60 0.20 ≤ 35 157 27.79 214 30.61 63 39.13 15 25.42 36～40 277 49.03 326 46.64 64 39.75 29 49.15 ≥ 41 131 23.18 159 22.75 34 21.12 15 25.42 学历 53.77 < 0.01 中专/高中及以下 109 19.29 177 25.32 71 44.10 15 25.42 大专 173 30.62 230 32.90 43 26.71 11 18.64 本科 256 45.31 259 37.05 45 27.95 28 47.46 研究生及以上 27 4.78 33 4.72 2 1.24 5 8.47 家庭月收入（元） 49.07 < 0.01 ≤ 5000 50 8.85 71 10.16 37 22.98 2 3.39 5001～10000 154 27.26 220 31.47 56 34.78 17 28.81 10001～15000 140 24.78 154 22.03 28 17.39 9 15.25 15001～20000 109 19.29 120 17.17 23 14.29 12 20.34 ≥ 20001 112 19.82 134 19.17 17 10.56 19 32.20 认知得分 低分组 135 23.89 193 27.61 56 34.78 18 30.51 8.19 0.04 高分组 430 76.11 506 72.39 105 65.22 41 69.49 注：方案一，采用参照二针国产双价HPV疫苗价格（约600元）的现金补贴方案；方案二，免费接种中标国产双价HPV疫苗或自费补差价接种其他疫苗的方案；方案三，免费接种中标国产双价HPV疫苗或全自费接种其他疫苗的方案；方案四，采用保证供应但纯自费接种方案。 
下载: 导出CSV
表 2 苏州市9～15岁女生母亲对HPV疫苗免费供应方案选择意愿多因素分析
Table 2. Education-, household income-, and relevant knowledge-specific intention choice of free HPV vaccination scheme among 1 484 mothers of girls aged 9 – 15 years in Suzhou city: multivariate analysis
项目 对照组 方案一 方案二 方案三 OR 值 P 值 95%CI OR 值 P 值 95%CI OR 值 P 值 95%CI 学历 中专/高中及以下 研究生及以上 0.93 0.90 0.28～3.07 1.19 0.77 0.37～3.87 5.26 0.07 0.86～32.39 大专 2.27 0.18 0.69～7.41 2.46 0.13 0.76～7.90 6.03 0.05 0.98～37.00 本科 1.47 0.47 0.52～4.20 1.23 0.70 0.44～3.44 3.10 0.20 0.55～17.34 家庭月收入（元） ≤ 5000 ≥ 20001 5.65 0.03 1.18～27.11 5.31 0.04 1.12～25.21 14.34 0.00 2.76～74.49 5001～10000 1.68 0.19 0.77～3.64 1.71 0.17 0.79～3.69 2.60 0.04 1.03～6.59 10001～15000 2.59 0.03 1.10～6.13 2.17 0.08 0.92～5.09 2.64 0.06 0.94～7.38 15001～20000 1.48 0.33 0.68～3.22 1.32 0.49 0.61～2.85 1.83 0.22 0.70～4.82 认知得分 低分组 高分组 0.67 0.19 0.36～1.23 0.73 0.31 0.40～1.34 0.80 0.51 0.41～1.57 注：方案一，采用参照二针国产双价HPV疫苗价格（约600元）的现金补贴方案；方案二，免费接种中标国产双价HPV疫苗或自费补差价接种其他疫苗的方案；方案三，免费接种中标国产双价HPV疫苗或全自费接种其他疫苗的方案。
下载: 导出CSV
表 3 苏州市9～15岁女生母亲在免费供应方案中选择HPV疫苗类型情况
Table 3. Intention choice of HPV vaccine type by free HPV vaccination scheme among 1 484 mothers of girls aged 9 – 15 years in Suzhou city
HPV疫苗 HPV疫苗免费供应方案 方案一 方案二 方案三 方案四 人数 构成比（%） 人数 构成比（%） 人数 构成比（%） 人数 构成比（%） 国产二价疫苗 7 1.24 59 8.44 53 32.92 0 0.00 进口二价疫苗 11 1.95 26 3.72 8 4.97 0 0.00 四价疫苗 15 2.65 31 4.43 10 6.21 1 1.69 九价疫苗 532 94.16 582 83.26 89 55.28 58 98.31 不接种疫苗 0 0.00 1 0.14 1 0.62 0 0.00 注：方案一，采用参照二针国产双价HPV疫苗价格（约600元）的现金补贴方案；方案二，免费接种中标国产双价HPV疫苗或自费补差价接种其他疫苗的方案；方案三，免费接种中标国产双价HPV疫苗或全自费接种其他疫苗的方案；方案四，采用保证供应但纯自费接种方案。
下载: 导出CSV
-
[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA:A Cancer Journal for Clinicians, 2021, 71(3): 209 – 249. doi: 10.3322/caac.21660 [2] Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chinese Medical Journal, 2021, 134(7): 783 – 791. doi: 10.1097/CM9.0000000000001474 [3] Gultekin M, Ramirez PT, Broutet N, et al. World Health Organiza-tion call for action to eliminate cervical cancer globally[J]. Inter-national Journal of Gynecologic Cancer, 2020, 30(4): 426 – 427. doi: 10.1136/ijgc-2020-001285 [4] 新华社. 国务院印发《中国妇女发展纲要 (2021 — 2030年)》和《中国儿童发展纲要 (2021 — 2030年)》[EB/OL]. (2021 – 09 – 27)[2022 – 12 – 25]. http://www.gov.cn/xinwen/2021-09/27/content_5639545.htm. [5] Jin RR, Yang XM, Bao JJ, et al. The prevalence and genotype distribution of human papilloma virus in cervical squamous intraepithelial lesion and squamous cell carcinoma in Taizhou, China[J]. Medicine, 2021, 100(28): e26593. doi: 10.1097/MD.0000000000026593 [6] World Health Organization. HPV vaccine, programme coverage in female[EB/OL]. (2022 – 07 – 07)[2022 – 12 – 25]. https://app.powerbi.com/view?r=eyJrIjoiNDIxZTFkZGUtMDQ1Ny00MDZkLThiZDktYWFlYTdkOGU2NDcwIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9. [7] 云雪霞, 王大虎, 谭慧峰, 等. 广州市初中女生监护人对人乳头瘤病毒(HPV)疫苗接种意愿及影响因素研究[J]. 医学动物防制, 2022, 38(7): 663 – 666. [8] 刘捷宸, 吴琳琳, 白庆瑞, 等. 上海市2017 — 2019年人乳头瘤病毒疫苗接种率和疑似预防接种异常反应监测[J]. 中国疫苗和免疫, 2020, 26(3): 322 – 325,348. [9] 袁克兵, 张培英, 杨猛, 等. 滕州市2018 — 2020年HPV疫苗接种及影响因素配对病例对照研究[J]. 中国公共卫生, 2021, 37(12): 1746 – 1750. doi: 10.11847/zgggws1134989 [10] 冉睿, 张春焕, 黄勇, 等. 广州市女性HPV疫苗接种意愿及其影响因素分析[J]. 中国公共卫生, 2021, 37(12): 1751 – 1755. doi: 10.11847/zgggws1135359 [11] 邓景景, 张钧, 王菁, 等. 苏州市中小学女生家长子宫颈癌防控认知调查[J]. 公共卫生与预防医学, 2019, 30(5): 138 – 141. [12] Chido-Amajuoyi OG, Jackson I, Yu R, et al. Declining awareness of HPV and HPV vaccine within the general US population[J]. Human Vaccines and Immunotherapeutics, 2021, 17(2): 420 – 427. doi: 10.1080/21645515.2020.1783952 [13] Lama Y, Quinn SC, Nan XL, et al. Social media use and human papillomavirus awareness and knowledge among adults with children in the household: examining the role of race, ethnicity, and gender[J]. Human Vaccines and Immunotherapeutics, 2021, 17(4): 1014 – 1024. doi: 10.1080/21645515.2020.1824498 [14] 李君, 石雅佳, 王洪岩, 等. 倾向性评分匹配分析大学生HPV疫苗接种的影响因素[J]. 现代预防医学, 2021, 48(15): 2819 – 2824. -
点击查看大图
表(3)
计量
- 文章访问数: 605
- HTML全文浏览量: 113
- PDF下载量: 232
- 被引次数: 0