电子健康记录提醒早期人类乳头瘤病毒疫苗接种
Tina Kumra1, Yongyi Lu2, Steve Blash3
1Department of Pediatrics, Johns Hopkins Community Physicians, Baltimore, Maryland.
JAMA network open
|February 16, 2026
概括
早期启动人类乳头瘤病毒 (HPV) 疫苗接种至关重要. 电子健康记录 (EHR) 的最佳实践警报与临床医师教育相结合,显著增加了9至10岁儿童的HPV疫苗接种率.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 医疗信息学 医疗信息学
背景情况:
- 人类乳头瘤病毒 (HPV) 疫苗接种率仍然低于最佳水平,尽管建议早在9岁开始接种.
- 确定有效的策略来改善早期HPV疫苗接种的启动和系列的完成对于公共卫生至关重要.
- 质量改善举措对于优化疫苗接种计划和覆盖率至关重要.
研究的目的:
- 为了比较两个干预措施对早期HPV疫苗启动的有效性.
- 为了比较9-10岁开始接种疫苗的青少年与11-14岁开始接种疫苗的青少年之间的HPV疫苗系列完成率.
- 确定与早期HPV疫苗接种启动和系列完成相关的因素.
主要方法:
- 一项追溯质量改进研究分析了来自21个美国门诊初级保健中心的数据.
- 实施了电子健康记录 (EHR) 的最佳实践警报 (BPAs),建议在9岁时接种HPV疫苗,其中一支包括额外的临床医生教育组件.
- 包括9-14岁的青少年,他们以前没有接种过HPV疫苗,并且有完整的EHR数据;使用了描述性统计数据和生存分析.
主要成果:
- 结合EHR BPA和临床医师教育的干预措施显著增加了9至10岁儿童在HPV疫苗启动的可能性,与仅BPA组相比 (调整后危险比率1.39).
- 虽然在年轻的发起者中,系列完成率最初较低,但到第3年,年龄在9-10岁的人的累计完成率 (33.9%) 比年龄在11-14岁的人 (30.7%) 高.
- 黑人或非裔美国人种族和公共保险与HPV疫苗启动和完成有关.
结论:
- 与临床医师教育相结合的EHR最佳实践警报是促进早期HPV疫苗接种启动的有效策略.
- 早期启动HPV疫苗接种,虽然可能导致系列完成延迟,但最终会改善整体完成率.
- 解决种族差异和社会经济因素,如公共保险状况,对于改善HPV疫苗接种覆盖率至关重要.
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