Environmental factors associated with human papillomavirus vaccine coverage in adolescents: 2016-2020 analysis.
Bianca Maria Oliveira Luvisaro, Thales Philipe Rodrigues da Silva, Tercia Moreira Ribeiro da Silva and 3 others
PMID 36449925WHAT IT FOUND
HPV vaccine second-dose coverage in Minas Gerais remained well below target.
First-dose coverage and local violence rates were linked to second-dose coverage. Nurses can track adolescents due for dose two, especially where violence rates are high.
Key findings
01Second-dose HPV coverage was below expected targets in all regions, and only 9-year-olds showed an increasing trend.
02In the final model for 9-year-olds, first-dose coverage and violence rate had p-values of 0.000 for second-dose coverage, while municipal human development index longevity had p=0.364.
03The authors reported that the model explained 93.2% of variation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is an ecological study using aggregated regional data, not individual adolescents, so it cannot show what causes an individual to miss the second dose. The paper says data came from secondary databases and were not segregated by gender. The final model was adjusted only for 9-year-olds because older age groups had very low coverage. The text says municipal human development index longevity was significant, but the table lists p=0.364. The methods describe a random effect model, then the results say the Hausman test justified a fixed effects model. The violence variable combines many different crimes, so it is not clear which aspect of safety affects vaccination.
The easy way to misread this
Do not read the model results as proof that violence or first-dose coverage causes low second-dose coverage in individual adolescents. This is an ecological analysis of regional data, and the model only included the youngest age group.