Background: Human papillomavirus (HPV) is the most common sexually transmitted infection within the United States (US). Despite clinical agreement on the effectiveness and widespread availability of the prophylactic HPV vaccine, vaccination coverage in the US is suboptimal and varies by geographic region and area-level variables. The goals of this article were to model the variation in vaccination rates among boys and girls within ZIP Codes in Virginia, determine whether neighborhood sociodemographic variables explain variation in HPV vaccination, and identify areas with significantly depressed vaccination coverage. Methods: We used Bayesian hierarchical spatial regression models with statewide immunization registry data to consider the correlation in vaccination among boys and girls, as well as the spatial correlation in vaccination for each sex. Results: The results showed low vaccination coverage in our birth cohort (28.9% in girls and 23.8% in boys) relative to the national level (56.8% and 51.8%, respectively). Several area-level variables were significantly and positively associated with vaccination coverage, including population density, percentage of Hispanic population, and average number of vehicles. In addition, there were several areas of significantly lowered vaccination coverage, including predominantly rural ones, and overall large geographic disparities in HPV vaccination. Conclusions: Determining the geospatial patterning and area-level factors associated with HPV vaccination within a prescribed geographic area helps to inform future planning efforts. Impact: The results of this study will help inform future planning efforts for geographically targeted interventions and policies, as well as drive new research to implement clinical and community strategies to increase HPV vaccination.

中文翻译：

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使用地理空间分析确定人乳头瘤病毒疫苗接种覆盖率的区域差异

背景：人乳头瘤病毒 (HPV) 是美国 (US) 内最常见的性传播感染。尽管临床上就预防性 HPV 疫苗的有效性和广泛可用性达成了一致，但美国的疫苗接种覆盖率并不理想，并且因地理区域和地区级变量而异。本文的目标是模拟弗吉尼亚州邮政编码内男孩和女孩的疫苗接种率变化，确定社区社会人口变量是否解释了 HPV 疫苗接种的变化，并确定疫苗接种覆盖率显着下降的地区。方法：我们使用贝叶斯分层空间回归模型和全州免疫登记数据来考虑男孩和女孩之间疫苗接种的相关性，以及每种性别疫苗接种的空间相关性。结果：结果显示，相对于全国水平（分别为 56.8% 和 51.8%），我们的出生队列中的疫苗接种覆盖率较低（女孩为 28.9%，男孩为 23.8%）。几个地区级变量与疫苗接种覆盖率显着正相关，包括人口密度、西班牙裔人口百分比和平均车辆数量。此外，有几个地区的疫苗接种覆盖率显着降低，包括主要是农村地区，以及 HPV 疫苗接种的总体地理差异很大。结论：在规定的地理区域内确定与 HPV 疫苗接种相关的地理空间模式和区域水平因素有助于为未来的规划工作提供信息。影响：