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Unintended vaccination of pregnant adolescents: Estimating the scope of the problem and the impact of different pregnancy testing strategies

机译：怀孕少女意外接种：估计问题的范围以及不同妊娠测试策略的影响

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Among a hypothetical cohort of 11-18-year-old females, we used a probabilistic decision tree model to estimate the number of pregnant adolescent females potentially receiving contraindicated vaccines during well child exams, and to determine the impact of two different pregnancy screening strategies on pregnancy detection rates, vaccine administration and pregnancy detection-associated costs. We found that under current practice conditions, the majority (95-99%) of adolescent pregnancies are likely missed during well child exams, allowing the opportunity to administer contraindicated vaccines. A strategy to test everyone detected the highest proportion of pregnancies, but at a substantial financial cost ($12,270,037-$19,430,607). Testing was more efficient for older adolescents, but both testing strategies were associated with a significant number of false positive test results (41-98%), regardless of age. These results suggest that systematic pregnancy screening strategies would be effective for preventing pregnant adolescents from receiving contraindicated vaccines, but may not be worth the potentially high financial and psychological costs.
机译：在一个假设的11-18岁女性队列中，我们使用了概率决策树模型来估计在良好儿童检查期间可能接受禁忌疫苗接种的青春期怀孕女性人数，并确定两种不同的妊娠筛查策略对怀孕检测率，疫苗管理和与怀孕检测相关的费用。我们发现，在当前的实践条件下，在进行良好儿童检查时可能会错过大多数（95-99％）的青春期怀孕，从而有机会使用禁忌疫苗。一种测试每个人的策略，发现怀孕的比例最高，但财务费用却很高（12,270,037美元至19,430,607美元）。对于年龄较大的青少年，测试效率更高，但无论年龄大小，两种测试策略均与大量假阳性测试结果（41-8％）相关。这些结果表明，系统的妊娠筛查策略可以有效地防止怀孕的青少年接受禁忌疫苗，但可能不值得承担潜在的高昂经济和心理成本。

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