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Bakhshi A, Eslami N, Norouzi N, Letafatkar N, Amini-Salehi E, Hassanipour S. The association between various viral infections and multiple sclerosis: An umbrella review on systematic review and meta-analysis. Rev Med Virol 2024; 34:e2494. [PMID: 38010852 DOI: 10.1002/rmv.2494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
Multiple Sclerosis (MS) is one of the immune-mediated demyelinating disorders. Multiple components, including the environment and genetics, are possible factors in the pathogenesis of MS. Also, it can be said that infections are a key component of the host's response to MS development. Finally, we evaluated the relationship between different pathogens and MS disease in this umbrella research. We systematically collected and analysed multiple meta-analyses focused on one particular topic. We utilised the Scopus, PubMed, and Web of Science databases starting with inception until 30 May 2023. The methodological quality of the analysed meta-analysis has been determined based on Assessing the Methodological Quality of Systematic Reviews 2 and Grade, and graph construction and statistical analysis were conducted using Comprehensive Meta-Analysis. The Confidence Interval of effect size was 95% in meta-analyses, and p < 0.05 indicated a statistically meaningful relationship. The included studies evaluated the association between MS and 12 viruses containing SARS-CoV-2, Epstein-Barr virus (EBV), Hepatitis B virus, varicella-zoster virus (VZV), human herpesvirus 6 (HHV-6), HHV-7, HHV-8, HSV-1, HSV-2, Cytomegalovirus, Human Papillomavirus, and influenza. SARS-CoV-2, with a 3.74 odds ratio, has a significantly more potent negative effect on MS among viral infections. After that, EBV, HHV-6, HSV-2, and VZV, respectively, with 3.33, 2.81, 1.76, and 1.72 odds ratios, had a significantly negative relationship with MS (p < 0.05). Although the theoretical evidence mostly indicates that EBV has the greatest effect on MS, recent epidemiological studies have challenged this conclusion and put forward possibilities that SARS-CoV-2 is the culprit. Hence, it was necessary to investigate the effects of SARS-CoV-2 and EBV on MS.
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Affiliation(s)
- Arash Bakhshi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Narges Eslami
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Naeim Norouzi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Negin Letafatkar
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Amini-Salehi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Asempah E, Wiktorowicz ME. Understanding HPV Vaccination Policymaking in Rwanda: A Case of Health Prioritization and Public-Private-Partnership in a Low-Resource Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6998. [PMID: 37947556 PMCID: PMC10649882 DOI: 10.3390/ijerph20216998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Rwanda is the first African country to implement a national HPV vaccination program in 2011. This study sought to clarify the HPV vaccination policymaking process in Rwanda through the lens of Kingdon's multiple stream framework and Foucault's concept of governmentality. Perspectives of policymakers engaged in HPV vaccination policy were gathered from published sources, along with key informant interviews. Rwanda's track record of successful vaccination programs enabled by a culture of local accountability created public and private sector incentives. Effective stakeholder engagement, health priority setting, and resource mobilization garnered locally and through international development aid, reflect indicators of policy success. The national HPV policymaking process in Rwanda unfolded in a relatively cohesive and stable policy network. Although peripheral stakeholder resistance and a constrained national budget can present a threat to policy survival, the study shows that such factors as the engagement of policy entrepreneurs within a policy network, private sector incentives, and international aid were effective in ensuring policy resolution.
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Affiliation(s)
- Eric Asempah
- School of Health Policy & Management, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada;
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Lakneh EA, Mersha EA, Asresie MB, Belay HG. Knowledge, attitude, and uptake of human papilloma virus vaccine and associated factors among female preparatory school students in Bahir Dar City, Amhara Region, Ethiopia. PLoS One 2022; 17:e0276465. [PMID: 36409675 PMCID: PMC9678319 DOI: 10.1371/journal.pone.0276465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/07/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The human papillomavirus vaccine is one of the main preventative measures for cervical cancer. However, global vaccine uptake is low; the problem is particularly acute in low and middle-income countries. The purpose of this study is to assess female preparatory school students' knowledge, attitude, and uptake of the human papillomavirus vaccine and associated factors in Bahir Dar City, Ethiopia. METHODS Institutional-based cross-sectional study was conducted among 633 female preparatory school students in Bahir Dar city from March 1-30, 2021. Participants were selected using the multistage sampling technique. Data were collected using a structured self-administered questionnaire and entered into Epi-data and exported to SPSS for analysis. Binary and multivariable logistic regression analyses were done using an odds ratio with a 95% confidence interval. Finally-value < 0.05 was considered significant in multivariable analysis. RESULT The proportion of Human Papillomavirus (HPV) vaccine uptake, knowledge of the vaccine, and respondents' attitudes toward the vaccine were 45.3% (95% CI = 41.6-49.4%), 58.1% (95% CI = 54.4-61.9%), and 16% (95% CI = 13.2-19.5%), respectively. Having a history of sexual contact AOR = 2.80 (95% CI = 1.64-4.76), hearing about HPV infection AOR = 1.59 (95% CI = 1.13-2.24), and having a positive attitude toward HPV vaccine AOR = 1.46 (95% CI = 1.03-2.08) were significantly associated with knowledge about the HPV vaccine. Discussion of reproductive health issues with family AOR = 2.558 (95%CI = 1.800-3.636), and having good knowledge about HPV vaccine AOR = 3.571(95%CI = 2.494-5.113) were associated with a positive attitude toward the HPV vaccine. Good knowledge AOR = 2.36(95%CI = 1.48-3.76) and a positive attitude toward HPV vaccine AOR = 2.87(95%CI = 1.70-4.85) were strongly associated with HPV vaccine utilization. CONCLUSION In this study, there was a very low uptake of HPV vaccination among female students, and only a small proportion of them had good knowledge of the HPV vaccine and a favorable attitude toward the HPV vaccine.
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Affiliation(s)
- Etenesh Adela Lakneh
- Department of Midwifery, Debre Tabor Health Sciences College, Debre Tabor, Ethiopia
| | - Eleni Admassu Mersha
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melash Belachew Asresie
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habtamu Gebrehana Belay
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Villa A, Patton LL, Giuliano AR, Estrich CG, Pahlke SC, O'Brien KK, Lipman RD, Araujo MWB. Summary of the evidence on the safety, efficacy, and effectiveness of human papillomavirus vaccines: Umbrella review of systematic reviews. J Am Dent Assoc 2020; 151:245-254.e24. [PMID: 31983391 DOI: 10.1016/j.adaj.2019.10.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND This objective of this umbrella review was to summarize the evidence on safety, efficacy, and effectiveness of human papillomavirus (HPV) vaccines in the general population. METHODS The authors conducted a literature search and selected systematic reviews if they were published from January 2006 through November 2018, included randomized controlled trials or observational studies, related to the general population, and evaluated HPV vaccine-related clinical outcomes. The authors independently and in duplicate screened literature, extracted data, and appraised reviews using AMSTAR 2, a critical appraisal tool for systematic reviews. RESULTS The authors selected 30 systematic reviews that included male and female participants aged 9 through 76 years from multiple countries. Reviews evaluated postvaccine seroconversion, HPV infection rates, precancerous or benign lesions, and adverse events; none of the researchers reported on oral or oropharyngeal lesions. Results from the reviews showed that, compared with those who received a placebo or non-HPV-type vaccine, HPV-vaccinated participants had statistically significantly higher rates of seroconversion and local adverse events, statistically significantly lower rates of HPV infection and condylomata lesions, and decreased rates of HPV-related precancerous lesions, which did not always attain statistical significance. CONCLUSIONS Systematic reviews have found evidence that the available HPV vaccines are safe, effective, and efficacious against vaccine-type HPV infection and HPV-associated cellular changes, including precancerous and benign lesions. PRACTICAL IMPLICATIONS Dentists may use this resource to better understand the literature on the potential harms and benefits of HPV vaccination.
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Attipoe-Dorcoo S, Singh V, Moodley J. A content analysis of online news media reporting on the human papillomavirus vaccination programme in South Africa. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2018. [DOI: 10.1080/20742835.2018.1509928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Sharon Attipoe-Dorcoo
- Health Science Center, School of Public Health, University of Texas, Houston, Texas, USA
- Cancer Research Initiative, University of Cape Town, Cape Town, South Africa
| | - Vedantha Singh
- Cancer Research Initiative, University of Cape Town, Cape Town, South Africa
| | - Jennifer Moodley
- Cancer Research Initiative, University of Cape Town, Cape Town, South Africa
- Women’s Health Research Unit, School of Public Health and Family Medicine, Cape Town, South Africa
- SAMRC Gynecological Cancer Research Centre, University of Cape Town, Cape Town, South Africa
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Karamanidou C, Dimopoulos Κ. Knowledge, beliefs and communication preferences with regards to the HPV vaccine; the perspective of unvaccinated Greek adolescent girls, young women, and mothers of vaccine-eligible girls. Health Psychol Behav Med 2018; 6:180-202. [PMID: 34040827 PMCID: PMC8114387 DOI: 10.1080/21642850.2018.1505518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. The introduction of the HPV vaccine constitutes a shift in health policy and health promotion practice. The aim of this study was to investigate knowledge, beliefs and communication preferences of the Greek public with regards to the HPV vaccine. Methods: Six focus groups (5–8 participants) were conducted with unvaccinated teenage girls, young women and mothers of vaccine-eligible girls, recruited via schools and universities. Pre-focus group questionnaires consisted of: socio-demographic details and a knowledge questionnaire. The discussion guide was based on issues raised by relevant studies such as disease severity and personal risk perception, perceived benefits and barriers to vaccination, etc. Participants were also shown three types of stimuli namely, a leaflet, an expert interview and a documentary containing equivalent information on HPV and the HPV vaccine. Thematic analysis was used for analysis of the qualitative data. Findings: Findings revealed that participants had low to moderate knowledge levels on HPV and cervical cancer. Beliefs specific to the HPV vaccine as well as general beliefs about medicines and their use in everyday life were prevalent. The vaccination dilemma was exacerbated by the conflicting advice received by health professionals coupled with the difficulties participants experienced in evaluating relevant health information. Participants judged all stimuli according to content and format but the documentary was their preferred health information communication option. Conclusions: Findings could contribute to the understanding of health decision making with regards to preventive vaccination and help formulate recommendations for health policy adjustments.
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Affiliation(s)
- Christina Karamanidou
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece.,Department of Education, University of Nicosia, Nicosia, Cyprus
| | - Κostas Dimopoulos
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece
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Abstract
Human papillomavirus (HPV) is known to cause genital warts, cervical cancer, penile cancer, anal cancer and oropharyngeal cancer. In North America, the lifetime cumulative incidence of HPV infection is estimated at more than 70% for all HPV types combined. A safe and effective vaccine against nine HPV types is available. HPV vaccine should be administered routinely to all girls and boys between the ages of 9 and 13 years of age. All youth who have not received the vaccine in a routine program should receive the vaccine in a 'catch-up' program. Physicians caring for children and youth should advocate for funding and implementation of universal HPV vaccine programs.
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Affiliation(s)
- Marina I Salvadori
- Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario
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Salvadori MI. Le vaccin contre le virus du papillome humain chez les enfants et les adolescents. Paediatr Child Health 2018. [DOI: 10.1093/pch/pxy030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marina I Salvadori
- Société canadienne de pédiatrie, comité des maladies infectieuses et d’immunisation, Ottawa (Ontario)
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Meggiolaro A, Migliara G, La Torre G. Association between Human Papilloma Virus (HPV) vaccination and risk of Multiple Sclerosis: A systematic review. Hum Vaccin Immunother 2018; 14:1266-1274. [PMID: 29333935 DOI: 10.1080/21645515.2017.1423155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The vaccination against Humanpapilloma Virus (HPV) is an effective strategy to prevent high-risk HPV infection and subsequent cervical carcinogenesis. Although the safety profile has been ascertained, the relation with the development of central nervous system (CNS) autoimmune disorders (AD) appears still controversial. Multiple Sclerosis (MS) is the most common cause of chronic neurological impairment in young people, typically striking females. The main purpose of this review was to assess the association between HPV vaccination and MS. METHODS The systematic review of the literature was carried out using 5 search engines: MEDLINE, SCOPUS, ISI WEB OF KNOWLEDGE, GOOGLE SCHOLAR and ClinicalTrial.gov. The web search was updated on January 2017. PRISMA checklist was adopted to address the content of the systematic review. The measures of outcome were reported as relative risk (RR) in cohort studies and odds ratio (OR) in case-control studies. RESULTS The systematic review identified 5 observational studies, 9 reviews, and 1 randomized clinical trials (RCT) pooled analysis. The RR of MS onset detected by cohort studies ranged from 1.54 (95%CI, 0.04-8.59) to 1.37 (95%CI, 0.74-3.20). Concerning case-control studies, the OR spanned from 0.3, (95%CI 0.1-0.9) to 1.60 (95%CI = 0.79-3.25) for the group exposed to HPV vaccination. No result was significant. CONCLUSION This review showed no significant association between HPV vaccination and MS. The low statistical power of the studies agreed with the low incidence of MS disease among general population. In order to overcome the shortcoming the research may be extended to the entire pattern of CNS ADs.
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Affiliation(s)
- Angela Meggiolaro
- a Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy
| | - Giuseppe Migliara
- a Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy
| | - Giuseppe La Torre
- a Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy
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Vorsters A, Arbyn M, Baay M, Bosch X, de Sanjosé S, Hanley S, Karafillakis E, Lopalco PL, Pollock KG, Yarwood J, Van Damme P. Overcoming barriers in HPV vaccination and screening programs. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 4:45-53. [PMID: 29179869 PMCID: PMC7268103 DOI: 10.1016/j.pvr.2017.07.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 01/17/2023]
Abstract
The Human Papillomavirus Prevention and Control Board brought together experts to discuss optimizing HPV vaccination and screening programs. Board members reviewed the safety profile of licensed HPV vaccines based on clinical and post-marketing data, reaching a consensus that current safety data is reassuring. Successful vaccination programs used well-coordinated communication campaigns, integrating (social) media to spread awareness. Communication of evidence supporting vaccine effectiveness had beneficial effects on the perception of the vaccine. However, anti-vaccination campaigns have threatened existing programs in many countries. Measurement and monitoring of HPV vaccine confidence over time could help understand the nature and scale of waning confidence, define issues and intervene appropriately using context-specific evidence-based strategies. Finally, a broad group of stakeholders, such as teachers, health care providers and the media should also be provided with accurate information and training to help support prevention efforts through enhanced understanding of the risks and benefits of vaccination. Similarly, while cervical cancer screening through population-based programs is highly effective, barriers to screening exist: awareness in countries with population-based screening programs, access for vulnerable populations, and access and affordability in low- and middle-income countries. Integration of primary and secondary prevention has the potential to accelerate the decrease in cervical cancer incidence.
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Affiliation(s)
- Alex Vorsters
- Centre for Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Scientific Institute of Public Health, Brussels, Belgium
| | - Marc Baay
- P95, Epidemiology and Pharmacovigilance Consulting and Services, Leuven, Belgium
| | - Xavier Bosch
- Cancer Research Epidemiology Program, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain
| | - Silvia de Sanjosé
- Cancer Research Epidemiology Program, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Sharon Hanley
- Department of Women's Health Medicine, Hokkaido University Graduate School of Medicine, Kita Ku, Sapporo, Japan
| | - Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | | | - Joanne Yarwood
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - Pierre Van Damme
- Centre for Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
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Terlizzi JP, Goldstone SE. The role of HPV vaccination in the prevention of anal dysplasia. SEMINARS IN COLON AND RECTAL SURGERY 2017. [DOI: 10.1053/j.scrs.2017.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Šubelj M, Učakar V, Kraigher A, Klavs I. Adverse events following school-based vaccination of girls with quadrivalent human papillomavirus vaccine in Slovenia, 2009 to 2013. ACTA ACUST UNITED AC 2016; 21:30187. [PMID: 27103551 DOI: 10.2807/1560-7917.es.2016.21.14.30187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 08/04/2015] [Indexed: 01/19/2023]
Abstract
Adverse events following immunisation (AEFIs) with qHPV reported to the Slovenian AEFI Registry for the first four school years of the vaccination programme were analysed. We calculated annual reporting rates for 11-14 year-old vaccinees with AEFIs, using the number of qHPV doses distributed within the school-based vaccination programme as the denominator. Between September 2009 and August 2013, 211 AEFIs that occurred in 89 vaccinees were reported, a rate of 149.5 vaccinees with AEFI per 100,000 qHPV doses distributed. For five vaccinees, serious AEFIs (8.4 per 100,000 doses distributed) were reported. The highest reporting rates were for fatigue, headache, and fever (≥ 38.0⁰) (53.8, 40.3, and 35.3 per 100,000 qHPV doses distributed, respectively). As no AEFI resulted in permanent sequelae and they all were categorised as serious only due to the criterion of a minimum of one day of hospitalisation, this provides reassurance for the safety of our school-based HPV vaccination programme. Further AEFI surveillance is warranted to provide data for HPV vaccination programme monitoring and evaluation of its safety.
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Affiliation(s)
- Maja Šubelj
- National Institute of Public Health, Centre for Communicable Diseases, Ljubljana, Slovenia
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Wilson KL, Smith ML, Rosen BL, Pulczinski JC, Ory MG. HPV Vaccination Status and Mandate Support for School-Aged Adolescents Among College Females. J Sch Nurs 2016; 33:232-245. [PMID: 27470309 DOI: 10.1177/1059840516659764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to describe college-aged females' human papillomavirus (HPV) knowledge and beliefs, perceptions and perceived benefits of the HPV vaccine, and identify characteristics associated with vaccination status and support for HPV vaccine mandates. Data were collected from 1,105 females by an Internet-delivered questionnaire during February to March 2011. This descriptive study utilizes χ2 tests and t-tests to compare participant responses. HPV-related knowledge scores were 8.08 out of 11 points. Those who initiated HPV vaccination were significantly younger, single, engaged in sex, were sexually active, and had a Pap test. Participants who had more friends receiving the vaccine were significantly more likely to support mandates for 9-11 and 12-17 years and were more likely to complete the HPV vaccination cycle. Findings suggest the importance of educational programs adopted and delivered by school nurses, which aim to improve student knowledge and reduce misconceptions related to the HPV vaccine and vaccination mandates.
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Affiliation(s)
- Kelly L Wilson
- 1 Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- 2 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA.,3 Texas A&M Health Science Center, School of Public Health, Department of Health Promotion and Community Health Sciences, College Station, TX, USA
| | - Brittany L Rosen
- 4 School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Jairus C Pulczinski
- 3 Texas A&M Health Science Center, School of Public Health, Department of Health Promotion and Community Health Sciences, College Station, TX, USA
| | - Marcia G Ory
- 3 Texas A&M Health Science Center, School of Public Health, Department of Health Promotion and Community Health Sciences, College Station, TX, USA
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Abstract
Introduction There is growing interest in whether social media can capture patient-generated information relevant for medicines safety surveillance that cannot be found in traditional sources. Objective The aim of this study was to evaluate the potential contribution of mining social media networks for medicines safety surveillance using the following associations as case studies: (1) rosiglitazone and cardiovascular events (i.e. stroke and myocardial infarction); and (2) human papilloma virus (HPV) vaccine and infertility. Methods We collected publicly accessible, English-language posts on Facebook, Google+, and Twitter until September 2014. Data were queried for co-occurrence of keywords related to the drug/vaccine and event of interest within a post. Messages were analysed with respect to geographical distribution, context, linking to other web content, and author’s assertion regarding the supposed association. Results A total of 2537 posts related to rosiglitazone/cardiovascular events and 2236 posts related to HPV vaccine/infertility were retrieved, with the majority of posts representing data from Twitter (98 and 85 %, respectively) and originating from users in the US. Approximately 21 % of rosiglitazone-related posts and 84 % of HPV vaccine-related posts referenced other web pages, mostly news items, law firms’ websites, or blogs. Assertion analysis predominantly showed affirmation of the association of rosiglitazone/cardiovascular events (72 %; n = 1821) and of HPV vaccine/infertility (79 %; n = 1758). Only ten posts described personal accounts of rosiglitazone/cardiovascular adverse event experiences, and nine posts described HPV vaccine problems related to infertility. Conclusions Publicly available data from the considered social media networks were sparse and largely untrackable for the purpose of providing early clues of safety concerns regarding the prespecified case studies. Further research investigating other case studies and exploring other social media platforms are necessary to further characterise the usefulness of social media for safety surveillance. Electronic supplementary material The online version of this article (doi:10.1007/s40264-015-0333-5) contains supplementary material, which is available to authorized users.
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Gee J, Weinbaum C, Sukumaran L, Markowitz LE. Quadrivalent HPV vaccine safety review and safety monitoring plans for nine-valent HPV vaccine in the United States. Hum Vaccin Immunother 2016; 12:1406-17. [PMID: 27029786 PMCID: PMC4964727 DOI: 10.1080/21645515.2016.1168952] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Quadrivalent human papillomavirus (4vHPV) vaccine was licensed for use in the United States in 2006 and through 2015 was the predominate HPV vaccine used. With the exception of syncope, a known preventable adverse event after any injected vaccination, both pre-licensure and post-licensure 4vHPV safety data have been reassuring with no confirmed safety signals identified. Nine-valent HPV vaccine (9vHPV) was licensed in 2014. This review includes post-licensure 4vHPV safety findings published to date that have informed the US vaccination program; these data will inform US safety monitoring and evaluation for 9vHPV.
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Affiliation(s)
- Julianne Gee
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Cindy Weinbaum
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Lakshmi Sukumaran
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Lauri E Markowitz
- b Division of Viral Diseases, National Center Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
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Pérez MRO, Violeta VB, Del Campo AV, Ruiz C, Castaño SY, Conde LPP, López JSJ. Cross-sectional study about primary health care professionals views on the inclusion of the vaccine against human papillomavirus in the vaccine schedules. Infect Agent Cancer 2015; 10:41. [PMID: 26576200 PMCID: PMC4645478 DOI: 10.1186/s13027-015-0034-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the inclusion of the HPV vaccine has been registered in Spain since 2007, vaccination rates are lower than expected. The patients wish to be vaccinated is heavily influenced by information they have received from many source. The Knowledge of primary health care professionals affects the information provided to patients and is fundamental in the decision making. The aim of this study is to assess the opinions of primary health care professionals on the vaccine against HPV and their knowledge about HPV infection and its links to with gynecological and oropharyngeal cancer. METHODS Cross-sectional study. A 19-item survey was drawn up. It included questions on basic aspects of HPV infection and marketed vaccines, personal opinion about the inclusion in the immunization schedules and their level of prescription and recommendation to patients in their clinical practice. From October 2013 to December 2013, 607 surveys were distributed among 20 primary health centers affiliated to the University Hospital 12 de Octubre. The results were analyzed using SPSS statistical package. RESULTS One hundred sixty four successfully completed surveys were obtained for analysis. 89 % of the professionals knew about the relationship between HPV infection and cervical cancer, 57.3 % did not know any of the serotypes against which vaccines are targeted; 40.4 % believed that there is insufficient data to support the commercialization of the vaccines. Of these, 65.7 % argue that there is no data of its long-term effectiveness, 13.4 % that there is no data as to its side effects, 13.4 % believed that the cost effectiveness is not worthwhile. CONCLUSIONS There is a strong controversy among health professionals regarding the marketing and inclusion of HPV vaccine in immunization schedules. However, the knowledge of the primary care health professionals on key aspects of infection and vaccine protection are insufficient. The training of professionals in vaccination, cervical pathology and HPV infection should be improved to provide objective information on the use as this vaccine for patients.
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Affiliation(s)
- M Reyes Oliver Pérez
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
| | - Victoria Bravo Violeta
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
| | - Ana Vazquez Del Campo
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Cristina Ruiz
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Sonia Yáñez Castaño
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Laura P Pérez Conde
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Jesús S Jiménez López
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
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Nikolaidis C, Nena E, Panagopoulou M, Balgkouranidou I, Karaglani M, Chatzaki E, Agorastos T, Constantinidis TC. PAX1 methylation as an auxiliary biomarker for cervical cancer screening: a meta-analysis. Cancer Epidemiol 2015; 39:682-6. [PMID: 26234429 DOI: 10.1016/j.canep.2015.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/29/2015] [Accepted: 07/17/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Several studies have implicated PAX1 epigenetic regulation in cervical neoplasia. The aim of this meta-analysis was to assess PAX1 gene methylation as a potential biomarker in cervical cancer screening. METHODS A systematical search of all major databases was performed, in order to include all relevant publications in English until December 31(st) 2014. Studies with insufficient data, conducted in experimental models or associated with other comorbidities were excluded from the meta-analysis. Summary receiver operating characteristics (SROC) for Cervical Intraepithelial Neoplasia grade 2 or worse (CIN2(+)) versus normal, and CIN grade 3 or worse (CIN3(+)) versus normal, were estimated using the bivariate model. RESULTS Out of the 20 initially included studies, finally 7 (comprising of 1385 subjects with various stages of CIN and normal cervical pathology) met the inclusion criteria. The sensitivity of CIN2(+) versus normal was estimated to be 0.66 (CI 95%, 0.46-0.81) and the specificity 0.92 (CI 95%, 0.88-0.95). On the other hand, the sensitivity of CIN3(+) versus normal was 0.77 (CI 95%, 0.58-0.89) and the specificity 0.92 (CI 95%, 0.88-0.94). Moreover, the area under the curve (AUC) in the former case was 0.923, and in the latter 0.931. CONCLUSION The results of this meta-analysis support the utility of PAX1 methylation as an auxiliary biomarker in cervical cancer screening. PAX1 could be used effectively to increase the specificity of HPV DNA by detecting women with more advanced cervical abnormalities.
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Affiliation(s)
- Christos Nikolaidis
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Maria Panagopoulou
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Ioanna Balgkouranidou
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Makrina Karaglani
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Ekaterini Chatzaki
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Theodoros Agorastos
- IV. University Clinic of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Hippokrateion Hospital, Thessaloniki 54642, Greece
| | - Theodoros C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
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Baker B, Eça Guimarães L, Tomljenovic L, Agmon-Levin N, Shoenfeld Y. The safety of human papilloma virus-blockers and the risk of triggering autoimmune diseases. Expert Opin Drug Saf 2015. [DOI: 10.1517/14740338.2015.1073710] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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19
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Determination of freeze damage on HPV vaccines by use of flow cytometry. Biologicals 2015; 43:266-73. [DOI: 10.1016/j.biologicals.2015.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 11/22/2022] Open
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20
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Littlejohn ES, Clothier HJ, Perrett KP, Danchin M. Surveillance of adverse events following the introduction of 13-valent pneumococcal conjugate vaccine in infants, and comparison with adverse events following 7-valent pneumococcal conjugate vaccine, in Victoria, Australia. Hum Vaccin Immunother 2015; 11:1828-35. [PMID: 26075435 DOI: 10.1080/21645515.2015.1048937] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The 13-valent pneumococcal vaccine (PCV13) replaced the 7-valent vaccine (PCV7) on the Australian National Immunization Program (NIP) in 2011. Post-marketing surveillance of adverse events following immunization (AEFI) is crucial for detecting potential safety signals and maintaining confidence in the NIP. This study describes all AEFI reported to Surveillance of Adverse Events following Vaccination in the Community (SAEFVIC), Melbourne, Australia, following both the primary series of PCV13 (children <7 months) and the catch-up dose (12 months-35 months) in its first year of inclusion on the NIP. AEFI reporting rates per 100,000 doses of vaccine administered were compared for the PCV13 primary series and PCV7 primary series in the previous year. SAEFVIC received 229 reports describing 406 AEFI following PCV13 vaccine in the 12 months post introduction. There was no difference in the total number of AEFI cases reported between the vaccines but 7 AEFI categories were reported at a significantly higher rate following PCV13 compared with PCV7. No difference in reporting rate was observed for serious AEFI (p = 0.25). Post-hoc analysis of a further 12 months of PCV13 data revealed that all 7 AEFI categories that were initially reported at a significantly higher rate following PCV13 compared to PCV7 in the first 12 months post introduction, were no longer significantly increased in the 13-24 month period. The initial high reporting rate for several common AEFI post PCV13 compared to PCV7 may be explained by heightened awareness of the new vaccine. There were no safety signals detected for rare or serious AEFI that would require further investigation at this time.
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Affiliation(s)
- E S Littlejohn
- a Department of General Medicine ; Royal Children's Hospital ; Melbourne , Australia
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Abstract
INTRODUCTION Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. AREAS COVERED Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. EXPERT OPINION Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence.
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Affiliation(s)
- Michela Stillo
- Department of Public Health and Paediatric sciences, University of Turin
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Agorastos T, Chatzistamatiou Κ, Zafrakas Μ, Siamanta V, Katsamagkas T, Constantinidis T, Lampropoulos Α. Distinct demographic factors influence the acceptance of vaccination against HPV. Arch Gynecol Obstet 2015; 292:197-205. [DOI: 10.1007/s00404-015-3614-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/05/2015] [Indexed: 11/25/2022]
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23
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Rodríguez-Galán M, Pérez-Vilar S, Díez-Domingo J, Tuells J, Gomar-Fayos J, Morales-Olivas F, Pastor-Villalba E. Notificación de reacciones adversas a la vacuna frente al virus del papiloma humano en la Comunidad Valenciana (2007-2011). An Pediatr (Barc) 2014; 81:303-9. [DOI: 10.1016/j.anpedi.2013.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/27/2013] [Accepted: 11/28/2013] [Indexed: 12/01/2022] Open
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Adverse reactions to human papillomavirus vaccine in the Valencian Community (2007–2011). ANALES DE PEDIATRÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.anpede.2013.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pan XF, Zhao ZM, Sun J, Chen F, Wen QL, Liu K, Song GQ, Zhang JJ, Wen Y, Fu CJ, Yang CX. Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education. PLoS One 2014; 9:e110353. [PMID: 25360743 PMCID: PMC4215919 DOI: 10.1371/journal.pone.0110353] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/14/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. METHODS We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. RESULTS We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). CONCLUSIONS The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.
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Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhi-Mei Zhao
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jing Sun
- Department of Pathology, Development and Regeneration Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Feng Chen
- Department of Preventive Healthcare and Hospital Infection Control, Deyang People's Hospital, Deyang, China
| | - Qing-Lian Wen
- Department of Oncology, the Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Kang Liu
- Institute of Tissue Engineering and Stem Cells, The Second Clinical Hospital of North Sichuan Medical College, Nanchong, China
| | - Gui-Qin Song
- Department of Biology, North Sichuan Medical University, Nanchong, China
| | - Jing-Jing Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Ying Wen
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Chun-Jing Fu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chun-Xia Yang
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
- * E-mail:
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26
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Garland SM, Brown DR. Potential of the quadrivalent human papillomavirus vaccine in the prevention and treatment of cervical cancer. Expert Opin Biol Ther 2014; 14:527-34. [DOI: 10.1517/14712598.2014.880418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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Papagiannis D, Rachiotis G, Symvoulakis EK, Daponte A, Grivea IN, Syrogiannopoulos GA, Hadjichristodoulou C. Vaccination against human papillomavirus among 865 female students from the health professions in central Greece: a questionnaire-based cross-sectional study. J Multidiscip Healthc 2013; 6:435-9. [PMID: 24324338 PMCID: PMC3855014 DOI: 10.2147/jmdh.s49558] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There are still sparse data on vaccination coverage against human papillomavirus (HPV) among students in the health professions. The aim of this study was to investigate HPV vaccination coverage in female students from the health professions in Greece. METHODS A self-administered, anonymous questionnaire was distributed to second-year and third-year female students pursuing degrees in medicine, nursing, and paramedical health disciplines in central Greece. RESULTS Overall vaccination coverage was 44.3%. The major reason for lack of vaccination was fear about safety of the vaccine. Participants who had received information about safety of the vaccine from the mass media and paramedical students had lower vaccination coverage in comparison with students who had received information about vaccine safety from alternative sources. CONCLUSION Further quantitative and qualitative research is needed to design educational activities targeting female students in the health professions in order to create a positive domino effect and improve HPV vaccination coverage levels in Greece.
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Affiliation(s)
- Dimitrios Papagiannis
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
| | - George Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
| | | | - Alexandros Daponte
- Department of Obstetrics and Gynaecology, University of Thessalia Medical School, Thessalia, Greece
| | - Ioanna N Grivea
- Department of Paediatrics, University of Thessaly, School of Medicine, General University Hospital of Larissa, Thessalia, Greece
| | - George A Syrogiannopoulos
- Department of Paediatrics, University of Thessaly, School of Medicine, General University Hospital of Larissa, Thessalia, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
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Zimet GD, Rosberger Z, Fisher WA, Perez S, Stupiansky NW. Beliefs, behaviors and HPV vaccine: correcting the myths and the misinformation. Prev Med 2013; 57:414-8. [PMID: 23732252 DOI: 10.1016/j.ypmed.2013.05.013] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 05/13/2013] [Accepted: 05/26/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Human papillomavirus (HPV) vaccine uptake in many countries has been sub-optimal. We examine several issues associated with non-vaccination that have received particular attention, including fears about sexual risk compensation, concerns about vaccine safety, inadequate vaccination recommendations by health care providers (HCPs), and distrust due to the perceived "newness" of HPV vaccines. METHODS Selective review of behavioral and social science literature on HPV vaccine attitudes and uptake. RESULTS There is no evidence of post-vaccination sexual risk compensation, HPV vaccines are quite safe, and they can no longer be considered "new". Nonetheless, research findings point to these issues and, most importantly, to the failure of HCPs to adequately recommend HPV vaccine as major drivers of non-vaccination. CONCLUSION Most fears related to HPV vaccine are more related to myth than reality. In the absence of major health policy initiatives, such as those implemented in Canada, the U.K., and Australia, a multi-level, multi-faceted approach will be required to achieve high rates of HPV vaccination. It will be essential to focus on the education of HCPs regarding indications for HPV vaccination and approaches to communicating most effectively with parents and patients about the safety and benefits of vaccination and the risks associated with non-vaccination.
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Affiliation(s)
- Gregory D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, 410W. 10th St., HS1001, Indianapolis, IN 46260, USA.
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Tozzi AE, Asturias EJ, Balakrishnan MR, Halsey NA, Law B, Zuber PLF. Assessment of causality of individual adverse events following immunization (AEFI): a WHO tool for global use. Vaccine 2013; 31:5041-6. [PMID: 24021304 DOI: 10.1016/j.vaccine.2013.08.087] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/23/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
Serious illnesses or even deaths may rarely occur after childhood vaccinations. Public health programs are faced with great challenges to establish if the events presenting after the administration of a vaccine are due to other conditions, and hence a coincidental presentation, rather than caused by the administered vaccines. Given its priority, the Global Advisory Committee for Vaccine Safety (GACVS) commissioned a group of experts to review the previously published World Health Organization (WHO) Adverse Event Following Immunization (AEFI) causality assessment methodology and aide-memoire, and to develop a standardized and user friendly tool to assist health care personnel in the processing and interpretation of data on individual events, and to assess the causality after AEFIs. We describe a tool developed for causality assessment of individual AEFIs that includes: (a) an eligibility component for the assessment that reviews the diagnosis associated with the event and identifies the administered vaccines; (b) a checklist that systematically guides users to gather available information to feed a decision algorithm; and (c) a decision support algorithm that assists the assessors to come to a classification of the individual AEFI. Final classification generated by the process includes four categories in which the event is either: (1) consistent; (2) inconsistent; or (3) indeterminate with respect of causal association; or (4) unclassifiable. Subcategories are identified to assist assessors in resulting public health decisions that can be used for action. This proposed tool should support the classification of AEFI cases in a standardized, transparent manner and to collect essential information during AEFI investigation. The algorithm should provide countries and health officials at the global level with an instrument to respond to vaccine safety alerts, and support the education, research and policy decisions on immunization safety.
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Affiliation(s)
- Alberto E Tozzi
- Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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Clothier HJ, Lee KJ, Sundararajan V, Buttery JP, Crawford NW. Human papillomavirus vaccine in boys: background rates of potential adverse events. Med J Aust 2013; 198:554-8. [DOI: 10.5694/mja12.11751] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/10/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Hazel J Clothier
- Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), Murdoch Childrens Research Institute, Melbourne, VIC
- School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Katherine J Lee
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, VIC
| | | | - Jim P Buttery
- Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), Murdoch Childrens Research Institute, Melbourne, VIC
- Department of Infectious Diseases and Department of Paediatrics, Monash University, Melbourne, VIC
| | - Nigel W Crawford
- Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), Murdoch Childrens Research Institute, Melbourne, VIC
- Department of General Medicine, Royal Children's Hospital, Melbourne, VIC
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31
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Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JML. Human papillomavirus vaccine introduction--the first five years. Vaccine 2013. [PMID: 23199957 DOI: 10.1016/j.vaccine.2012.05.039] [Citation(s) in RCA: 222] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The availability of prophylactic human papillomavirus (HPV) vaccines has provided powerful tools for primary prevention of cervical cancer and other HPV-associated diseases. Since 2006, the quadrivalent and bivalent vaccines have each been licensed in over 100 countries. By the beginning of 2012, HPV vaccine had been introduced into national immunization programs in at least 40 countries. Australia, the United Kingdom, the United States, and Canada were among the first countries to introduce HPV vaccination. In Europe, the number of countries having introduced vaccine increased from 3 in 2007 to 22 at the beginning of 2012. While all country programs target young adolescent girls, specific target age groups vary as do catch-up recommendations. Different health care systems and infrastructure have resulted in varied implementation strategies, with some countries delivering vaccine in schools and others through health centers or primary care providers. Within the first 5 years after vaccines became available, few low- or middle-income countries had introduced HPV vaccine. The main reason was budgetary constraints due to the high vaccine cost. Bhutan and Rwanda implemented national immunization after receiving vaccine through donation programs in 2010 and 2011, respectively. The GAVI Alliance decision in 2011 to support HPV vaccination should increase implementation in low-income countries. Evaluation of vaccination programs includes monitoring of coverage, safety, and impact. Vaccine safety monitoring is part of routine activities in many countries. Safety evaluations are important and communication about vaccine safety is critical, as events temporally associated with vaccination can be falsely attributed to vaccination. Anti-vaccination efforts, in part related to concerns about safety, have been mounted in several countries. In the 5 years since HPV vaccines were licensed, there have been successes as well as challenges with vaccine introduction and implementation. Further progress is anticipated in the coming years, especially in low- and middle-income countries where the need for vaccine is greatest. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Lauri E Markowitz
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia, 30333, US.
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Macartney KK, Chiu C, Georgousakis M, Brotherton JML. Safety of Human Papillomavirus Vaccines: A Review. Drug Saf 2013; 36:393-412. [DOI: 10.1007/s40264-013-0039-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Implementation of the quadrivalent vaccine against HPV in the Municipality of Campos dos Goytacazes, Brazil – A combination of strategies to increase immunization coverage and early reduction of genital warts. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.trivac.2013.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Poljak M. Prophylactic human papillomavirus vaccination and primary prevention of cervical cancer: issues and challenges. Clin Microbiol Infect 2012; 18 Suppl 5:64-9. [DOI: 10.1111/j.1469-0691.2012.03946.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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35
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Gupta SK, Srivastava M, Akhoon BA, Gupta SK, Grabe N. In silico accelerated identification of structurally conserved CD8+ and CD4+ T-cell epitopes in high-risk HPV types. INFECTION GENETICS AND EVOLUTION 2012; 12:1513-8. [DOI: 10.1016/j.meegid.2012.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 02/06/2012] [Accepted: 02/12/2012] [Indexed: 01/18/2023]
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36
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Vacunación frente al virus del papiloma humano. Documento de consenso 2011 de las sociedades científicas españolas. Semergen 2012; 38:312-26. [DOI: 10.1016/j.semerg.2012.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 04/27/2012] [Indexed: 11/21/2022]
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37
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38
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Sotiriadis A, Dagklis T, Siamanta V, Chatzigeorgiou K, Agorastos T. Increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine. Arch Gynecol Obstet 2012; 285:1719-24. [DOI: 10.1007/s00404-011-2208-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 12/31/2011] [Indexed: 01/05/2023]
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39
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Dawar DM, Harris MT, McNeil DS. Update on Human Papillomavirus (HPV) Vaccines: An Advisory Committee Statement (ACS) National Advisory Committee on Immunization (NACI) †. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2012; 38:1-62. [PMID: 31701955 PMCID: PMC6802461 DOI: 10.14745/ccdr.v38i00a01] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Haupt RM, Sings HL. The efficacy and safety of the quadrivalent human papillomavirus 6/11/16/18 vaccine gardasil. J Adolesc Health 2011; 49:467-75. [PMID: 22018560 DOI: 10.1016/j.jadohealth.2011.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/20/2011] [Accepted: 07/01/2011] [Indexed: 11/29/2022]
Abstract
Human papillomavirus (HPV) infection causes cervical cancer, a significant portion of anal, genital, and oropharyngeal cancers, genital warts, and recurrent respiratory papillomatosis. In June 2006, a quadrivalent HPV-6/11/16/18 vaccine (Gardasil/Silgard) was licensed in the United States, and subsequently in the European Union (September 2006). It has since been approved in 121 countries, with >74 million doses distributed globally as of March 2011. As the incidence of HPV infection peaks 5-10 years after the onset of sexual activity, preadolescents and adolescents represent an appropriate target group to implement HPV vaccination programs so as to achieve the maximal public health benefit. In this article, we provide an overview of the prophylactic efficacy of the vaccine in young women who were found to be negative to at least one of the four vaccine HPV types, thus approximating sexually naive adolescents. Because adolescents are also at high risk for other infections which are preventable by currently available vaccines, the development of concurrent immunization strategies may lead to better compliance, thereby contributing to the overall goal of protection against preventable diseases. We also summarize concomitant administration studies with meningococcal, diphtheria, tetanus, and pertussis vaccines, which were conducted in adolescents aged 9-15 years. Prophylactic efficacy in other populations (males aged 16-26 years) is also summarized along with long-term safety and efficacy studies.
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Affiliation(s)
- Richard M Haupt
- Vaccine Clinical Research, Merck Sharp and Dohme Corp., Whitehouse Station, New Jersey, USA.
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41
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Monitoring the safety of quadrivalent human papillomavirus vaccine: Findings from the Vaccine Safety Datalink. Vaccine 2011; 29:8279-84. [DOI: 10.1016/j.vaccine.2011.08.106] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/24/2011] [Indexed: 11/18/2022]
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42
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Abstract
Recent data demonstrate that human papillomavirus also plays a role in cancers other than ano-genital cancers, specifically head and neck cancers, and non-cancerous conditions such as recurrent respiratory papillomatosis. As more and more information about the role of infection in non-cervical diseases is amassed, additional questions about whether prophylactic human papillomavirus vaccines will effectively prevent these conditions are raised. This article reviews the epidemiology of oral human papillomavirus infection and the role of human papillomavirus in head and neck cancers. In addition, it will review the known clinical indications for human papillomavirus vaccination, and highlight other potential clinical targets for the vaccine that have not yet been demonstrated in clinical trials but for which there is biologic plausibility.
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43
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Kunze U, Böhm G. [Public health analysis -- human papillomavirus data and facts for Austria]. Wien Klin Wochenschr 2011; 122:655-9. [PMID: 21136186 DOI: 10.1007/s00508-010-1496-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ursula Kunze
- Institut für Sozialmedizin, Zentrum für Public Health, Medizinische Universität Wien, Wien, Österreich.
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44
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Frazer IH, Leggatt GR, Mattarollo SR. Prevention and treatment of papillomavirus-related cancers through immunization. Annu Rev Immunol 2011; 29:111-38. [PMID: 21166538 DOI: 10.1146/annurev-immunol-031210-101308] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cervical and other anogenital cancers are initiated by infection with one of a small group of human papillomaviruses (HPV). Virus-like particle-based vaccines have recently been developed to prevent infection with two cancer-associated HPV genotypes (HPV16, HPV18) and have been ∼95% effective at preventing HPV-associated disease caused by these genotypes in virus-naive subjects. Although immunization induces virus-neutralizing antibody sufficient to prevent infection, persistence of antibody as measured by current assays does not appear necessary to maintain protection over time. Investigators have not identified a reliable surrogate immunological marker of protection against disease following immunization. The prophylactic vaccines are not therapeutic for existing infection. Trials of HPV-specific immunotherapy have shown some efficacy for existing disease, although animal modeling suggests that a combination of immunization and local enhancement of innate immunity may be necessary for optimal therapeutic outcome. HPV prophylactic vaccines are the first vaccines designed to prevent a human cancer and are the practical outcome of a global collaborative effort between basic and applied scientists, clinicians, and industry.
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Affiliation(s)
- Ian H Frazer
- The University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, Australia.
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45
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Hellner K, Münger K. Human papillomaviruses as therapeutic targets in human cancer. J Clin Oncol 2011; 29:1785-94. [PMID: 21220591 PMCID: PMC3675666 DOI: 10.1200/jco.2010.28.2186] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 10/05/2010] [Indexed: 01/22/2023] Open
Abstract
Cervical carcinomas are almost universally associated with high-risk human papillomavirus (HPV) infections, and are a leading cause of cancer death in women worldwide. HPV oncoproteins contribute to cancer initiation and progression and their expression is necessary for the maintenance of the transformed state. The fact that the initiating oncogenic insult, infection with a high-risk HPV and viral oncoprotein expression, is common to almost all cervical cancers offers unique opportunities for prevention, early detection, and therapy. The potential for prevention has been realized by introduction of prophylactic vaccines that are to prevent transmission of specific high-risk HPVs. Given, however, that these vaccines have no therapeutic efficacy and HPV-associated cervical cancers arise years if not decades after the initial infection, it has been estimated that there will be no measurable decline of HPV-associated tumors before 2040. Cervical cancer alone will be diagnosed in more than 375,000 US women between now and 2040. Other HPV-associated anogenital and head and neck cancers are predicted to afflict another 700,000 men and women over this time period. Hence, therapeutic efforts to combat high-risk HPV-associated disease remain of critical importance.
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Affiliation(s)
- Karin Hellner
- From The Channing Laboratories, Brigham and Women's Hospital; and Harvard Medical School, Harvard University, Boston, MA
| | - Karl Münger
- From The Channing Laboratories, Brigham and Women's Hospital; and Harvard Medical School, Harvard University, Boston, MA
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46
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Asia oceania guidelines for the implementation of programs for cervical cancer prevention and control. J Cancer Epidemiol 2011; 2011:794861. [PMID: 21559068 PMCID: PMC3083000 DOI: 10.1155/2011/794861] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 01/17/2011] [Indexed: 01/20/2023] Open
Abstract
This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to healthcare is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world.
The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.
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Crawford NW, Clothier HJ, Elia S, Lazzaro T, Royle J, Buttery JP. Syncope and seizures following human papillomavirus vaccination: a retrospective case series. Med J Aust 2011; 194:16-8. [DOI: 10.5694/j.1326-5377.2011.tb04138.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 09/01/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Nigel W Crawford
- SAEFVIC Immunisation Safety Group, Murdoch Childrens Research Institute, Melbourne, VIC
- Department of General Medicine, Royal Children's Hospital, Melbourne, VIC
- Department of Paediatrics, University of Melbourne, Melbourne, VIC
| | - Hazel J Clothier
- SAEFVIC Immunisation Safety Group, Murdoch Childrens Research Institute, Melbourne, VIC
| | - Sonja Elia
- Immunisation Service, Royal Children's Hospital, Melbourne, VIC
| | - Teresa Lazzaro
- SAEFVIC Immunisation Safety Group, Murdoch Childrens Research Institute, Melbourne, VIC
- Department of General Medicine, Royal Children's Hospital, Melbourne, VIC
- Immunisation Service, Royal Children's Hospital, Melbourne, VIC
| | - Jenny Royle
- Department of General Medicine, Royal Children's Hospital, Melbourne, VIC
- Immunisation Service, Royal Children's Hospital, Melbourne, VIC
| | - Jim P Buttery
- SAEFVIC Immunisation Safety Group, Murdoch Childrens Research Institute, Melbourne, VIC
- Department of General Medicine, Royal Children's Hospital, Melbourne, VIC
- Paediatric Infectious Diseases Unit, Monash Children's Hospital, Melbourne, VIC
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48
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Approaches to monitoring biological outcomes for HPV vaccination: Challenges of early adopter countries. Vaccine 2011; 29:878-85. [DOI: 10.1016/j.vaccine.2010.10.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/03/2010] [Accepted: 10/07/2010] [Indexed: 11/20/2022]
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49
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Haupt RM, Sattler C. HPV vaccine continues to be safe and effective, and its benefits continue to outweigh its risks. Expert Rev Vaccines 2010; 9:697-701. [PMID: 20624041 DOI: 10.1586/erv.10.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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50
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Kent H, Heffernan ME, Silvers J, Moore E, Garland SM. Role of the nurse immuniser in implementing and maintaining the National Human Papillomavirus 'Cervical Cancer' Vaccine rollout through a school-based program in Victoria. Sex Health 2010; 7:391-3. [PMID: 20719232 DOI: 10.1071/sh09148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Accepted: 04/13/2010] [Indexed: 11/23/2022]
Abstract
In an effort to understand the strengths and limitations of current approaches to human papillomavirus vaccine (HPV) delivery in schools, we conducted an audit of nurse immunisers (NI). In this survey of 159 Victorian NI, the NI perceived that knowledge, safety and side effects were among the most important issues raised by parents, schoolgirls, and teachers in the school setting. The most common concern identified by NIs was the physical layout of the vaccination setting (41%), followed by safety, then knowledge of the vaccine. There is a need for ongoing assessment of factors that improve or impede the delivery of HPV vaccines.
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