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Dalon F, Majed L, Belhassen M, Jacoud F, Bérard M, Lévy-Bachelot L, de Pouvourville G, Rouzier R, Raude J, Baldauf JJ. Human papillomavirus (HPV) vaccine coverage rates (VCRs) in France: A French claims data study. Vaccine 2021; 39:5129-5137. [PMID: 34334252 DOI: 10.1016/j.vaccine.2021.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/16/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The French Cancer Plan 2014-2019 had a target of 60% HPV vaccine coverage. The PAPILLON study investigated the annual age-specific vaccination initiation rates and cumulative partial and complete vaccination rates in France from 2017 to 2022. It also identified the factors associated with vaccination in different age groups and those associated with the type of completion of the vaccination scheme (partial vs full vaccination). METHODS For this publication, all females recorded in the French National Claims database who initiated HPV vaccination between 1 July 2007 and 31 December 2018 and were aged between 11 and 19 years at initiation were included. Annual HPV vaccination initiation rates were estimated in 11- to 14-year-old (target population) and 15- to 19-year-old females (catch-up). Cumulative vaccine coverage rates (VCRs) were estimated among those who were 15, 16, 20 and 21 years old. Partial vaccination was defined by dispensing of at least one dose of HPV vaccine by the pharmacy, while full vaccination was defined by two or three doses dispensed by a pharmacy over an 18-month period, according to current French recommendations based on the age at vaccination initiation. RESULTS Among the 465,629 females who initiated HPV vaccination in 2017 or 2018, the initiation rate increased from 7.7 to 11.1% in 11- to 14-year-old girls and from 4.5 to 6.5% in 15- to 19-year-old females. In 2017 and 2018, the cumulative VCRs for partial vaccination by age 15 were 28.2% and 32.8%, respectively, while by age 20, they were 41.6% and 38.8%. The cumulative VCRs for full vaccination were 15.6% and 18.6% by age 16, while they were 25.9 and 23.6% by age 20. HPV vaccination initiation and completion were strongly associated with the use of health services. CONCLUSION Overall, the HPV VCR substantively increased between 2017 and 2018, which is positive evidence of the resumption of vaccination. Updates in 2022 should confirm these results.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jocelyn Raude
- Ecole des Hautes Etudes en Santé Publique (EHESP), Rennes, France
| | - Jean-Jacques Baldauf
- University Hospital of Strasbourg and EA3181, University of Bourgogne Franche-Comte, Besançon, France
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2
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HPV cervical infections and serological status in vaccinated and unvaccinated women. Vaccine 2020; 38:8167-8174. [PMID: 33168348 DOI: 10.1016/j.vaccine.2020.10.078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
Understanding genital infections by Human papillomaviruses (HPVs) remains a major public health issue, especially in countries where vaccine uptake is low. We investigate HPV prevalence and antibody status in 150 women (ages 18 to 25) in Montpellier, France. At inclusion and one month later, cervical swabs, blood samples and questionnaires (for demographics and behavioural variables) were collected. Oncogenic, non-vaccine genotypes HPV51, HPV66, HPV53, and HPV52 were the most frequently detected viral genotypes overall. Vaccination status, which was well-balanced in the cohort, showed the strongest (protective) effect against HPV infections, with an associated odds ratio for alphapapillomavirus detection of 0.45 (95% confidence interval: [0.22;0.58]). We also identified significant effects of age, number of partners, body mass index, and contraception status on HPV detection and on coinfections. Type-specific IgG serological status was also largely explained by the vaccination status. IgM seropositivity was best explained by HPV detection at inclusion only. Finally, we identify a strong significant effect of vaccination on genotype prevalence, with a striking under-representation of HPV51 in vaccinated women. Variations in HPV prevalence correlate with key demographic and behavioural variables. The cross-protective effect of the vaccine against HPV51 merits further investigation.
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Mohammadpour F, Mansouri A, Hadjibabaie M. Utilization Evaluation of Human Papilloma Virus Vaccine (GARDASIL®) in Iran; A Cross-Sectional Study. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2020; 19:68-76. [PMID: 32922470 DOI: 10.22037/ijpr.2020.1100923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Vaccination against HPV seems to be a good approach for prevention of cervical cancer and genital warts. But in Iran we are confronted with lack of evidence for its cost-effectiveness whereas its consumption is dramatically increasing. This was a cross- sectional study. We used a questionnaire including 5 sections as follows; Patients demographic information, Patients medical history, Pregnancy and lactation considerations, Gardasil prescription characteristics and HPV infection characteristics. Prescriber with adherence to guideline were defined as those prescribing Gardasil for correct age range and indication with accurate dosage and administration. Descriptive statistics for variables was shown by frequency (percent) or mean (± SD) and evaluation of relation between categorical variables was performed by using Chi-square test. Total 566 Gardasil recipients participated in the study. There were mostly female with mean age of 28.1 (± 6.68). For 128 (22.6%) participants Gardasil prescribed correctly considering both age range (9-26 years) and indication (prophylactic). From this group, 80 participants (14.1%/566) have received accurate Gardasil dosage and interval (prescriber had adherence to guideline). Patients' out of pocket payment in guidelines adherent prescriptions was a seventh of total costs obtained from 566 consumers. Gynecologists significantly prescribed for prophylaxis higher than other specialties (p-value = 0.01). Prescribers' practice in administrating Gardasil is obviously not appropriate and it is imposing burdensome cost to community and government. On the other hand, we have encountered with increasing rate of its use in Iran in past years. Therefore, we are in urgent need for appropriate interventions in national level and prompt supervision to regulate Gardasil consumption.
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Affiliation(s)
- Fateme Mohammadpour
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Ava Mansouri
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Molouk Hadjibabaie
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.,Faculty of Pharmacy, Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Murall CL, Rahmoun M, Selinger C, Baldellou M, Bernat C, Bonneau M, Boué V, Buisson M, Christophe G, D’Auria G, Taroni FD, Foulongne V, Froissart R, Graf C, Grasset S, Groc S, Hirtz C, Jaussent A, Lajoie J, Lorcy F, Picot E, Picot MC, Ravel J, Reynes J, Rousset T, Seddiki A, Teirlinck M, Tribout V, Tuaillon É, Waterboer T, Jacobs N, Bravo IG, Segondy M, Boulle N, Alizon S. Natural history, dynamics, and ecology of human papillomaviruses in genital infections of young women: protocol of the PAPCLEAR cohort study. BMJ Open 2019; 9:e025129. [PMID: 31189673 PMCID: PMC6576111 DOI: 10.1136/bmjopen-2018-025129] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Human papillomaviruses (HPVs) are responsible for one-third of all cancers caused by infections. Most HPV studies focus on chronic infections and cancers, and we know little about the early stages of the infection. Our main objective is to better understand the course and natural history of cervical HPV infections in healthy, unvaccinated and vaccinated, young women, by characterising the dynamics of various infection-related populations (virus, epithelial cells, vaginal microbiota and immune effectors). Another objective is to analyse HPV diversity within hosts, and in the study population, in relation to co-factors (lifestyle characteristics, vaccination status, vaginal microbiota, human genetics). METHODS AND ANALYSIS The PAPCLEAR study is a single center longitudinal study following 150 women, aged 18-25 years, for up to 2 years. Visits occur every 2 or 4 months (depending on HPV status) during which several variables are measured, such as behaviours (via questionnaires), vaginal pH, HPV presence and viral load (via qPCR), local concentrations of cytokines (via MesoScale Discovery technology) and immune cells (via flow cytometry). Additional analyses are outsourced, such as titration of circulating anti-HPV antibodies, vaginal microbiota sequencing (16S and ITS1 loci) and human genotyping. To increase the statistical power of the epidemiological arm of the study, an additional 150 women are screened cross-sectionally. Finally, to maximise the resolution of the time series, participants are asked to perform weekly self-samples at home. Statistical analyses will involve classical tools in epidemiology, genomics and virus kinetics, and will be performed or coordinated by the Centre National de la Recherche Scientifique (CNRS) in Montpellier. ETHICS AND DISSEMINATION This study has been approved by the Comité de Protection des Personnes Sud Méditerranée I (reference number 2016-A00712-49); by the Comité Consultatif sur le Traitement de l'Information en matière de Recherche dans le domaine de la Santé (reference number 16.504); by the Commission Nationale Informatique et Libertés (reference number MMS/ABD/AR1612278, decision number DR-2016-488) and by the Agence Nationale de Sécurité du Médicament et des Produits de Santé (reference 20160072000007). Results will be published in preprint servers, peer-reviewed journals and disseminated through conferences. TRIAL REGISTRATION NUMBER NCT02946346; Pre-results.
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Affiliation(s)
| | | | | | - Monique Baldellou
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Claire Bernat
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
| | - Marine Bonneau
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Vanina Boué
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
| | - Mathilde Buisson
- Department of Research and Innovation (DRI), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Guillaume Christophe
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Giuseppe D’Auria
- CIBER en Epidemiología y Salud Pública (CIBEResp), Madrid, Spain
- Sequencing and Bioinformatics Service, Fundaciónpara el Fomento de la Investigación Sanitaria y Biomédica de laComunidad Valenciana (FISABIO-Salud Pública), Valencia, Spain
| | - Florence De Taroni
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Vincent Foulongne
- Pathogenesis and Control of Chronic Infections, INSERM, CHU, University of Montpellier, Montpellier, France
- Department of Virology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Rémy Froissart
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
| | - Christelle Graf
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Sophie Grasset
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Soraya Groc
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
- Department of Virology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Christophe Hirtz
- LBPC/PPC- IRMB, CHU de Montpellier and Université de Montpellier, Montpellier, France
| | - Audrey Jaussent
- Department of Medical Information (DIM), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Julie Lajoie
- Department of Medical microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Frédérique Lorcy
- Department of pathology and oncobiology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Eric Picot
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Marie-Christine Picot
- Department of Medical Information (DIM), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jacques Reynes
- Department of Infectious and Tropical Diseases, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Thérèse Rousset
- Department of pathology and oncobiology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Aziza Seddiki
- Department of Research and Innovation (DRI), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Martine Teirlinck
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Vincent Tribout
- Center for Free Information, Screening and Diagnosis (CGIDD), Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Édouard Tuaillon
- Pathogenesis and Control of Chronic Infections, INSERM, CHU, University of Montpellier, Montpellier, France
- Department of Virology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Infections and Cancer Epidemiology, Heidelberg, Germany
| | - Nathalie Jacobs
- GIGA-Research, Cellular and molecular immunology, University of Liège, Liège, Belgium
| | | | - Michel Segondy
- Pathogenesis and Control of Chronic Infections, INSERM, CHU, University of Montpellier, Montpellier, France
- Department of Virology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Nathalie Boulle
- Pathogenesis and Control of Chronic Infections, INSERM, CHU, University of Montpellier, Montpellier, France
- Department of pathology and oncobiology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Samuel Alizon
- MIVEGEC (UMR 5290 CNRS, IRD, UM), CNRS, Montpellier, France
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Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018; 10:E729. [PMID: 30572620 PMCID: PMC6315375 DOI: 10.3390/v10120729] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/12/2018] [Accepted: 12/15/2018] [Indexed: 12/25/2022] Open
Abstract
Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.
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Affiliation(s)
- Andreas C Chrysostomou
- Department of Biological Sciences, University of Cyprus, 1 University Avenue, Aglantzia 2109, Nicosia, Cyprus.
| | - Dora C Stylianou
- Department of Biological Sciences, University of Cyprus, 1 University Avenue, Aglantzia 2109, Nicosia, Cyprus.
| | - Anastasia Constantinidou
- Medical School, University of Cyprus, Shakolas Educational Center for Clinical Medicine, Palaios dromos Lefkosias Lemesou No.215/6 2029 Aglantzia, Nicosia, Cyprus.
| | - Leondios G Kostrikis
- Department of Biological Sciences, University of Cyprus, 1 University Avenue, Aglantzia 2109, Nicosia, Cyprus.
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6
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Shield KD, Marant Micallef C, de Martel C, Heard I, Megraud F, Plummer M, Vignat J, Bray F, Soerjomataram I. New cancer cases in France in 2015 attributable to infectious agents: a systematic review and meta-analysis. Eur J Epidemiol 2018; 33:263-274. [PMID: 29214413 DOI: 10.1007/s10654-017-0334-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 11/20/2017] [Indexed: 12/31/2022]
Abstract
To provide an assessment of the burden of cancer in France in 2015 attributable to infectious agents. A systematic literature review in French representative cancer cases series was undertaken of the prevalence of infectious agents with the major associated cancer types. PubMed was searched for original studies published up to September 2016; random-effects meta-analyses were performed. Cancer incidence data were obtained from the French Cancer Registries Network, thereby allowing the calculation of national incidence estimates. The number of new cancer cases attributable to infectious agents was calculated using population-attributable fractions according to published methods. Of the 352,000 new cancer cases in France in 2015, 14,336 (4.1% of all new cancer cases) were attributable to infectious agents. The largest contributors were human papillomavirus (HPV) and Helicobacter pylori, responsible for 6333 and 4406 new cancer cases (1.8 and 1.3% of all new cancer cases) respectively. Infectious agents caused a non-negligible number of new cancer cases in France in 2015. Most of these cancers were preventable. The expansion of vaccination (i.e., for hepatitis B virus and HPV) and screen-and-treat programs (for HPV and hepatitis C virus, and possibly for H. pylori) could greatly reduce this cancer burden.
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Affiliation(s)
- Kevin David Shield
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France.
| | - Claire Marant Micallef
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Catherine de Martel
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Heard
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
- Hospital Tenon, AP-HP, Paris, France
| | - Francis Megraud
- Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France
| | - Martyn Plummer
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Jérôme Vignat
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
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7
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Loke AY, Kwan ML, Wong YT, Wong AKY. The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review. J Prim Care Community Health 2017; 8:349-362. [PMID: 29161946 PMCID: PMC5932744 DOI: 10.1177/2150131917742299] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
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Affiliation(s)
- Alice Yuen Loke
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Miu Ling Kwan
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR.,2 Tuen Mun Hospital, Hospital Authority, Hong Kong SAR
| | - Yuen-Ting Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Alice Kar Yan Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
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Value of a national administrative database to guide public decisions: From the système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France. Rev Epidemiol Sante Publique 2017; 65 Suppl 4:S149-S167. [DOI: 10.1016/j.respe.2017.05.004] [Citation(s) in RCA: 337] [Impact Index Per Article: 48.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 12/11/2022] Open
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9
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Miranda S, Chaignot C, Collin C, Dray-Spira R, Weill A, Zureik M. Human papillomavirus vaccination and risk of autoimmune diseases: A large cohort study of over 2million young girls in France. Vaccine 2017; 35:4761-4768. [PMID: 28750853 DOI: 10.1016/j.vaccine.2017.06.030] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/01/2017] [Accepted: 06/09/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Whether human papillomavirus (HPV) vaccination could induce or trigger autoimmune diseases (AID) has been questioned, and potentially contributes to low immunization coverage in France. This study evaluated the association between HPV vaccination and the risk of AID using routinely collected data sources. METHODS All girls aged 13-16years between 2008 and 2012, covered by the general health insurance scheme and without history of HPV vaccination or AID, were included and followed using French nationwide databases. Fourteen neurological, rheumatological, haematological, gastrointestinal or endocrine AID, were identified from ICD-10 codes allocated to hospital stays and long-term illnesses or by marker drugs. Their incidence was compared between girls exposed and non-exposed to HPV vaccination, using a Cox model adjusted for inclusion year, geographic area, socio-economic indicators, healthcare use level and other immunizations. RESULTS Among 2,252,716 girls, 37% received HPV vaccine and 4,096 AID occurred during a mean follow-up time of 33months. The incidence of AID was not increased after exposure to HPV vaccination, except for Guillain-Barré syndrome (GBS) (incidence rate of 1.4 among exposed [20 cases] versus 0.4 per 100,000 PY among unexposed [23 cases]; adjusted HR: 3.78 [1.79-7.98]). This association persisted across numerous sensitivity analyses and was particularly marked in the first months following vaccination. Under the hypothesis of a causal relationship, this would result in 1-2 GBS cases attributable to HPV vaccine per 100,000 girls vaccinated. CONCLUSIONS Our study provides reassuring results regarding the risk of AID after HPV vaccination, but an apparently increased risk of GBS was detected. Further studies are warranted to confirm this finding.
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Affiliation(s)
- Sara Miranda
- Agence Nationale de Sécurité des Médicaments et des Produits de Santé (ANSM) [French National Agency for Medicines and Health Products Safety], Saint-Denis, France
| | - Christophe Chaignot
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS) [French National Health Insurance Fund for Salaried Workers], Paris, France
| | - Cédric Collin
- Agence Nationale de Sécurité des Médicaments et des Produits de Santé (ANSM) [French National Agency for Medicines and Health Products Safety], Saint-Denis, France
| | - Rosemary Dray-Spira
- Agence Nationale de Sécurité des Médicaments et des Produits de Santé (ANSM) [French National Agency for Medicines and Health Products Safety], Saint-Denis, France
| | - Alain Weill
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS) [French National Health Insurance Fund for Salaried Workers], Paris, France
| | - Mahmoud Zureik
- Agence Nationale de Sécurité des Médicaments et des Produits de Santé (ANSM) [French National Agency for Medicines and Health Products Safety], Saint-Denis, France.
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10
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Fonteneau L, Le Meur N, Cohen-Akenine A, Pessel C, Brouard C, Delon F, Desjeux G, Durand J, Kirchgesner J, Lapidus N, Lemaitre M, Tala S, Thiébaut A, Watier L, Rudant J, Guillon-Grammatico L. [The use of administrative health databases in infectious disease epidemiology and public health]. Rev Epidemiol Sante Publique 2017. [PMID: 28624133 DOI: 10.1016/j.respe.2017.03.131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The public health burden resulting from infectious diseases requires efforts in surveillance and evaluation of health care. The use of administrative health databases (AHD) and in particular the French national health insurance database (SNIIRAM) is an opportunity to improve knowledge in this field. The SNIIRAM data network (REDSIAM) workshop dedicated to infectious diseases conducted a narrative literature review of studies using French AHD. From the results, benefits and limits of these new tools in the field of infectious diseases are presented. METHODS Publications identified by the members of the workgroup were collected using an analytical framework that documented the pathology of interest, the aim of the study, the goal of the developed algorithm, the kind of data, the study period, and the presence of an evaluation or a discussion of the performance of the performed algorithm. RESULTS Fifty-five articles were identified. A majority focused on the field of vaccination coverage and joint infections. Excluding vaccine coverage field, the aim of 28 studies was epidemiological surveillance. Twenty-six studies used hospital databases exclusively, 18 used ambulatory databases exclusively and 4 used both. Validation or discussion of the performed algorithm was present in 18 studies. CONCLUSIONS The literature review confirmed the interest of the French AHD in the infectious diseases field. The AHD are additional tools of the existing surveillance systems and their use will probably be more frequent in the coming years given their advantage and reliability. However, incoming users need to be assisted. Thus, the workgroup will contribute to a reasonable use of AHD and support future developments.
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Affiliation(s)
- L Fonteneau
- REDSIAM, groupe de travail infectieux, France; Santé publique France, direction des maladies infectieuses, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
| | | | - A Cohen-Akenine
- REDSIAM, groupe de travail infectieux, France; Haute Autorité de santé, Saint-Denis la Plaine, France
| | - C Pessel
- Haute Autorité de santé, Saint-Denis la Plaine, France
| | - C Brouard
- REDSIAM, groupe de travail infectieux, France; Santé publique France, direction des maladies infectieuses, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
| | - F Delon
- REDSIAM, groupe de travail infectieux, France; Centre d'épidémiologie et de santé publique des armées, Marseille, France
| | - G Desjeux
- REDSIAM, groupe de travail infectieux, France; Caisse nationale militaire de sécurité sociale, Toulon, France
| | - J Durand
- REDSIAM, groupe de travail infectieux, France; Santé publique France, direction des maladies infectieuses, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
| | - J Kirchgesner
- REDSIAM, groupe de travail infectieux, France; Inserm, unité mixte de recherche en santé 1136, institut Pierre-Louis d'épidémiologie et de santé publique, Paris, France
| | - N Lapidus
- REDSIAM, groupe de travail infectieux, France; Département de santé publique, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP UMRS 1136), Sorbonne universités, UPMC université Paris 06, hôpital Saint-Antoine, AP-HP, 75000 Paris, France
| | - M Lemaitre
- REDSIAM, groupe de travail infectieux, France; Haute Autorité de santé, Saint-Denis la Plaine, France
| | - S Tala
- REDSIAM, groupe de travail infectieux, France; Département études sur l'offre de soins, direction de la stratégie, des études et des statistiques, Caisse nationale d'assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France
| | - A Thiébaut
- REDSIAM, groupe de travail infectieux, France; Biostatistics, biomathematics, pharmacoepidemiology and infectious diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, université Paris-Saclay, 75000 Paris, France
| | - L Watier
- REDSIAM, groupe de travail infectieux, France; Biostatistics, biomathematics, pharmacoepidemiology and infectious diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, université Paris-Saclay, 75000 Paris, France
| | - J Rudant
- REDSIAM, groupe de travail infectieux, France; Département études de santé publique, direction de la stratégie, des études et des statistiques, Caisse nationale d'assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France
| | - L Guillon-Grammatico
- REDSIAM, groupe de travail infectieux, France; Service d'information médicale d'épidémiologie et d'économie de la santé, unité régionale d'épidémiologie hospitalière (UREH), université F.-abelais, CHRU de Tours, 37000 Tours, France
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Ekwunife OI, O’Mahony JF, Gerber Grote A, Mosch C, Paeck T, Lhachimi SK. Challenges in Cost-Effectiveness Analysis Modelling of HPV Vaccines in Low- and Middle-Income Countries: A Systematic Review and Practice Recommendations. PHARMACOECONOMICS 2017; 35:65-82. [PMID: 27637758 PMCID: PMC5209408 DOI: 10.1007/s40273-016-0451-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Low- and middle-income countries (LMICs) face a number of challenges in implementing cervical cancer prevention programmes that do not apply in high-income countries. OBJECTIVE This review assessed how context-specific challenges of implementing cervical cancer prevention strategies in LMICs were accounted for in existing cost-effectiveness analysis (CEA) models of human papillomavirus (HPV) vaccination. METHODS The databases of MEDLINE, EMBASE, NHS Economic Evaluation Database, EconLit, Web of Science, and the Center for the Evaluation of Value and Risk in Health (CEA) Registry were searched for studies published from 2006 to 2015. A descriptive, narrative, and interpretative synthesis of data was undertaken. RESULTS Of the 33 studies included in the review, the majority acknowledged cost per vaccinated girl (CVG) (26 studies) and vaccine coverage rate (21 studies) as particular challenges for LMICs, while nine studies identified screening coverage rate as a challenge. Most of the studies estimated CVG as a composite of different cost items. However, the basis for the items within this composite cost was unclear. The majority used an assumption rather than an observed rate to represent screening and vaccination coverage rates. CVG, vaccine coverage and screening coverage were shown by some studies through sensitivity analyses to reverse the conclusions regarding cost-effectiveness, thereby significantly affecting policy recommendations. CONCLUSIONS While many studies recognized aspects of the particular challenges of HPV vaccination in LMICs, greater efforts need to be made in adapting models to account for these challenges. These include adapting costings of HPV vaccine delivery from other countries, learning from the outcomes of cervical cancer screening programmes in the same geographical region, and taking into account the country's previous experience with other vaccination programmes.
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Affiliation(s)
- Obinna I. Ekwunife
- Collaborative Research Group for Evidence-Based Public Health, Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS/University of Bremen, Achterstr. 30, 28359 Bremen, Germany
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - James F. O’Mahony
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Andreas Gerber Grote
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
- Department of Health, ZHAW, Winterthur, Switzerland
| | - Christoph Mosch
- Institute for Research in Operative Medicine (IFOM), Universität Witten/Herdecke, Witten, Germany
| | - Tatjana Paeck
- Institute for Public Health and Nursing Research, IPP, Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Stefan K. Lhachimi
- Collaborative Research Group for Evidence-Based Public Health, Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS/University of Bremen, Achterstr. 30, 28359 Bremen, Germany
- Institute for Public Health and Nursing Research, IPP, Health Sciences Bremen, University of Bremen, Bremen, Germany
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12
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Mammas IN, Theodoridou M, Koutsaftiki C, Bertsias G, Sourvinos G, Spandidos DA. Vaccination against Human Papillomavirus in relation to Financial Crisis: The "Evaluation and Education of Greek Female Adolescents on Human Papillomaviruses' Prevention Strategies" ELEFTHERIA Study. J Pediatr Adolesc Gynecol 2016; 29:362-6. [PMID: 26724746 DOI: 10.1016/j.jpag.2015.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/24/2015] [Accepted: 12/18/2015] [Indexed: 12/28/2022]
Abstract
STUDY OBJECTIVE In this study we aimed to explore financial and other sociodemographic factors that affect nonvaccination against the human papillomavirus (HPV) in Greece, one of the first European Union countries to introduce the vaccination against HPV into its National Immunization Programme in 2008. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Six hundred thirty-two female adolescents (aged 11-16 years) from Greece completed a pilot cross-sectional questionnaire-based survey (ELEFTHERIA study) from 2008 to 2014. RESULTS Overall, only 8.9% (56 of 632) of the female adolescents reported that they had received all 3 doses of the HPV vaccination. The HPV vaccination uptake rates increased gradually from 3.2% (3 of 95) in 2008 to 17.1% (14 of 82) in 2011. However, it abruptly decreased to 2.1% (2 of 95) in 2012 and it reached 9.2% (8 of 87) in 2013 and 11.5% (11 of 96) in 2014. The most common factors for nonvaccination included fear of side effects, which decreased (Spearman ρ = -0.860; P = .024) and financial issues, which increased statistically significantly (Spearman ρ = 0.890; P = .012) during the years 2008 to 2014. CONCLUSION In our study we addressed the novel topic of the association of financial issues with HPV vaccination compliance and highlighted the urgent need to provide and maintain health insurance coverage to children in Greece, a country in financial crisis.
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Affiliation(s)
- Ioannis N Mammas
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion, Heraklion, Greece.
| | - Maria Theodoridou
- First Department of Paediatrics, 'Aghia Sophia' Children's Hospital, University of Athens School of Medicine, Athens, Greece
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, Penteli, Greece
| | - George Bertsias
- Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece
| | - George Sourvinos
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion, Heraklion, Greece
| | - Demetrios A Spandidos
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion, Heraklion, Greece
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13
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Sahli L, Lapeyre-Mestre M, Derumeaux H, Moulis G. Positive predictive values of selected hospital discharge diagnoses to identify infections responsible for hospitalization in the French national hospital database. Pharmacoepidemiol Drug Saf 2016; 25:785-9. [DOI: 10.1002/pds.4006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Line Sahli
- UMR 1027 INSERM; University of Toulouse; France
| | - Maryse Lapeyre-Mestre
- UMR 1027 INSERM; University of Toulouse; France
- Department of Medical and Clinical Pharmacology; Toulouse University Hospital; Toulouse France
- Centre d'Investigation Clinique 1436; Toulouse University Hospital; Toulouse France
| | - Hélène Derumeaux
- UMR 1027 INSERM; University of Toulouse; France
- Department of Medical Information; Toulouse University Hospital; Toulouse France
| | - Guillaume Moulis
- UMR 1027 INSERM; University of Toulouse; France
- Centre d'Investigation Clinique 1436; Toulouse University Hospital; Toulouse France
- Department of Internal medicine; Toulouse University Hospital; Toulouse France
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14
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Bailey HH, Chuang LT, duPont NC, Eng C, Foxhall LE, Merrill JK, Wollins DS, Blanke CD. American Society of Clinical Oncology Statement: Human Papillomavirus Vaccination for Cancer Prevention. J Clin Oncol 2016; 34:1803-12. [PMID: 27069078 DOI: 10.1200/jco.2016.67.2014] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
American Society of Clinical Oncology (ASCO), the leading medical professional oncology society, is committed to lessening the burden of cancer and as such will promote underused interventions that have the potential to save millions of lives through cancer prevention. As the main providers of cancer care worldwide, our patients, their families, and our communities look to us for guidance regarding all things cancer related, including cancer prevention. Through this statement and accompanying recommendations, ASCO hopes to increase awareness of the tremendous global impact of human papillomavirus (HPV) -caused cancers, refocus the discussion of HPV vaccination on its likely ability to prevent millions of cancer deaths, and increase HPV vaccination uptake via greater involvement of oncology professionals in ensuring accurate public discourse about HPV vaccination and calling for the implementation of concrete strategies to address barriers to vaccine access and acceptance.
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Affiliation(s)
- Howard H Bailey
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR.
| | - Linus T Chuang
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Nefertiti C duPont
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Cathy Eng
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Lewis E Foxhall
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Janette K Merrill
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Dana S Wollins
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Charles D Blanke
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
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15
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Voidăzan S, Tarcea M, Morariu SH, Grigore A, Dobreanu M. Human Papillomavirus Vaccine - Knowledge and Attitudes among Parents of Children Aged 10-14 Years: a Cross-sectional Study, Tîrgu Mureş, Romania. Cent Eur J Public Health 2016; 24:29-38. [DOI: 10.21101/cejph.a4287] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/11/2015] [Indexed: 11/15/2022]
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16
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Mammas IN, Greenough A, Theodoridou M, Kramvis A, Christaki I, Koutsaftiki C, Koutsaki M, Portaliou DM, Kostagianni G, Panagopoulou P, Sourvinos G, Spandidos DA. Current views and advances on Paediatric Virology: An update for paediatric trainees. Exp Ther Med 2015; 11:6-14. [PMID: 26889211 PMCID: PMC4726865 DOI: 10.3892/etm.2015.2890] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/24/2015] [Indexed: 12/31/2022] Open
Abstract
Paediatric Virology is a bold new scientific field, which combines Paediatrics with Virology, Epidemiology, Molecular Medicine, Evidence-based Medicine, Clinical Governance, Quality Improvement, Pharmacology and Immunology. The Workshop on Paediatric Virology, which took place on Saturday October 10, 2015 in Athens, Greece, provided an overview of recent views and advances on viral infections occurring in neonates and children. It was included in the official programme of the 20th World Congress on Advances in Oncology and the 18th International Symposium on Molecular Medicine, which attracted over 500 delegates from the five continents. During the Workshop, the topics covered included the challenges of vaccine implementation against human papillomaviruses in countries under financial crisis, strategies for eradicating poliomyelitis and its 60th vaccine anniversary, as well as the debate on the association between autism and vaccination against measles, mumps and rubella. Among the non-vaccine related topics, emphasis was given to viral infections in prematurely born infants and their long-term outcomes, new paediatric intensive care management options for bronchiolitis related to respiratory syncytial virus, the clinical implications of hepatitis B virus and cytomegalovirus genotyping, the Ebola virus threat and preparedness in Paediatric Emergency Departments, oral, oropharynx, laryngeal, nasal and ocular viral infections and Merkel cell polyomavirus as a novel emerging virus of infancy and childhood. In this review, we provide selected presentations and reports discussed at the Workshop.
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Affiliation(s)
- Ioannis N Mammas
- Department of Clinical Virology, University of Crete School of Medicine, Heraklion 71003, Greece
| | - Anne Greenough
- Division of Asthma, Allergy and Lung Biology, King's College London, London SE5 9RS, UK
| | - Maria Theodoridou
- First Department of Paediatrics, 'Aghia Sophia' Children's Hospital, University of Athens School of Medicine, Athens 11527, Greece
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Iliana Christaki
- Edinburgh Medical School, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, Penteli 15236, Greece
| | - Maria Koutsaki
- Department of Paediatrics, University Hospital of Heraklion, Heraklion 71110, Greece
| | - Dimitra M Portaliou
- Institute of Vision and Optics (BEMMO-IVO), University of Crete School of Medicine, Heraklion 71003, Greece
| | - Georgia Kostagianni
- Department of Otorhinolaryngology - Head and Neck Surgery, 'Thriassio' General Hospital, Elefsina 19200, Greece
| | - Paraskevi Panagopoulou
- 4th Department of Paediatrics, Aristotle University of Thessaloniki, 'Papageorgiou' General Hospital, Thessaloniki 56403, Greece
| | - George Sourvinos
- Department of Clinical Virology, University of Crete School of Medicine, Heraklion 71003, Greece
| | - Demetrios A Spandidos
- Department of Clinical Virology, University of Crete School of Medicine, Heraklion 71003, Greece
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17
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Moreman C, Redman CWE, Moss EL. Human Papillomavirus and Its Role in Cervical Cancer Screening and Treatment. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2015. [DOI: 10.1007/s40506-015-0052-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Vaccination coverage in French 17-year-old young adults: an assessment of mandatory and recommended vaccination statuses. Epidemiol Infect 2015; 144:612-7. [PMID: 26159149 DOI: 10.1017/s0950268815001533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We aimed to assess vaccination coverage (VC) in 17-year-old French young adults (YAs) participating in one mandatory Day of Defence and Citizenship (DDC). Between June 2010 and May 2011, YAs participating in 43 randomly selected mandatory sessions of the DDC programme in Poitou-Charentes (France) were asked to provide their personal vaccination record. Tetanus, diphtheria, polio, hepatitis B, Haemophilus influenzae b, pertussis, measles, mumps and rubella vaccination status were assessed at ages 2, 6, 13 and 17 years. Of 2610 participants, 2111 (81%) supplied documents for evaluation. Of these, 1838 (87%, M:F sex ratio 0·96) were aged 17 years (9% of the global population of this age in the area). The assessment of the 17-year-olds demonstrated the following rates of complete vaccination: diphtheria-tetanus-polio 83%; measles, mumps and rubella 83%; pertussis 69%; H. influenzae b 61%; human papillomavirus 47%; and hepatitis B 40%. At age 6 years, only 46% had received two doses of the vaccine against measles. The YAs were not aware of their status but were in favour of vaccination. VC in YAs is insufficient, particularly for hepatitis B, pertussis and measles. Combined vaccines and the simplification of vaccination schedules should improve VC. Preventive messages should focus on YAs.
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Carcopino X, Camus C, Halfon P. [Diagnosis and clinical management of cervical HPV infections]. Presse Med 2015; 44:716-26. [PMID: 26067573 DOI: 10.1016/j.lpm.2015.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 01/30/2015] [Accepted: 02/17/2015] [Indexed: 11/15/2022] Open
Affiliation(s)
- Xavier Carcopino
- Service de gynécologie-obstétrique du CHU Marseille Nord, 13000 Marseille, France; Université d'Aix-Marseille Université (AMU), faculté de médecine, 13000 Marseille, France.
| | - Claire Camus
- Hôpital Européen, laboratoire Alphabio, service maladies infectieuses, 13000 Marseille, France
| | - Philippe Halfon
- Hôpital Européen, laboratoire Alphabio, service maladies infectieuses, 13000 Marseille, France
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20
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Loulergue P, Floret D, Launay O. Strategies for decision-making on vaccine use: the French experience. Expert Rev Vaccines 2015; 14:917-22. [PMID: 25913015 DOI: 10.1586/14760584.2015.1035650] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
France enjoys benefits of a good organization of its healthcare system. National Health Insurance is reimbursing vaccines if they are used according to the national recommendation guidelines. Vaccination is the responsibility of the government, advised by its National Immunization Technical Advisory Group (Comité Technique des vaccinations). But France, like many other countries, faces insufficient involvement from the public in immunization programs and, consequently, numerous outbreaks of vaccine-preventable diseases. The French government launched a 5-year national program for improvement in vaccination policy in 2012 to simplify the guidelines, facilitate access to vaccination, invest in research and evaluate its vaccine policy. The role of the public and healthcare professionals to encourage vaccination is crucial for the future.
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Affiliation(s)
- Pierre Loulergue
- Université Paris Descartes, Sorbonne Paris Cité; INSERM, CIC 1417; Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Broca Hôtel Dieu, CIC Cochin-Pasteur, 27, rue du faubourg Saint Jacques 75014 Paris, France
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21
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Bouillon K, Bertrand M, Maura G, Blotière PO, Ricordeau P, Zureik M. Risk of bleeding and arterial thromboembolism in patients with non-valvular atrial fibrillation either maintained on a vitamin K antagonist or switched to a non-vitamin K-antagonist oral anticoagulant: a retrospective, matched-cohort study. LANCET HAEMATOLOGY 2015; 2:e150-9. [PMID: 26687957 DOI: 10.1016/s2352-3026(15)00027-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with non-valvular atrial fibrillation who are receiving or have been previously exposed to a vitamin K antagonist could be switched to a non-vitamin K-antagonist oral anticoagulant (NOAC) but little information is available about the risk of bleeding and arterial thromboembolism after such a switch. We aimed to compare the risk of bleeding between individuals who switched and those who remained on a vitamin K antagonist (non-switchers) in real-world conditions. METHODS We did a matched-cohort study with information from French health-care databases. We extracted data for adults (aged ≥18 years) with non-valvular atrial fibrillation who received their first prescription for a vitamin K antagonist (fluindione, warfarin, or acenocoumarol) between Jan 1, 2011, and Nov 30, 2012, and who were either switched to a NOAC (dabigatran or rivaroxaban) or maintained on the vitamin K antagonist. Each switcher was matched with up to two non-switchers on the basis of eight variables, including sex, age, and international normalised ratio number. The primary endpoint was incidence of bleeding (intracranial haemorrhage, gastrointestinal haemorrhage, or other) in switchers versus non-switchers, and switchers stratified by type of NOAC versus non-switchers, noted from databases of hospital admissions. Each patient was followed up to 1 year; the study closed on Oct 1, 2013. FINDINGS Of 17,410 participants, 6705 switched to a NOAC (switchers) and 10,705 remained on vitamin K-antagonist therapy (non-switchers). Median age of participants was 75 years (IQR 67-82), 8339 (48%) were women, and the median duration of vitamin K-antagonist exposure before a switch was 8.1 months (IQR 3.9-14.0). After a median follow-up of 10.0 months (IQR 9.8-10.0), we noted no difference between groups for bleeding events (99 [1%] in switchers vs 193 [2%] in non-switchers, p=0.54). In adjusted multivariate analyses, the risk of bleeding in switchers was not different from that in non-switchers (hazard ratio [HR] 0.87; 95% CI 0.67-1.13, p=0.30). Additionally, no differences were noted when the risk of bleeding was compared between switchers from a vitamin K antagonist to dabigatran (HR 0.78, 95% CI 0.54-1.09, p=0.15), switchers from a vitamin K antagonist to rivaroxaban (HR 1.04, 95% CI 0.68-1.58, p=0.86), and non-switchers. INTERPRETATION In this matched-cohort study, our findings suggest that patients with non-valvular atrial fibrillation who switch their oral anticoagulant treatment from a vitamin K antagonist to a non-vitamin K antagonist are not at increased risk of bleeding. Future studies with longer follow-up might be needed. FUNDING None.
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Affiliation(s)
- Kim Bouillon
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis, France
| | - Marion Bertrand
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis, France
| | - Géric Maura
- Strategy and Research Department, National Health Insurance, Paris, France
| | | | - Philippe Ricordeau
- Strategy and Research Department, National Health Insurance, Paris, France
| | - Mahmoud Zureik
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis, France.
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Moulis G, Lapeyre-Mestre M, Mahévas M, Montastruc JL, Sailler L. Need for an improved vaccination rate in primary immune thrombocytopenia patients exposed to rituximab or splenectomy. A nationwide population-based study in France. Am J Hematol 2015; 90:301-5. [PMID: 25557586 DOI: 10.1002/ajh.23930] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 01/19/2023]
Abstract
International guidelines on immune thrombocytopenia (ITP) management recommend vaccination against Streptococcus pneumoniae (S.p.), Haemophilus influenza b (Hib) and Neisseiria meningitidis (N.m.) before splenectomy. French guidelines also recommend these vaccinations before rituximab. The aim of this study was to assess the application of these recommendations. The French Adult ITP: a French pHarmacoepidemiological study (FAITH, n°ENCEPP 4574) is aimed at following in the French national health insurance system database (SNIIRAM) the cohort of all incident and persistent or chronic primary ITP adults treated in France. We assessed vaccine exposure in the 1,106 patients who entered the FAITH cohort between 2009 and 2011. Vaccination was said "recommended" if performed at least 2 weeks before rituximab or splenectomy accordingly with French guidelines. Among the 423 non-splenectomized patients exposed to rituximab, vaccination rates against S.p., Hib and N.m. were respectively 32.4%, 18.9%, and 3.8%. It was recommended in 12.8%, 6.6%, and 1.2% of the patients, respectively. Among the 178 splenectomized patients, vaccination rates were 70.2%, 47.0%, and 11.9%, respectively (recommended: 60.1%, 35.7%, and 9.5%). Among the splenectomized patients previously exposed to rituximab (n = 67), 53.3% of the vaccinations occurred during the semester following a rituximab infusion that is during the maximal B-cell depletion period. In multivariate analyses, a disease duration exceeding 3 months was the sole factor associated to recommended vaccination in rituximab-treated patients as well as in splenectomized patients. This study stresses the need of better and earlier vaccination of ITP patients.
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Affiliation(s)
- Guillaume Moulis
- Service De Médecine Interne; CHU De Toulouse; Toulouse F-31000 France
- Inserm; UMR1027; Toulouse; F-31000 France; Université De Toulouse III, UMR1027; Toulouse F-31000 France
| | - Maryse Lapeyre-Mestre
- Inserm; UMR1027; Toulouse; F-31000 France; Université De Toulouse III, UMR1027; Toulouse F-31000 France
- Service De Pharmacologie Médicale Et Clinique; CHU De Toulouse; Toulouse F-31000 France
| | - Matthieu Mahévas
- Service De Médecine Interne; Centre De Référence Des Cytopénies auto-Immunes De L'adulte; Hôpital Henri Mondor; Assistance Publique-Hôpitaux De Paris; Université Paris Est Créteil; Créteil; F-94000 France; Etablissement Français Du Sang Ile De France, Inserm U955, Créteil, Hôpital Henri Mondor; Paris F-94000 France
| | - Jean-Louis Montastruc
- Inserm; UMR1027; Toulouse; F-31000 France; Université De Toulouse III, UMR1027; Toulouse F-31000 France
- Service De Pharmacologie Médicale Et Clinique; CHU De Toulouse; Toulouse F-31000 France
- Centre Midi-Pyrénées De PharmacoVigilance; De Pharmacoépidémiologie Et D'informations Sur Le Médicament; CHU De Toulouse; Toulouse F-31000 France
| | - Laurent Sailler
- Service De Médecine Interne; CHU De Toulouse; Toulouse F-31000 France
- Inserm; UMR1027; Toulouse; F-31000 France; Université De Toulouse III, UMR1027; Toulouse F-31000 France
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Bouhnik AD, Bendiane MK, Cortaredona S, Sagaon Teyssier L, Rey D, Berenger C, Seror V, Peretti-Watel P. The labour market, psychosocial outcomes and health conditions in cancer survivors: protocol for a nationwide longitudinal survey 2 and 5 years after cancer diagnosis (the VICAN survey). BMJ Open 2015; 5:e005971. [PMID: 25805526 PMCID: PMC4386221 DOI: 10.1136/bmjopen-2014-005971] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. METHOD AND ANALYSIS The target population included patients aged 18-82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18-52 and 53-82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. Second data collection, 5 years after diagnosis, will be conducted in 2015. Analyses will be conducted on various outcomes: quality of life, health status and psychosocial conditions, with a particular focus on the impact of cancer diagnosis on the labour market. The variety of measurements included in the survey will enable us to control a wide range of factors. ETHICS AND DISSEMINATION The methodology of the VICAN survey was approved by three national ethics commissions. Results of the study will be disseminated through national and international research conferences, and in articles published in international peer-reviewed journals.
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Affiliation(s)
- Anne-Deborah Bouhnik
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
| | - Marc-Karim Bendiane
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Sebastien Cortaredona
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Luis Sagaon Teyssier
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Dominique Rey
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Valerie Seror
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
| | - Patrick Peretti-Watel
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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Vaccination anti-HPV : évaluation de la couverture vaccinale et des facteurs qui l’influencent chez les lycéennes et étudiantes de la région PACA. ACTA ACUST UNITED AC 2015; 44:126-35. [DOI: 10.1016/j.jgyn.2014.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/09/2014] [Accepted: 02/14/2014] [Indexed: 11/20/2022]
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25
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Ribassin-Majed L, Hill C, Lounes R. Efficacy of vaccination against HPV infection to prevent cervical cancer in France. Public Health 2015; 129:78-81. [DOI: 10.1016/j.puhe.2014.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/06/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
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Palmaro A, Bissuel R, Renaud N, Durrieu G, Escourrou B, Oustric S, Montastruc JL, Lapeyre-Mestre M. Off-label prescribing in pediatric outpatients. Pediatrics 2015; 135:49-58. [PMID: 25511119 DOI: 10.1542/peds.2014-0764] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To study the characteristics of off-label prescribing and adverse drug reaction (ADR) occurrence in a sample of pediatric outpatients treated by general practitioners. METHODS A survey on pediatric drug prescribing was implemented in 46 general practices in southwestern France. All consecutive patients aged 0 to 16 years were included. Patient characteristics, reasons for consultation, and drug prescribed (including indications) were collected. ADRs occurring ≤10 days after the date of consultation were recorded by the general practitioners (spontaneous notification). Off-label prescription was defined as prescribing outside the specifications of the Summary of Product Characteristics. RESULTS Among the 2313 children seen between March 8, 2011 and July 31, 2011, 1960 were exposed to ≥1 prescribed drug. Mean age was 5.6 years, with a gender ratio of 1.1. Among children with prescriptions, 37.6% (n = 736) were exposed to ≥1 off-label prescription and 6.7% (n = 132) to ≥1 unlicensed drug. Off-label prescribing involved an unapproved indication in 56.4% of cases (n = 416), a lower dosage (26.5%, n = 195) or higher dosage (19.5%, n = 144) than specified, age not labeled (7.2%, n = 53), incorrect route of administration (3.5%, n = 26), and contraindication (0.3%, n = 2). A total of 23 ADRs were reported (1.5% of patients with off-label prescriptions). ADR occurrence was not significantly related to off-label drug prescribing. CONCLUSIONS Despite the numerous initiatives implemented for promoting rational medicine use in children, the prevalence of off-label prescription in outpatient pediatric practice remains high.
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Affiliation(s)
- Aurore Palmaro
- Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Equipe de Pharmacoépidémiologie, INSERM U1027, Centre Hospitalier Universitaire, Faculté de Médecine, Université de Toulouse, France; and
| | - Raphael Bissuel
- Département Universitaire de Médecine Générale des Facultés de Médecine de Toulouse, France
| | - Nicholas Renaud
- Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Equipe de Pharmacoépidémiologie, INSERM U1027, Centre Hospitalier Universitaire, Faculté de Médecine, Université de Toulouse, France; and
| | - Geneviève Durrieu
- Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Equipe de Pharmacoépidémiologie, INSERM U1027, Centre Hospitalier Universitaire, Faculté de Médecine, Université de Toulouse, France; and
| | - Brigitte Escourrou
- Département Universitaire de Médecine Générale des Facultés de Médecine de Toulouse, France
| | - Stephane Oustric
- Département Universitaire de Médecine Générale des Facultés de Médecine de Toulouse, France
| | - Jean-Louis Montastruc
- Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Equipe de Pharmacoépidémiologie, INSERM U1027, Centre Hospitalier Universitaire, Faculté de Médecine, Université de Toulouse, France; and
| | - Maryse Lapeyre-Mestre
- Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Equipe de Pharmacoépidémiologie, INSERM U1027, Centre Hospitalier Universitaire, Faculté de Médecine, Université de Toulouse, France; and
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27
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French health insurance databases: What interest for medical research? Rev Med Interne 2014; 36:411-7. [PMID: 25547954 DOI: 10.1016/j.revmed.2014.11.009] [Citation(s) in RCA: 253] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/08/2014] [Accepted: 11/23/2014] [Indexed: 12/13/2022]
Abstract
French health insurance databases are organized since 2003 into a huge digital data warehouse, the Système national d'information inter-régime de l'assurance maladie (SNIIR-AM). It covers the entire French population (65 million inhabitants). In order to facilitate studies on more frequent conditions, a random sample of 1/97th of national health system beneficiaries has been built since 2005, called the échantillon généraliste des bénéficiaires (EGB). The aim of this article is to describe the main characteristics of the SNIIR-AM and the EGB, to detail their accessibility according to French law, and to present their strengths and limits. It is illustrated with the most recent studies conducted in these databases. These databases include demographic, out-hospital reimbursement (including drug dispensing), medical (costly long-term diseases, occupational diseases, sick-leaves…), and in-hospital data. All these data are prospectively recorded, individualized, made anonymous and linkable. Consequently, the SNIIR-AM is a very useful data source for epidemiological, pharmacoepidemiological and health economics studies, particularly for rare diseases. The EGB is appropriate for long-term research on more frequent diseases.
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28
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Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France. Blood 2014; 124:3308-15. [DOI: 10.1182/blood-2014-05-578336] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Key Points
Incidence of ITP was 2.9/100 000 person-years with age, seasonal, and regional variations; in adults, 18% were secondary. Severe (gastrointestinal or central nervous system) bleeding at ITP onset was rare (<1%); the risk increased with age.
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Whelan NW, Steenbeek A, Martin-Misener R, Scott J, Smith B, D’Angelo-Scott H. Engaging parents and schools improves uptake of the human papillomavirus (HPV) vaccine: Examining the role of the public health nurse. Vaccine 2014; 32:4665-71. [DOI: 10.1016/j.vaccine.2014.06.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/27/2014] [Accepted: 06/06/2014] [Indexed: 11/15/2022]
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30
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LaMontagne DS, Nghi NQ, Nga LT, Janmohamed A, Huyen DTT, Hien NT, Tsu VD. Qualitative study of the feasibility of HPV vaccine delivery to young adolescent girls in Vietnam: evidence from a government-implemented demonstration program. BMC Public Health 2014; 14:556. [PMID: 24898950 PMCID: PMC4067078 DOI: 10.1186/1471-2458-14-556] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 05/30/2014] [Indexed: 11/21/2022] Open
Abstract
Background Introduction of human papillomavirus (HPV) vaccine in national programs has proceeded apace since 2006, mostly in high-income countries. Recently concluded pilots of HPV vaccination in low-income countries have provided important lessons learned for these settings; however, rigorous evaluations of the feasibility of these delivery strategies that effectively reach young adolescents have been few. This paper presents results from a qualitative evaluation of a demonstration program which implemented school-based and health center–based HPV vaccinations to all girls in grade 6, or 11 years of age, for two years in four districts of Vietnam. Methods Using semi-structured interviews of 131 health and education staff from local, district, province, and national levels and 26 focus-group discussions with local project implementers (n = 153), we conducted a qualitative two-year evaluation to measure the impact of HPV vaccinations on the health and education systems. Results HPV vaccine delivery at schools or health centers was made feasible by: a. close collaboration between the health and education sectors, b. detailed planning for implementation, c. clearly defined roles and responsibilities for project implementers, d. effective management and supervision of vaccinations during delivery, and e. engagement with community organizations for support. Both the health and education systems were temporarily challenged with the extra workload, but the disruptions were short-lived (a few days for each of three doses) and perceived as worth the longer-term benefit of cervical cancer prevention. Conclusion The learning from Vietnam has identified critical elements for successful vaccine delivery that can provide a model for other countries to consider during their planning of national rollout of HPV vaccine.
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Affiliation(s)
- D Scott LaMontagne
- Vaccine Access & Delivery Department, PATH, PO Box 900922, Seattle, WA 98109, USA.
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31
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Lyseng-Williamson KA. Human papillomavirus-16/18 AS04-adjuvanted vaccine (cervarix®): a guide to its two-dose schedule in girls aged 9-14 years in the EU. Paediatr Drugs 2014; 16:247-53. [PMID: 24659468 DOI: 10.1007/s40272-014-0071-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A two-dose vaccination schedule for the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine is approved for the prevention of premalignant cervical lesions and cervical cancer causally related to certain oncogenic HPV types in girls aged 9-14 years in countries in the EU and elsewhere. In this patient population, the two-dose schedule elicited a high immunogenic response that matched that of the three-dose schedule in women aged 15-25 years and, therefore, was inferred to provide clinical protection against oncogenic HPV cervical infection and, consequently, against precancerous lesions and cervical cancer.
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33
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Brotherton JML, Murray SL, Hall MA, Andrewartha LK, Banks CA, Meijer D, Pitcher HC, Scully MM, Molchanoff L. Human papillomavirus vaccine coverage among female Australian adolescents: success of the school‐based approach. Med J Aust 2013; 199:614-7. [DOI: 10.5694/mja13.10272] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/08/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Julia M L Brotherton
- National HPV Vaccination Program Register, Victorian Cytology Service, Melbourne, VIC
- Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW
| | | | | | - Lynne K Andrewartha
- Communicable Diseases Control Unit, Department of Health and Human Services, Hobart, TAS
| | | | - Dennis Meijer
- Communicable Diseases Branch, Health Protection NSW, NSW Health, Sydney, NSW
| | | | - Megan M Scully
- Communicable Disease Control Directorate, WA Health, Perth, WA
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Human papillomavirus vaccines in Picardy, France: Coverage and correlation with socioeconomic factors. Rev Epidemiol Sante Publique 2013; 61:447-54. [DOI: 10.1016/j.respe.2013.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 02/21/2013] [Accepted: 04/19/2013] [Indexed: 11/20/2022] Open
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Abstract
Despite strong national recommendations to vaccinate adolescents against the human papillomavirus (HPV), only 14% of teenage girls completed all 3 doses in 2010. Parental hesitancy may be one of the strongest reasons behind this low uptake rate. This review investigates sources of parental hesitancy including parental concerns associated with vaccinations in general, parental knowledge as a basis of HPV vaccine hesitancy, social qualms parents may have with regards to the HPV vaccine, and parental attitudes toward allowing their sons to be vaccinated against HPV. By better understanding these sources of hesitancy, we can focus research efforts towards addressing them in an attempt to improve HPV vaccine uptake.
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Affiliation(s)
- Pooja R Patel
- Department of Obstetrics and Gynecology and the Center for Interdisciplinary Research in Women's Health; The University of Texas Medical Branch; Galveston, TX USA
| | - Abbey B Berenson
- Department of Obstetrics and Gynecology and the Center for Interdisciplinary Research in Women's Health; The University of Texas Medical Branch; Galveston, TX USA
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Bertaut A, Chavanet P, Aho S, Astruc K, Douvier S, Fournel I. HPV vaccination coverage in French girls attending middle and high schools: a declarative cross sectional study in the department of Côte d'Or. Eur J Obstet Gynecol Reprod Biol 2013; 170:526-32. [PMID: 23953913 DOI: 10.1016/j.ejogrb.2013.07.028] [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] [Received: 01/09/2013] [Revised: 06/21/2013] [Accepted: 07/16/2013] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To assess human papillomavirus prophylactic vaccine coverage among a representative population of French girls, aged 14 years and above, attending middle and high schools, and to determine factors associated with the initiation and completion of the vaccination protocol. STUDY DESIGN This cross-sectional study, designed with cluster sampling, was conducted from October 2010 to May 2011, in 29 schools in the department of Côte d'Or, France. The schools were randomized according to their status (public or private) and location (rural or urban). Two classes per level were then included. All analyses were stratified on age. RESULTS 948 questionnaires were collected (87.9% participation). Mean age was 15.2 years (SD=1.3), ranging between 14 and 19. Only 31.7% of 14-year-old girls and 61.4% of girls aged 15 and above initiated vaccination (one dose), and 7.8% of 14-year-old girls and 48.5% of girls aged 15 and above completed it (three doses). An urban school location and a physician's recommendation were independently associated with vaccination initiation in girls aged 14. In girls aged 15 and above, the parents' socioeconomic status, the family composition and a recommendation by a physician were independently associated with vaccination initiation. Once vaccination had been initiated, girls who attended private school, who belonged to families with higher outcomes, who lived with a single parent or who smoked were less likely to complete the vaccination protocol. CONCLUSION HPV prophylactic vaccine coverage in girls attending school in Côte d'Or appears to be low. Physicians play a major role in vaccine acceptance.
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Affiliation(s)
- Aurélie Bertaut
- Hospital Hygiene and Epidemiology Unit, CHU Dijon, France; Breast and Gynecologic Cancer Registry of Côte d'Or, Centre Georges François Leclerc, Dijon, EA 4184, France.
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Deleré Y, Böhmer MM, Walter D, Wichmann O. HPV vaccination coverage among women aged 18-20 years in Germany three years after recommendation of HPV vaccination for adolescent girls: results from a cross-sectional survey. Hum Vaccin Immunother 2013; 9:1706-11. [PMID: 23732901 DOI: 10.4161/hv.24904] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Routine immunization of adolescent girls aged 12-17 y against human papillomavirus (HPV) was recommended in Germany in March 2007. We aimed to assess HPV-vaccine uptake and knowledge about post-vaccination cervical cancer screening and condom use in women aged 18-20 years, three years after adoption of HPV-vaccination into the routine vaccination schedule. RESULTS Overall 2,001 females participated in our study. Of these, 49% reported receipt of a complete three-dose course of HPV-vaccines; 11% received 1 or 2 doses. Living in East Germany, high educational status, and interest in health-related issues were independently associated with HPV-vaccination. Misconceptions among survey-participants were rare: Only 8% believed that HPV-vaccination would obviate the need for cervical screening and 1% that condom use would be dispensible after vaccination. METHODS In 2010, a nationwide cross-sectional telephone-survey was performed among randomly-selected women aged 18-20 years living in Germany. Telephone interviews were conducted by a large professional market research institute as part of a daily omnibus survey. CONCLUSION HPV-vaccination coverage is low in Germany. The results indicate that there is an urgent need for the implementation of a coordinated adolescent vaccination program to facilitate access to vaccination, including balanced information tailored to this age group. Otherwise, the HPV-vaccination effort will fall short of reaching its maximum public health benefit.
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Affiliation(s)
- Yvonne Deleré
- Immunisation Unit; Department for Infectious Disease Epidemiology; Robert Koch Institute (RKI); Berlin, Germany
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Riethmuller D, Ramanah R, Carcopino X, Levêque J. [The follow up of the women vaccinated against HPV]. ACTA ACUST UNITED AC 2013; 42:525-33. [PMID: 23669416 DOI: 10.1016/j.jgyn.2013.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 03/14/2013] [Accepted: 03/22/2013] [Indexed: 10/26/2022]
Abstract
HPV vaccine decreases significantly the risk of cervical cancer in women. However, continuing screening strategies in vaccinated women remains relevant as there is a small residual risk of cancer and pre-cancerous lesions even after prophylactic vaccination. The follow-up strategy to adopt has been the object of reflection by many experts, and especially since the vaccination catch-up population concerning women until 23 years of age will soon become the target screening population following recent guidelines. Finally, the arrival of HPV vaccines forces us to think about screening organization and optimization in a broader way so as it benefits all women concerned, whether vaccinated or not, and not only barely half of them as is the case now. The aim of this work was to clarify the issue and to make proposals for management.
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Affiliation(s)
- D Riethmuller
- Service de gynécologie-obstétrique, CHU Jean-Minjoz, 3, boulevard Flemming, 25000 Besançon, France.
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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: 226] [Impact Index Per Article: 20.5] [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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Fregnani JHTG, Carvalho AL, Eluf-Neto J, Ribeiro KDCB, Kuil LDM, da Silva TA, Rodrigues SL, Mauad EC, Longatto-Filho A, Villa LL. A school-based human papillomavirus vaccination program in barretos, Brazil: final results of a demonstrative study. PLoS One 2013; 8:e62647. [PMID: 23638130 PMCID: PMC3634818 DOI: 10.1371/journal.pone.0062647] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/25/2013] [Indexed: 11/30/2022] Open
Abstract
Introduction The implementation of a public HPV vaccination program in several developing countries, especially in Latin America, is a great challenge for health care specialists. Aim To evaluate the uptake and the three-dose completion rates of a school-based HPV vaccination program in Barretos (Brazil). Methods The study included girls who were enrolled in public and private schools and who regularly attended the sixth and seventh grades of elementary school (mean age: 11.9 years). A meeting with the parents or guardians occurred approximately one week before the vaccination in order to explain the project and clarify the doubts. The quadrivalent vaccine was administered using the same schedule as in the product package (0–2–6 months). The school visits for regular vaccination occurred on previously scheduled dates. The vaccine was also made available at Barretos Cancer Hospital for the girls who could not be vaccinated on the day when the team visited the school. Results Among the potential candidates for vaccination (n = 1,574), the parents or guardians of 1,513 girls (96.1%) responded to the invitation to participate in the study. A total of 1,389 parents or guardians agreed to participate in the program (acceptance rate = 91.8%). The main reason for refusing to participate in the vaccination program was fear of adverse events. The vaccine uptake rates for the first, second, and third doses were 87.5%, 86.3% and 85.0%, respectively. The three-dose completion rate was 97.2%. Conclusions This demonstrative study achieved high rates of vaccination uptake and completion of three vaccine doses in children 10–16 years old from Brazil. The feasibility and success of an HPV vaccination program for adolescents in a developing country may depend on the integration between the public health and schooling systems.
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Lions C, Pulcini C, Verger P. Papillomavirus vaccine coverage and its determinants in South-Eastern France. Med Mal Infect 2013; 43:195-201. [PMID: 23582828 DOI: 10.1016/j.medmal.2013.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/11/2013] [Accepted: 03/08/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We wanted: (i) to assess vaccine coverage (VC) for papillomavirus (HPV) (one and three doses of the vaccine, VC1 and VC3) and compliance with the recommended vaccination regimen (3rd dose within 1 year after the 1st dose) among 14-16 year-old girls; and (ii) to identify the factors independently associated with VC and compliance with the recommended vaccination regimen. METHODS We conducted a descriptive longitudinal study, using the National Health Insurance reimbursement database, for years 2007 to 2009, in South-Eastern France. We performed a multivariate analysis (Cox proportional hazards model). RESULTS VC1 was 35.5%, with 68.8% of those who started vaccination having completed the 3-dose regimen, 64.1% within one year. VC1 and VC3 were positively associated with the girl's age. Girls covered by the complementary social welfare healthcare program and those living in rural areas had lower VC1 and VC3. Being covered by the complementary social welfare healthcare program was also associated with lower compliance with the recommended vaccination regimen. VC1 and VC3 were positively associated with the number of medical consultations during the study period. Important geographical variations were noted regarding VC1. CONCLUSIONS Our study confirms that VC for HPV is insufficient in our region, and that there are socio-economic and geographical inequalities. Even though the vaccine is reimbursed for all girls, efforts must be made to improve VC, particularly for girls covered by the complementary social welfare healthcare program and those living in rural areas.
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Affiliation(s)
- C Lions
- Inserm, U912, SESSTIM, 13006 Marseille, France
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Bresse X, Adam M, Largeron N, Roze S, Marty R. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France. Hum Vaccin Immunother 2013; 9:823-33. [PMID: 23563511 PMCID: PMC3903902 DOI: 10.4161/hv.22994] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases.
The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection.
Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%).
In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types.
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Tomljenovic L, Shaw CA. Human papillomavirus (HPV) vaccine policy and evidence-based medicine: are they at odds? Ann Med 2013; 45:182-93. [PMID: 22188159 DOI: 10.3109/07853890.2011.645353] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
All drugs are associated with some risks of adverse reactions. Because vaccines represent a special category of drugs, generally given to healthy individuals, uncertain benefits mean that only a small level of risk for adverse reactions is acceptable. Furthermore, medical ethics demand that vaccination should be carried out with the participant's full and informed consent. This necessitates an objective disclosure of the known or foreseeable vaccination benefits and risks. The way in which HPV vaccines are often promoted to women indicates that such disclosure is not always given from the basis of the best available knowledge. For example, while the world's leading medical authorities state that HPV vaccines are an important cervical cancer prevention tool, clinical trials show no evidence that HPV vaccination can protect against cervical cancer. Similarly, contrary to claims that cervical cancer is the second most common cancer in women worldwide, existing data show that this only applies to developing countries. In the Western world cervical cancer is a rare disease with mortality rates that are several times lower than the rate of reported serious adverse reactions (including deaths) from HPV vaccination. Future vaccination policies should adhere more rigorously to evidence-based medicine and ethical guidelines for informed consent.
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Affiliation(s)
- Lucija Tomljenovic
- Neural Dynamics Research Group, Department of Ophthalmology and Visual Sciences, University of British Columbia, 828 W. 10th Ave, Vancouver, BC, V5Z 1L8, Canada.
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Fagot JP, Blotière PO, Ricordeau P, Weill A, Alla F, Allemand H. Does insulin glargine increase the risk of cancer compared with other basal insulins?: A French nationwide cohort study based on national administrative databases. Diabetes Care 2013; 36:294-301. [PMID: 22966091 PMCID: PMC3554310 DOI: 10.2337/dc12-0506] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To explore in France the relationship between insulin glargine use and overall and specific cancer risks in type 2 diabetic patients compared with other basal insulins. RESEARCH DESIGN AND METHODS Data were extracted from French health insurance information system (Système National d'Information Inter-Régimes de l'Assurance Maladie) linked with data from the French Hospital Discharge database (Programme de Médicalisation des Systèmes d'Information). Included were 70,027 patients aged 40-79 years who started a basal insulin in 2007-2009. Cox proportional hazards models with age as time-scale were used to calculate multivariate-adjusted hazard ratios for associations between type of basal insulin and risk of overall cancer, breast cancer, and seven other cancer sites. RESULTS The median follow-up was 2.67 years in patients exposed to insulin glargine. Absolute event rates for all cancer in patients exposed to glargine versus other basal insulin users were 1,622 and 1,643 per 100,000 person-years, respectively. No significant association was observed between glargine exposure and overall cancer incidence after adjustment for sex, with a hazard ratio of 0.97 (95% CI 0.87-1.07), or after additional adjustment for any other hypoglycemic agent use and duration of diabetes. No increased risk of breast cancer was observed for glargine users compared with other basal insulins users, with a fully adjusted hazard ratio of 1.08 (0.72-1.62). CONCLUSIONS In a large cohort of patients newly treated by basal insulin, no increased risk of any cancer was observed in insulin glargine users compared with other basal insulin users. Because follow-up did not exceed 4 years, longer-term studies are needed.
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Affiliation(s)
- Jean-Paul Fagot
- Strategy and Research Department, National Health Insurance, Paris, Ile de France, France.
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Hopkins TG, Wood N. Female human papillomavirus (HPV) vaccination: global uptake and the impact of attitudes. Vaccine 2013; 31:1673-9. [PMID: 23375978 DOI: 10.1016/j.vaccine.2013.01.028] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 01/09/2013] [Accepted: 01/15/2013] [Indexed: 01/27/2023]
Abstract
Human papillomavirus (HPV) is the causative agent in cervical cancer and has been implicated in a range of other malignancies. Preventative vaccines are now internationally available and provide high levels of protection from common viral strains. The introduction of a comprehensive vaccination programme (except 'program' in computers) could prevent over 60% of current cervical cancer cases, but this is dependent on such programmes achieving a high level of coverage. In this review, we summarise the current trends in female HPV vaccination coverage throughout the world, and place it in the context of available research on attitudes towards vaccination amongst the public and health professionals. Where countries have the resources for mass vaccination programmes, uptake has varied. School-based opt-out programmes consistently achieve highest coverage, whilst countries and regions without systematic vaccination schemes have low coverage. In all countries, the success of vaccination programmes is dependent on the support of the public and healthcare professionals. Whilst public acceptance is dependent on multiple factors, it has repeatedly been shown that recommendation by a health professional, particularly clinicians, is key to vaccine uptake. Worryingly, it appears that a proportion of clinicians still have significant reservations about promoting vaccination, particularly for younger age groups. A commitment now, to fully educating both the public and clinicians, has the potential to make a dramatic future impact.
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Affiliation(s)
- Tom Glass Hopkins
- Institute of Reproductive and Developmental Biology, Imperial College, London, UK.
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Wilson SE, Harris T, Sethi P, Fediurek J, Macdonald L, Deeks SL. Coverage from Ontario, Canada's school-based HPV vaccine program: the first three years. Vaccine 2012; 31:757-62. [PMID: 23246265 DOI: 10.1016/j.vaccine.2012.11.090] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 11/29/2012] [Accepted: 11/30/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2007, Ontario implemented a school-based human papillomavirus (HPV) vaccination program targeting grade 8 girls. Girls may complete the series in grade 9 (extended eligibility). Limitations in the existing provincial data sources for assessing HPV vaccine coverage in Ontario prompted the use of two surveys of Health Units (HUs) to calculate provincial vaccine coverage for the first three years of the vaccination program. METHODS We surveyed Ontario's 36 HUs in March and November 2011 to obtain vaccine coverage information, including source of denominator data, and use of local information systems. The second survey was necessary in order to assess coverage including extended eligibility for the third year. HU-reported HPV vaccine coverage was compared to coverage estimates obtained from two provincial systems: the Immunization Records Information System (IRIS) and the HPV reimbursement database, a system used to remunerate HUs for HPV vaccine doses administered. RESULTS 100% of HUs participated in the two surveys. The provincial coverage estimates using HU-reported data were: 51% (2007-2008), 58% (2008-2009), and 59% (2009-2010) with large variation by HU. Coverage increased significantly over time. The number of HUs that were able to report on doses given as part of extended eligibility also increased over time (47% in 2007-2008 to 89% in 2009-2010; p=0.0008). Comparisons across the three data sources (survey, IRIS and reimbursement database) revealed significantly different coverage estimates. Class or school lists were the most common source of denominator data used by HUs (27/36, 75%), however independent schools were not included by all. CONCLUSIONS As not all HUs were able to report on HPV vaccine coverage including extended eligibility doses these findings likely underestimate the true coverage attained by Ontario's program. Although coverage is below the Canadian Immunization Committee benchmark of 80% within two years of program implementation, the upward trend in coverage is encouraging.
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Cohen R, Vié Le Sage F, Weil-Olivier C, Romain O, Hau I, Guérin N, Thiebault G, Virey B, Bakhache P, Dommergues MA, Gaudelus J. [Plea for advancement of the age of vaccination against human papillomavirus in France: Position of the Pediatric Infections Pathology Group (GPIP) and the French Association of Ambulatory Pediatrics (AFPA)]. Arch Pediatr 2012. [PMID: 23178137 DOI: 10.1016/s0929-693x(12)71289-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Vaccination against human papillomavirus (HPV) is recommended in France at 14 years. The Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie takes a clear position for advancement of age of vaccination at 11-12 years based on the following arguments: (i) data on the long-term persistence of protective antibodies are reassuring; (ii) these vaccines can be co-administered with vaccines recommended in the current immunization schedule at this age; (iii) actually, nearly 20% of adolescents have had sexual intercourse when the vaccination schedule is finished; (iv) vaccination beyond 14 years increases the risk of occurrence of coincidental autoimmune diseases; (v) the immunogenicity of vaccines against HPV is better when they are administered before age 15; (vi) finally, especially by reducing the number of injections from 3 to 2, the immunization at 11-12 years could improve immunization coverage which is insufficient nowadays.
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Affiliation(s)
- R Cohen
- Centre Hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France.
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Boyce T, Holmes A. Addressing health inequalities in the delivery of the human papillomavirus vaccination programme: examining the role of the school nurse. PLoS One 2012; 7:e43416. [PMID: 23028452 PMCID: PMC3441494 DOI: 10.1371/journal.pone.0043416] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 07/20/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND HPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake. METHODS AND FINDINGS A rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake. CONCLUSIONS Despite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities in childhood and adolescent vaccination programmes.
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Affiliation(s)
- Tammy Boyce
- National Centre for Infection Prevention and Management, Department of Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom.
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Hayashi Y, Shimizu Y, Netsu S, Hanley S, Konno R. High HPV vaccination uptake rates for adolescent girls after regional governmental funding in Shiki City, Japan. Vaccine 2012; 30:5547-50. [PMID: 22749837 DOI: 10.1016/j.vaccine.2012.06.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 06/11/2012] [Accepted: 06/13/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND In Japan, the bivalent HPV vaccine was approved in October, 2009 and became available as a non-routine vaccine from December, 2009. While routine vaccinations are free, the cost and responsibility for non-routine vaccinations are left to the individual. In exceptional circumstances regional governments fund non-routine vaccinations. This was the case in Shiki City, Saitama Prefecture, where a high uptake rate for individual (non-school based) HPV vaccination was obtained. MATERIALS On January 20, 2010, the mayor of Shiki City announced to the media his decision to vaccinate adolescent girls in Shiki City against HPV. A project team for HPV vaccination was set up in the city's Health Promotion Center. To gain mutual consent for HPV vaccination, senior health professionals, city officials, the head of the board of education, school principals and health-care teachers met several times. The cohort to be vaccinated was 1254 girls aged 12-15 years. Individual notifications were mailed to each girl on April 23, 2010, along with information about the HPV vaccine. CONCLUSIONS As of April 10th, 2011, the uptake rate for girls aged 15 years old was 90.7% for the 1st dose. The vaccine registry is managed by the health care system of the city. The success of the HPV vaccination program and high uptake rates in Shiki City is a good model for the nationwide HPV vaccination program that started in February, 2011.
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Affiliation(s)
- Y Hayashi
- Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
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Ribassin-Majed L, Lounes R, Clémençon S. Efficacy of vaccination against HPV infections to prevent cervical cancer in France: present assessment and pathways to improve vaccination policies. PLoS One 2012; 7:e32251. [PMID: 22427828 PMCID: PMC3299653 DOI: 10.1371/journal.pone.0032251] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 01/25/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Seventy percent of sexually active individuals will be infected with Human Papillomavirus (HPV) during their lifetime. These infections are incriminated for almost all cervical cancers. In France, 3,068 new cases of cervical cancer and 1,067 deaths from cervical cancer occurred in 2005. Two vaccines against HPV infections are currently available and vaccination policies aim to decrease the incidence of HPV infections and of cervical cancers. In France, vaccine coverage has been reported to be low. METHODS We developed a dynamic model for the heterosexual transmission of Human Papillomavirus types 16 and 18, which are covered by available vaccines. A deterministic model was used with stratification on gender, age and sexual behavior. Immunity obtained from vaccination was taken into account. The model was calibrated using French data of cervical cancer incidence. RESULTS In view of current vaccine coverage and screening, we expected a 32% and 83% reduction in the incidence of cervical cancers due to HPV 16/18, after 20 years and 50 years of vaccine introduction respectively. Vaccine coverage and screening rates were assumed to be constant. However, increasing vaccine coverage in women or vaccinating girls before 14 showed a better impact on cervical cancer incidence. On the other hand, performing vaccination in men improves the effect on cervical cancer incidence only moderately, compared to strategies in females only. CONCLUSION While current vaccination policies may significantly decrease cervical cancer incidence, other supplementary strategies in females could be considered in order to improve vaccination efficacy.
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Affiliation(s)
- Laureen Ribassin-Majed
- Laboratoire Mathématiques Appliquées à Paris 5, Centre National de la Recherche Scientifique Unité Mixte de Recherche n°8145, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
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