Predictors of HPV vaccination in the southern US: A survey of caregivers from 13 states

Correlations of HPV vaccine uptake among eight-grade students in Israel: the importance of ethnicity and level of religious observance

In Israel, human papilloma virus (HPV) vaccines are included in the national childhood immunization program for eight-grade students, but uptake remains relatively low. This article explores which demographic factors are correlated with HPV vaccination rates. HPV vaccination data for the school year 2017-2018 was assessed among members of Maccabi Healthcare Services, the second largest health service provider in Israel. By matching eighth grade students to their family members' demographic data via an electronic medical records (EMR) system, we assessed vaccination rates by taking into account sex, socioeconomic status (SES), ethnic categorization, and maternal characteristics. In a total of 45,160 eligible students, 55.3 percent of girls and 48.5 percent of boys were vaccinated for HPV. In a multivariable model, students in Arab communities had a significantly (p < .001) higher odds ratio (2.02; 95 percent CI:1.55-2.64) of being vaccinated, while ultra-orthodox (UO) Jewish students were much less likely to be vaccinated compared to all other students (OR = 0.05; 95 percent CI:0.05-0.06). Ethnicity and level of religious practice are major determinants of HPV vaccine uptake in Israel. This should be taken into account when planning intervention programs in order to improve the uptake of the vaccine.

Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review

BACKGROUND

Human papillomavirus (HPV) represents the most common STI in the USA. HPV inequities in prevention, diagnostics and clinical care persist. We define inequities as systematic, avoidable and unfair differences in health outcomes.

OBJECTIVES

The objectives of this scoping review are to chart existing data on HPV-related inequities, identify gaps in existing literature and guide future research to reduce these inequities.

METHODS

We completed a scoping review following guidelines from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping reviews extension. We performed a literature search on PubMed and Ovid Embase in July 2022 for articles pertaining to HPV and evaluating populations within the USA. We included English language publications from 2018 to 2022 evaluating at least one health inequity outlined by the National Institutes of Health. General publication characteristics and health inequity data were charted in a masked, duplicate fashion using a pilot-tested Google Form. We analysed frequencies of health inequities and summarised main findings from included studies.

RESULTS

Our final sample included 170 publications. The most common inequities examined were race/ethnicity (140 studies), sex or gender (97 studies), and income (69 studies). Many historically marginalised racial/ethnic groups had lower rates of HPV-related knowledge, vaccination and worse overall outcomes related to HPV. Compared with women, men had lower rates of HPV vaccination and provider recommendation, and higher rates of HPV-infection. Results regarding income were largely conflicting.

CONCLUSION

Findings from our review demonstrate clear gaps in HPV-related inequity research. Vaccine completion, provider recommendation and intersectionality should continue to be evaluated to implement targeted interventions.

HPV Infection and Vaccination: A Question and Answer Guide for School Nurses

School nurses frequently interact with school-age children and their parents/guardians regarding vaccinations. As a trusted source of information, the school nurse is in a unique position to share vaccine information with parents/guardians and school-age children that may dispel myths and, consequently, improve vaccination rates. Nevertheless, some parents/guardians are still reluctant to vaccinate their school-age children against Human Papilloma Virus (HPV) for a variety of reasons. Common barriers to HPV vaccination include a lack of understanding of the vaccine's purpose, concerns regarding the vaccine's safety, and insufficient recommendation from healthcare workers. However, school nurses have many duties in addition to ensuring vaccine compliance. School nurses may have difficulty remaining up-to-date on evidence-based answers to parents'/guardians' questions about HPV vaccine. Therefore, the purpose of this article is to provide school nurses with a quick reference question and answer guide to parents'/guardians' common HPV-related vaccination questions.

Moving Beyond Detection: Charting a Path to Eliminate Health Care Disparities in Otolaryngology

The coronavirus pandemic has illuminated long-standing inequities in America's health care system and societal structure. While numerous studies have identified health care disparities within our specialty, few have progressed beyond detection. Otolaryngologists have the opportunity and the responsibility to act. Within this article, leaders from otolaryngology share their experience and perspective on health care disparities, including (1) a discussion of disparities in otolaryngology, (2) a summary of health care system design and incentives, (3) an overview of implicit bias, and (4) practical recommendations for providers to advance their awareness of health care disparities and the actions to mitigate them. While the path forward can be daunting, it should not be a deterrent. Throughout the course of this article, numerous resources are provided to support these efforts. To move ahead, our specialty needs to advance our level of understanding and develop, implement, and disseminate successful interventions toward the goal of eliminating health care disparities.