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Asriadi, Mutiarin D. Comparison of Achievements in the Implementation of COVID-19 Vaccination in Five Provinces to Establish Herd Immunity in Indonesia in the Perspective of the New Public Service. Viral Immunol 2023; 36:318-330. [PMID: 37204316 DOI: 10.1089/vim.2022.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
This study aims to analyze the achievements of coronavirus disease-2019 (COVID-19) vaccination in five provinces in Indonesia, North Maluku, West Sulawesi, Maluku, West Papua, and Papua. Furthermore, to establish herd immunity in the new normal perspective. Vaccination is important because it is an effective way to build immunity. This method uses qualitative research with a Qualitative Data Analysis Software (QDAS) approach. The source of data was obtained from the official website of the government, the ministry of health, in the category of areas with low vaccination achievement, and data were also obtained by capturing news in credible official media to find the cause of the low vaccination rate in the community. The data analyst uses NVivo12 software to code and visualizes data in graphs, images, and word clouds. The findings of this study indicate that in five provinces in Indonesia, North Maluku (68%), West Sulawesi (76%), Maluku (66%), West Papua (62%), and Papua (41%), the achievement of vaccination implementation is still relatively low. Due to doubts in the community about the status of the vaccine, information and communication education from the government have not been optimal; the environment and geography vary, so it becomes an obstacle in carrying out vaccination.
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Affiliation(s)
- Asriadi
- Government Affairs and Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Dyah Mutiarin
- Government Affairs and Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Barnabe C, Guichon JR, Colquhoun A, Ganshorn H, Bedingfield N, Vandenboogaard PD, Bednarczyk RA, Glaze S, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001406. [PMID: 36962871 PMCID: PMC10021254 DOI: 10.1371/journal.pgph.0001406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.
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Affiliation(s)
| | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Angeline Letendre
- Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | | | - Rita Henderson
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Performance Reporting, Alberta Health, Edmonton, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Glaze
- Tom Baker Cancer Centre, University of Calgary, Calgary, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
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Goyette A, Yen GP, Racovitan V, Bhangu P, Kothari S, Franco EL. Evolution of Public Health Human Papillomavirus Immunization Programs in Canada. Curr Oncol 2021; 28:991-1007. [PMID: 33617515 PMCID: PMC7985769 DOI: 10.3390/curroncol28010097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Since 2007, all Canadian provinces and territories have had a publicly funded program for vaccination against human papillomavirus (HPV) infection. The objective of this study was to describe the evolution of these vaccination programs. Methods: This was a targeted literature review of public HPV vaccination programs and vaccination coverage rates, based on information provided by jurisdictional public health authorities. Results: HPV vaccination of schoolgirls began in school years 2007/08 to 2010/11 with three doses of the quadrivalent HPV vaccine in all provinces except Quebec, which started with two doses. By 2018/19, all jurisdictions were vaccinating with two doses of the nonavalent vaccine in both girls and boys, except Quebec, which used a mixed vaccination schedule with one dose of the nonavalent and one dose of the bivalent vaccines. Public HPV vaccination programs in most provinces include after-school catch-up vaccination. Immunocompromised or other high-risk individuals are eligible for the HPV public vaccination program in most provinces, but policies vary by jurisdiction. In 2017/18, vaccination coverage rates in provincial HPV school-based programs varied from 62% in Ontario to 86% in Prince Edward Island in girls and from 58% in Ontario to 86% in Prince Edward Island in boys. Conclusions: Since their introduction, Canadian school-based HPV public vaccination programs have evolved from a three-dose to a two-dose schedule, from a quadrivalent to a nonavalent vaccine, and from a girls-only to a gender-neutral policy. Vaccination coverage rates have varied markedly and only Prince Edward Island and Newfoundland/Labrador have maintained rates exceeding 80%.
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Affiliation(s)
| | - Glorian P. Yen
- Merck & Co., Inc., Kenilworth, NJ 07033, USA; (G.P.Y.); (S.K.)
| | - Voica Racovitan
- Merck Canada Inc., Kirkland, QC H9H 4M7, Canada; (V.R.); (P.B.)
| | - Parambir Bhangu
- Merck Canada Inc., Kirkland, QC H9H 4M7, Canada; (V.R.); (P.B.)
| | - Smita Kothari
- Merck & Co., Inc., Kenilworth, NJ 07033, USA; (G.P.Y.); (S.K.)
| | - Eduardo L. Franco
- Division of Cancer Epidemiology, McGill University, Montreal, QC H4A 3T2, Canada;
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Abstract
HPV-related cancers can be prevented through HPV vaccination, however uptake and completion of the vaccination in the state of Georgia remains suboptimal. The research team conducted two online focus groups with members of the Georgia Cancer Control Consortium HPV Work Group in efforts to better understand the role that the working group could have on increasing vaccination uptake and completion in the state of Georgia. Analysis of the focus groups was completed using a Grounded Theory approach. Various aspects of the Working Group were discussed throughout the focus groups with a number of key points for growth identified both by the participants during the discussion, and by the research team during analysis. Predominantly, a primary point for growth of the Working Group lies in building its capacity to collectively conduct HPV vaccination-related activities. An online webportal specifically designed for the Working Group was identified as a tool for improving Working Group communication, sharing best practices and resources, and to collectively develop activities, research projects, and HPV vaccine promotion events in a culturally competent and age appropriate manner in efforts to improve vaccine uptake and completion throughout the state of Georgia.
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Perez S, Zimet GD, Tatar O, Stupiansky NW, Fisher WA, Rosberger Z. Human Papillomavirus Vaccines: Successes and Future Challenges. Drugs 2018; 78:1385-1396. [DOI: 10.1007/s40265-018-0975-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Koïvogui A, Carbunar A, Imounga LM, Laruade C, Laube S. Vaccination coverage among children and adolescents below 18 years of age in French Guiana: inventory and determinant factors. Public Health 2018. [PMID: 29525571 DOI: 10.1016/j.puhe.2018.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study was to estimate the vaccination coverage (VC) rate in persons aged from 9 months to 18 years and to describe it according to the predictive factors of good vaccination status. STUDY DESIGN Descriptive and etiological study. METHODS The study involved 1332 persons aged below 18 years and members of 521 representative households in French Guiana. VC was estimated by the proportion of people with complete immunization for 13 vaccines (four mandatory, seven recommended, and two specific). This vaccination status was described in terms of sociodemographic characteristics. The relationship between vaccination status and predictive factors was analyzed in a hierarchical mixed, polytomic, and ordered regression model. RESULTS For compulsory vaccination, VC was 81.2% for yellow fever, 63.4% for diphtheria, 61.7% for tetanus, and 61.6% for poliomyelitis. The proportion of people with complete immunization for recommended vaccines remains well below 50% (11.7% for pneumococcus and 6.2% for meningitis). Regardless of the vaccine, respondents aged 3-7 years were 2.5 times more likely to have an up-to-date vaccination compared to respondents younger than 3 years of age (P < 0.001). CONCLUSION The VC observed in this study is still below the departmental objectives. The link between age and vaccination status could be explained by the efforts of the national education authorities to systematically check health cards for preschool and school enrollment.
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Affiliation(s)
- A Koïvogui
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, 97335 Cayenne, French Guiana.
| | - A Carbunar
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, 97335 Cayenne, French Guiana; Université de Guyane, Observatoire de la Vie Etudiante et de l'Insertion Professionnelle, 97337 Cayenne, French Guiana.
| | - L-M Imounga
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, 97335 Cayenne, French Guiana
| | - C Laruade
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, 97335 Cayenne, French Guiana
| | - S Laube
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, 97335 Cayenne, French Guiana
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Shapiro GK, Guichon J, Prue G, Perez S, Rosberger Z. A Multiple Streams analysis of the decisions to fund gender-neutral HPV vaccination in Canada. Prev Med 2017; 100:123-131. [PMID: 28435081 DOI: 10.1016/j.ypmed.2017.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/03/2017] [Accepted: 04/09/2017] [Indexed: 12/25/2022]
Abstract
In Canada, the human papillomavirus (HPV) vaccine is licensed and recommended for females and males. Although all Canadian jurisdictions fund school-based HPV vaccine programs for girls, only six jurisdictions fund school-based HPV vaccination for boys. The research aimed to analyze the factors that underpin government decisions to fund HPV vaccine for boys using a theoretical policy model, Kingdon's Multiple Streams framework. This approach assesses policy development by examining three concurrent, but independent, streams that guide analysis: Problem Stream, Policy Stream, and Politics Stream. Analysis from the Problem Stream highlights that males are affected by HPV-related diseases and are involved in transmitting HPV infection to their sexual partners. Policy Stream analysis makes clear that while the inclusion of males in HPV vaccine programs is suitable, equitable, and acceptable; there is debate regarding cost-effectiveness. Politics Stream analysis identifies the perspectives of six different stakeholder groups and highlights the contribution of government officials at the provincial and territorial level. Kingdon's Multiple Streams framework helps clarify the opportunities and barriers for HPV vaccine policy change. This analysis identified that the interpretation of cost-effectiveness models and advocacy of stakeholders such as citizen-advocates and HPV-affected politicians have been particularly important in galvanizing policy change.
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Affiliation(s)
- Gilla K Shapiro
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal H3T 1E4, Quebec, Canada.
| | - Juliet Guichon
- Department of Community Health Sciences, 3280 Hospital Drive, Calgary T2N 4N1, Alberta, Canada
| | - Gillian Prue
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Samara Perez
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal H3T 1E4, Quebec, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal H3T 1E4, Quebec, Canada; Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal H3T 1E4, Quebec, Canada; Departments of Psychiatry and Oncology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada
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Perez S, Fedoruk C, Shapiro GK, Rosberger Z. Giving Boys a Shot: The HPV Vaccine's Portrayal in Canadian Newspapers. HEALTH COMMUNICATION 2016; 31:1527-1538. [PMID: 27123533 DOI: 10.1080/10410236.2015.1089466] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In January 2012, the National Advisory Committee on Immunization (NACI) of Canada recommended that males aged 9-26 years receive the human papillomavirus (HPV) vaccine to protect against genital warts and HPV-associated cancers. Estimated HPV vaccine uptake rates for Canadian males are extremely low. Using a content analysis of Canadian newspaper articles, this study investigated what information about the HPV vaccine was relayed to the public, and how this content was portrayed following the 2012 male HPV vaccine recommendation. A search was conducted using Proquest Canadian Newsstand Complete for newspaper articles published between January 1, 2012, and September 1, 2014. Researchers coded 232 articles on several relevant dimensions: article information; epidemiological information; public policy information; article topic; article and title tone; and informant testimony. The majority of articles (93%) mentioned that girls are eligible for the HPV vaccine, whereas only half (49%) mentioned male eligibility. While most articles associated HPV with cervical cancer (85%), fewer indicated its relation to other HPV-associated cancers (59%) or genital warts (52%). Most articles (60%) were positive or neutral (22%) in tone toward the HPV vaccine, while few had mixed messages (11%) or were negative (6%). Less than 5% of articles reported on issues of morality, suggesting that fears that the HPV vaccine causes promiscuity have largely subsided. Notably, article tone toward male vaccination became progressively more positive over time. However, half of the articles did not mention the vaccine's approval for males, and articles tended to report HPV's relation to cervical cancer over other HPV-associated cancers. The Canadian public may thus be unaware of male eligibility and the importance of HPV vaccine for males. The collaboration of researchers, health care providers, and policymakers with journalists is critical in order to disseminate complete and accurate HPV and HPV vaccine information.
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Affiliation(s)
- Samara Perez
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Claire Fedoruk
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
- c Department of Anthropology , McGill University
| | - Gilla K Shapiro
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Zeev Rosberger
- a Department of Psychology , McGill University
- b Lady Davis Institute for Medical Research, Jewish General Hospital
- d Department of Psychiatry and Oncology , McGill University
- e Lady Davis Institute for Medical Research and Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital
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Koïvogui A, Carbunar A, Imounga LM, Laruade C, Laube S. Vaccination against yellow fever in French Guiana: The impact of educational level, negative beliefs and attitude towards vaccination. Travel Med Infect Dis 2016; 15:37-44. [PMID: 27789244 DOI: 10.1016/j.tmaid.2016.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Analyze the impact of educational level, negative beliefs and negative attitudes on the yellow fever vaccination coverage (YFVC). METHODOLOGY This analytical study involved a sample of 2763 people from 866 households. Educational status was described in six levels: No level (Respondent had never attended school), level-1 (respondent left before intermediate school), level-2 (Respondent attended intermediate school), level-3 (respondent attended high school), level-4 (Respondent attended university), Other level (When the level could not be determined). The Attitude towards vaccination was described in terms of person's availability to recommend vaccination to third. The relationships were analyzed by multivariate mixed logistic regression. RESULTS Among the 2763 peoples, 2039 (73.8%) were vaccinated against yellow fever. People who left high school with or without the French baccalaureate were more likely to be vaccinated against YF than people without any diploma (OR = 1.4; p < 0.05). The probability of being vaccinated among people with negative attitudes was reduced by 40% (OR = 0.6; p < 0.05). CONCLUSION Low level of education, negative beliefs and negative attitudes have significant impacts on YFVC. Negatives beliefs and attitudes result often from a major lack of information about the benefits of vaccination. This deficit is exacerbated in persons with low educational level.
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Affiliation(s)
- Akoï Koïvogui
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, Cayenne, French Guiana.
| | - Aurel Carbunar
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, Cayenne, French Guiana
| | | | - Christelle Laruade
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, Cayenne, French Guiana
| | - Sylvaine Laube
- Observatoire Régional de la Santé de Guyane, Cellules Etudes, Cayenne, French Guiana
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Shapiro GK, Perez S, Rosberger Z. Including males in Canadian human papillomavirus vaccination programs: a policy analysis. CMAJ 2016; 188:881-886. [PMID: 27114488 PMCID: PMC5008935 DOI: 10.1503/cmaj.150451] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Gilla K Shapiro
- Department of Psychology (Shapiro, Perez, Rosberger); Departments of Psychiatry and Oncology (Rosberger), McGill University; Lady Davis Institute for Medical Research (Shapiro, Perez, Rosberger), Jewish General Hospital, Montréal, Que.
| | - Samara Perez
- Department of Psychology (Shapiro, Perez, Rosberger); Departments of Psychiatry and Oncology (Rosberger), McGill University; Lady Davis Institute for Medical Research (Shapiro, Perez, Rosberger), Jewish General Hospital, Montréal, Que
| | - Zeev Rosberger
- Department of Psychology (Shapiro, Perez, Rosberger); Departments of Psychiatry and Oncology (Rosberger), McGill University; Lady Davis Institute for Medical Research (Shapiro, Perez, Rosberger), Jewish General Hospital, Montréal, Que
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Vaccine hesitancy among general practitioners: evaluation and comparison of their immunisation practice for themselves, their patients and their children. Eur J Clin Microbiol Infect Dis 2016; 35:1837-1843. [DOI: 10.1007/s10096-016-2735-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/14/2016] [Indexed: 11/28/2022]
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Kasting ML, Shapiro GK, Rosberger Z, Kahn JA, Zimet GD. Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research. Hum Vaccin Immunother 2016; 12:1435-50. [PMID: 26864126 PMCID: PMC4964724 DOI: 10.1080/21645515.2016.1141158] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/21/2015] [Accepted: 01/07/2016] [Indexed: 10/24/2022] Open
Abstract
There has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4-0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15-0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06-5.00). These results should be reassuring to parents and health care providers.
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Affiliation(s)
- Monica L. Kasting
- Indiana University School of Public Health, Department of Epidemiology, Indianapolis, IN, USA
| | - Gilla K. Shapiro
- Department of Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, Montreal, QC, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, Montreal, QC, Canada
| | - Jessica A. Kahn
- Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Gregory D. Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, Indianapolis, IN, USA
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Gilbert NL, Gilmour H, Dubé È, Wilson SE, Laroche J. Estimates and determinants of HPV non-vaccination and vaccine refusal in girls 12 to 14 y of age in Canada: Results from the Childhood National Immunization Coverage Survey, 2013. Hum Vaccin Immunother 2016; 12:1484-90. [PMID: 26942572 PMCID: PMC4964714 DOI: 10.1080/21645515.2016.1153207] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/23/2016] [Accepted: 02/07/2016] [Indexed: 11/23/2022] Open
Abstract
Since the introduction of HPV vaccination programs in Canada in 2007, coverage has been below public health goals in many provinces and territories. This analysis investigated the determinants of HPV non-vaccination and vaccine refusal. Data from the Childhood National Immunization Coverage Survey (CNICS) 2013 were used to estimate the prevalence of HPV non-vaccination and parental vaccine refusal in girls aged 12-14 years, for Canada and the provinces and territories. Multivariate logistic regression was used to examine factors associated with non-vaccination and vaccine refusal, after adjusting for potential confounders. An estimated 27.7% of 12-14 y old girls had not been vaccinated against HPV, and 14.4% of parents reported refusing the vaccine. The magnitude of non-vaccination and vaccine refusal varied by province or territory and also by responding parent's country of birth. In addition, higher education was associated with a higher risk of refusal of the HPV vaccine. Rates of HPV non-vaccination and of refusal of the HPV vaccine differ and are influenced by different variables. These findings warrant further investigation.
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Affiliation(s)
- Nicolas L. Gilbert
- Centre for Immunization and Respiratory Infectious Diseases; Public Health Agency of Canada, Ottawa, Ontario, Canada
- Département de médecine sociale et préventive; Université de Montréal; Montréal; Québec; Canada
| | - Heather Gilmour
- Health Analysis Division; Statistics Canada; Ottawa; Ontario; Canada
| | - Ève Dubé
- Institut national de santé publique du Québec; Québec; Québec; Canada
| | - Sarah E. Wilson
- Public Health Ontario; Toronto; Ontario; Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto; Ontario; Canada
- Institute for Clinical Evaluative Sciences; Toronto; Ontario; Canada
| | - Julie Laroche
- Centre for Immunization and Respiratory Infectious Diseases; Public Health Agency of Canada, Ottawa, Ontario, Canada
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Masika MM, Ogembo JG, Chabeda SV, Wamai RG, Mugo N. Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya. PLoS One 2015; 10:e0135563. [PMID: 26266949 PMCID: PMC4534439 DOI: 10.1371/journal.pone.0135563] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 07/23/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vaccines against human papillomavirus (HPV) infection have the potential to reduce the burden of cervical cancer. School-based delivery of HPV vaccines is cost-effective and successful uptake depends on school teachers' knowledge and acceptability of the vaccine. The aim of this study is to assess primary school teachers' knowledge and acceptability of HPV vaccine and to explore facilitators and barriers of an ongoing Gavi Alliance-supported vaccination program in Kitui County, Kenya. METHODS This was a cross-sectional, mixed methods study in Central Division of Kitui County where the Ministry of Health is offering the quadrivalent HPV vaccine to grade four girls. Data on primary school teachers' awareness, knowledge and acceptability of HPV vaccine as well as facilitators and barriers to the project was collected through self-administered questionnaires and two focus group discussions. RESULTS 339 teachers (60% female) completed the survey (62% response rate) and 13 participated in 2 focus group discussions. Vaccine awareness among teachers was high (90%), the level of knowledge about HPV and cervical cancer among teachers was moderate (48%, SD = 10.9) and females scored higher than males (50% vs. 46%, p = 0.002). Most teachers (89%) would recommend the vaccine to their daughter or close relatives. Those who would recommend the vaccine had more knowledge than those who would not (p = <0.001). The main barriers were insufficient information about the vaccine, poor accessibility of schools, absenteeism of girls on vaccine days, and fear of side effects. CONCLUSIONS Despite low to moderate levels of knowledge about HPV vaccine among school teachers, vaccine acceptability is high. Teachers with little knowledge on HPV vaccine are less likely to accept the vaccine than those who know more; this may affect uptake if not addressed. Empowering teachers to be vaccine champions in their community may be a feasible way of disseminating information about HPV vaccine and cervical cancer.
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Affiliation(s)
- Moses Muia Masika
- Department of Medical Microbiology, School of Medicine, University of Nairobi, Nairobi, Kenya
- * E-mail:
| | - Javier Gordon Ogembo
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | | | - Richard G. Wamai
- Department of African-American Studies, Northeastern University, Boston, Massachusetts, United States of America
| | - Nelly Mugo
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Feinberg Y, Pereira JA, Quach S, Kwong JC, Crowcroft NS, Wilson SE, Guay M, Lei Y, Deeks SL. Understanding Public Perceptions of the HPV Vaccination Based on Online Comments to Canadian News Articles. PLoS One 2015; 10:e0129587. [PMID: 26053866 PMCID: PMC4460033 DOI: 10.1371/journal.pone.0129587] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/11/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Given the variation in human papillomavirus (HPV) vaccine coverage across Canada, and debate regarding delivery of HPV vaccines in Catholic schools, we studied online comments on Canadian news websites to understand public perceptions of HPV and HPV vaccine. METHODS We searched English- and French-language Canadian news websites for 2012 articles that contained the terms "HPV" or "human papillomavirus." Articles about HPV vaccinations that contained at least one comment were included. Two researchers independently coded comments, analyzing them for emerging themes. RESULTS We identified 3073 comments from 1198 individuals in response to 71 news articles; 630 (52.6%) individuals expressed positive sentiments about HPV vaccination (2.5 comments/individual), 404 (33.7%) were negative (3.0 comments/individual), 34 (2.8%) were mixed (1.5 comments/individual) and 130 (10.8%) were neutral (1.6 comments/individual). Vaccine-supportive commenters believed the vaccine is safe and effective. Common themes in negative comments included concerns regarding HPV vaccine safety and efficacy, distrust of pharmaceutical companies and government, and belief that school-age children are too young for HPV vaccine. Many comments focused on whether the Catholic Church has the right to inform health policy for students, and discussion often evolved into debates regarding HPV and sexual behaviour. We noted that many individuals doubted the credibility of vaccine safety information. CONCLUSION The majority of commenters do not appear to be against HPV vaccination, but public health messaging that focuses on both the vaccine's safety profile, and its use as a means to prevent cancer rather than sexually transmitted HPV infection may facilitate its acceptance.
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Affiliation(s)
| | | | | | - Jeffrey C. Kwong
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- University Health Network, Toronto, Canada
| | - Natasha S. Crowcroft
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Sarah E. Wilson
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Maryse Guay
- Département des sciences de la santé communautaire, Université de Sherbrooke, Longueuil, Canada
- Institut national de santé publique du Québec, Longueuil, Canada
- Centre de recherche de l’Hôpital Charles LeMoyne, Longueuil, Canada
| | - Yang Lei
- Public Health Ontario, Toronto, Canada
| | - Shelley L. Deeks
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- * E-mail:
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Abstract
The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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Affiliation(s)
- Noni E MacDonald
- Department of Paediatrics, Dalhousie University, Canadian Centre for Vaccinology, IWK Health Centre, Halifax, Canada.
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Cancer beliefs and prevention policies: comparing Canadian decision-maker and general population views. Cancer Causes Control 2014; 25:1683-96. [PMID: 25319013 DOI: 10.1007/s10552-014-0474-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The knowledge, attitudes, and beliefs of key policy influencers and the general public can support or hinder the development of public policies that support cancer prevention. To address gaps in knowledge concerning healthy public policy development, views on cancer causation and endorsement of policy alternatives for cancer prevention among government influencers (elected members of legislative assemblies and senior ministry bureaucrats), non-governmental influencers (school board chairs and superintendents, print media editors and reporters, and workplace presidents and senior human resource managers), and the general public were compared. METHODS Two structured surveys, one administered to a convenience sample of policy influencers (government and non-governmental) and the other to a randomly selected sample of the general public, were used. The aim of these surveys was to understand knowledge, attitudes, and beliefs regarding health promotion principles and the priority and acceptability of policy actions to prevent four behavioral risk factors for cancer (tobacco use, alcohol misuse, unhealthy eating, and physical inactivity). Surveys were administered in Alberta and Manitoba, two comparable Canadian provinces. RESULTS Although all groups demonstrated higher levels of support for individualistic policies (e.g., health education campaigns) than for fiscal and legislative measures, the general public expressed consistently greater support than policy influencers for using evidence-based policies (e.g., tax incentives or subsidies for healthy behaviors). CONCLUSIONS These results suggest that Canadian policy influencers may be less open that the general public to adopt healthy public policies for cancer prevention, with potential detriment to cancer rates.
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Mattebo M, Grün N, Rosenblad A, Larsson M, Häggström-Nordin E, Dalianis T, Tydén T. Sexual experiences in relation to HPV vaccination status in female high school students in Sweden. EUR J CONTRACEP REPR 2014; 19:86-92. [PMID: 24555926 DOI: 10.3109/13625187.2013.878021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate sexual experiences, sexually transmitted infections (STIs) and use of condoms in relation to human papillomavirus (HPV)-vaccination status in female high school students. METHODS In 2013, 355 female students with a median age of 18 years from randomly selected high schools in Sweden answered a classroom questionnaire on sexual experiences and HPV-vaccination status. RESULTS In total 227/348 (65%) of the women reported having received at least one HPV vaccine dose. Median age at first intercourse was 15 and 16 years respectively, in the 141/227 (62%) vaccinated after, and the 86/227 (38%) vaccinated before their sexual debut. There were no differences between the HPV-vaccinated and non-vaccinated groups regarding condom use, STIs, and experiences of oral and anal sex, or friends- with-benefit relationships. However, having had sexual intercourse and 'one-night stands' were more common in the vaccinated group (both p < 0.05). CONCLUSION Many students (62%) were vaccinated against HPV, with two-thirds after their sexual debut. There were no differences in condom use and STIs, and only a few differences in sexual experiences between the HPV-vaccinated and non-vaccinated groups. Initiating HPV vaccination before sexual debut is important, as is information about the link between HPV, sexual behaviour and cancer.
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Affiliation(s)
- Magdalena Mattebo
- * Department of Women's and Children's Health, Uppsala University , Uppsala
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Zimet GD, Buffler P. Prevention of human papillomavirus-related diseases: Impediments to progress. Prev Med 2013; 57:407-8. [PMID: 23954187 DOI: 10.1016/j.ypmed.2013.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 08/03/2013] [Indexed: 01/18/2023]
Affiliation(s)
- Gregory D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10th St., HS1001, Indianapolis, IN 46202, USA.
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