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Walker KK, Clare A, Kumar A, Gaviria-Agudelo C. A scoping review of the use of parent-adolescent dyads in HPV vaccination research. PATIENT EDUCATION AND COUNSELING 2024; 118:108007. [PMID: 37847989 DOI: 10.1016/j.pec.2023.108007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Parental vaccine hesitancy is a significant contributor to low adolescent HPV vaccination. Shared HPV vaccination decision-making among adolescents and parents is an important determinant of vaccination uptake. We performed a scoping review to identify studies that used parent-adolescent dyads in HPV vaccination research. METHODS We searched peer-reviewed articles in PubMed, Embase, and PsychInfo from 2012 to 2023. Randomized or observational studies with parent-adolescent dyads related to HPV vaccination were eligible for inclusion. Articles were coded for the main themes related to use of parent-adolescent dyads in HPV vaccination research. RESULTS Fifteen articles met the inclusion criteria and were categorized into two main themes: qualitative decision-making and quantitative vaccination intentions. Dyad members reported substantially different roles, barriers, and facilitators of HPV vaccine decisions and intentions. Dyad members disagreed on who made the final decision. Provider recommendation style and content were important to parental confidence in the vaccine decision. CONCLUSION The recent evidence for parent-adolescent HPV vaccination dyad research is sparse but indicates that factors that account for dyad vaccination decisions and intentions often differ between dyad members. PRACTICE IMPLICATIONS Studies in this review support ongoing research with parent-adolescent dyads to target HPV vaccine interventions at individual dyad members to increase HPV vaccination.
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Affiliation(s)
- Kimberly K Walker
- Zimmerman School of Advertising and Mass Communications, University of South Florida, Tampa, FL, USA.
| | - Alyssa Clare
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
| | - Ambuj Kumar
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
| | - Claudia Gaviria-Agudelo
- Pediatric Infectious Diseases, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
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Lubeya MK, Chibwesha CJ, Mwanahamuntu M, Mukosha M, Vwalika B, Kawonga M. Determinants of the Implementation of Human Papillomavirus Vaccination in Zambia: Application of the Consolidated Framework for Implementation Research. Vaccines (Basel) 2023; 12:32. [PMID: 38250845 PMCID: PMC10821054 DOI: 10.3390/vaccines12010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Cervical cancer can be prevented, primarily by the administration of the human papillomavirus (HPV) vaccine. Healthcare workers (HCWs) and teachers play important roles when schools are used for vaccine delivery; however, challenges exist. This study aimed to understand the barriers and facilitators to HPV vaccination that are perceived by HCWs and teachers. Guided by the consolidated framework for implementation research (CFIR), key informant interviews were conducted in Lusaka district between June 2021 and November 2021 using a semi-structured questionnaire. Recorded interviews were transcribed verbatim and imported into NVIVO 12 for data management and analysis. We coded transcripts inductively and deductively based on the adapted CFIR codebook. We reached saturation with 23 participants. We identified barriers and facilitators across the five CFIR domains. Facilitators included offering the HPV vaccine free of charge, HPV vaccine effectiveness, stakeholder engagement, and timely planning of the HPV vaccination. Barriers included vaccine mistrust due to its perceived novelty, low levels of parental knowledge, myths and misinformation about the vaccine, lack of parental consent to vaccinate daughters, lack of transport for vaccination outreach, lack of staff incentives, and inadequate sensitisation. Using the CFIR as a guiding framework, we have identified implementation barriers and facilitators to HPV vaccination among HCWs and teachers. Most of the identified barriers are modifiable, hence it is prudent that these are addressed for a high HPV vaccine uptake.
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Affiliation(s)
- Mwansa Ketty Lubeya
- Department of Obstetrics and Gynaecology, School of Medicine, The University of Zambia, Lusaka 10101, Zambia; (M.M.); (B.V.)
- Women and Newborn Hospital, University Teaching Hospitals, Nationalist Road, Ridgeway, Lusaka 10101, Zambia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 3193, South Africa; (M.M.); (M.K.)
| | - Carla J. Chibwesha
- Clinical HIV Research Unit, Helen Joseph Hospital, Johannesburg 2193, South Africa;
| | - Mulindi Mwanahamuntu
- Department of Obstetrics and Gynaecology, School of Medicine, The University of Zambia, Lusaka 10101, Zambia; (M.M.); (B.V.)
- Women and Newborn Hospital, University Teaching Hospitals, Nationalist Road, Ridgeway, Lusaka 10101, Zambia
| | - Moses Mukosha
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 3193, South Africa; (M.M.); (M.K.)
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia
| | - Bellington Vwalika
- Department of Obstetrics and Gynaecology, School of Medicine, The University of Zambia, Lusaka 10101, Zambia; (M.M.); (B.V.)
- Women and Newborn Hospital, University Teaching Hospitals, Nationalist Road, Ridgeway, Lusaka 10101, Zambia
| | - Mary Kawonga
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 3193, South Africa; (M.M.); (M.K.)
- Department of Public Health Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa
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Kohler RE, Wagner RB, Careaga K, Btoush R, Greene K, Kantor L. Mothers' perceptions and attitudes about HPV vaccination initiation among 9- and 10-year-olds. Hum Vaccin Immunother 2023; 19:2270842. [PMID: 37955127 PMCID: PMC10653617 DOI: 10.1080/21645515.2023.2270842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
HPV vaccination has potential to prevent 90% of HPV-associated cancers. The Advisory Committee on Immunization Practices recommends HPV vaccination for 11- and 12-year-olds, but vaccine initiation can start at age 9. The purpose of this study was to explore perceptions about starting HPV vaccination at a younger age to inform future interventions that promote initiation at ages 9 and 10 years. This was part of a larger study about vaccine hesitancy among racially/ethnically diverse parents of adolescents in the Greater Newark Area of New Jersey. We thematically analyzed transcripts from 16 interviews with English- and Spanish-speaking mothers who had at least one child ≤ 10 years. Analyses focused on perceptions of HPV-related disease risk, attitudes toward HPV vaccination need, and vaccine confidence specifically for 9- and 10-year-olds. Few parents with young adolescents reported receiving vaccination recommendations, and only one reported series initiation before age 11. Mothers' hesitation about younger HPV vaccination initiation revolved around: 1) low perceived necessity among English-speaking mothers due to young adolescents not being sexually active, 2) concerns about potential side effects associated with vaccinating prepubescent adolescents, and 3) a desire for adolescents to be old enough to provide assent. Participants were not opposed to younger initiation but wanted and relied on pediatricians to inform them about vaccination for younger adolescents. These findings suggest mothers are willing to vaccinate at younger ages after clear provider recommendations. Equipping providers with evidence about vaccine safety and cancer prevention communication strategies may promote initiation and timely completion at younger ages.
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Affiliation(s)
- Racquel E. Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Rachel B. Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Katherine Careaga
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Rula Btoush
- School of Nursing, Rutgers University, New Brunswick, NJ, USA
| | - Kathryn Greene
- School of Communication & Information, Rutgers University, New Brunswick, NJ, USA
| | - Leslie Kantor
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
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Kohler RE, Wagner RB, Careaga K, Vega J, Btoush R, Greene K, Kantor L. Parents' Intentions, Concerns and Information Needs about COVID-19 Vaccination in New Jersey: A Qualitative Analysis. Vaccines (Basel) 2023; 11:1096. [PMID: 37376485 DOI: 10.3390/vaccines11061096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND In 2019, the World Health Organization identified vaccine hesitancy as a top ten global health threat, which has been exacerbated by the COVID-19 pandemic. Despite local and nationwide public health efforts, adolescent COVID-19 vaccination uptake in the US remains low. This study explored parents' perceptions of the COVID-19 vaccine and factors influencing hesitancy to inform future outreach and education campaigns. METHODS We conducted two rounds of individual interviews via Zoom in May-September 2021 and January-February 2022, with parents of adolescents from the Greater Newark Area of New Jersey, a densely populated area with historically marginalized groups that had low COVID-19 vaccination uptake. Data collection and analysis was guided by the Increasing Vaccination Model and WHO Vaccine Hesitancy Matrix. Interview transcripts were double-coded and thematically analyzed in NVivo. RESULTS We interviewed 22 parents (17 in English, 5 in Spanish). Nearly half (45%) were Black and 41% were Hispanic. Over half (54%) were born outside of the US. Most of the parents described that their adolescents had received at least one dose of a COVID-19 vaccine. All but one parent had received the COVID-19 vaccine. Despite strong vaccination acceptance for themselves, parents remained hesitant about vaccinating their adolescents. They were mostly concerned about the safety and potential side effects due to the novelty of the vaccine. Parents sought information about the vaccines online, through healthcare providers and authorities, and at community spaces. Interpersonal communication exposed parents to misinformation, though some personal connections to severe COVID-19 illness motivated vaccination. Historical mistreatment by the healthcare system and politicization of the vaccine contributed to parents' mixed feelings about the trustworthiness of those involved with developing, promoting, and distributing COVID-19 vaccines. CONCLUSIONS We identified multilevel influences on COVID-19 vaccine-specific hesitancy among a racially/ethnically diverse sample of parents with adolescents that can inform future vaccination interventions. To increase vaccine confidence, future COVID booster campaigns and other vaccination efforts should disseminate information through trusted healthcare providers in clinical and also utilize community settings by addressing specific safety concerns and promoting vaccine effectiveness.
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Affiliation(s)
- Racquel E Kohler
- Center for Cancer Heath Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
| | - Rachel B Wagner
- Center for Cancer Heath Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
| | - Katherine Careaga
- Center for Cancer Heath Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Jacqueline Vega
- Center for Cancer Heath Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
| | - Rula Btoush
- School of Nursing, Rutgers University, New Brunswick, NJ 08901, USA
| | - Kathryn Greene
- Center for Cancer Heath Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- School of Communication & Information, Rutgers University, New Brunswick, NJ 08901, USA
| | - Leslie Kantor
- School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
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Gravelle TB, Phillips JB, Reifler J, Scotto TJ. Estimating the size of "anti-vax" and vaccine hesitant populations in the US, UK, and Canada: comparative latent class modeling of vaccine attitudes. Hum Vaccin Immunother 2022; 18:2008214. [PMID: 35349385 PMCID: PMC9009899 DOI: 10.1080/21645515.2021.2008214] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Vaccine hesitancy is a significant impediment to global efforts to vaccinate against the SARS-CoV-2 virus at levels that generate herd immunity. In this article, we show the utility of an inductive approach - latent class analysis (LCA) - that allows us to characterize the size and nature of different vaccine attitude groups; and to compare how these groups differ across countries as well as across demographic subgroups within countries. We perform this analysis using original survey data collected in the US, UK, and Canada. We also show that these classes are strongly associated with SARS-CoV-2 vaccination intent and perceptions of the efficacy and safety of the COVID-19 vaccines, suggesting that attitudes about vaccines to fight the novel coronavirus pandemic are well explained by latent vaccine attitudes that precede the pandemic. More specifically, we find four substantive classes of vaccine attitudes: strong supporters, supporters with concerns, vaccine hesitant, and "anti-vax" as well as a fifth measurement error class. The strong "anti-vax" sentiment class is small in all three countries, while the strong supporter class is the largest across all three countries. We observe different distributions of class assignments in different demographic groups - most notably education and political leaning (partisanship and ideology).
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Affiliation(s)
- Timothy B Gravelle
- Momentive, Aurora, Canada.,Laurier Institute for the Study of Public Opinion and Policy, Wilfrid Laurier University, Waterloo, Canada
| | | | - Jason Reifler
- Department of Politics, University of Exeter, Exeter, UK
| | - Thomas J Scotto
- School of Political and Social Sciences, University of Glasgow, Glasgow, UK
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Chen F, Pan X, Liang H, Shen L, Wang Y, Chen Y, Lv H, Hu Y. Real-world safety profile of the 9-valent human papillomavirus vaccine: A study in Zhejiang, China from 2019 to 2021. Hum Vaccin Immunother 2022; 18:2152256. [PMID: 36484114 PMCID: PMC9762803 DOI: 10.1080/21645515.2022.2152256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The safety profile of the 9-valent human papillomavirus vaccine (9vHPV) was evaluated based on the reporting rate of adverse events following immunization (AEFI) obtained from the passive surveillance data in Zhejiang. The 9vHPV AEFI reports in Zhejiang were collected and reviewed from the National Adverse Event Following Immunization Surveillance System (NAEFISS) from 2019 to 2021. Reporting rates of AEFI were analyzed under multiple aspects, including age, city, number of vaccinations, AEFI categories, and diagnosis categories. This study used the reporting odds ratio (ROR) for anomalous signal assessment. The NAEFISS collected 331 AEFI reports after administering 1,064,851 doses of 9vHPV, with a crude AEFI rate of 3.12/10,000 doses. The third dose had the highest reporting rate of minor vaccine-related reaction (n = 80, 3.06 per 10,000), followed by the first dose (n = 134, 2.98 per 10,000), and second dose (n = 76, 2.15 per 10,000). Fever/redness/induration was the most common minor adverse event (281 records, 2.64/10,000 doses). Nine cases of urticaria, ten cases of allergic rash, and ten cases of syncope were recorded. This study found a positive signal association between 9vHPV immunization and adverse events such as syncope, encephalitis, sterile abscess, and urticaria. This study did not identify any new emerging safety concerns. In the future, more research is needed to validate and further explore adverse reactions associated with 9vHPV.
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Affiliation(s)
- Fuxing Chen
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuejiao Pan
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hui Liang
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lingzhi Shen
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Wang
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yaping Chen
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Huakun Lv
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yu Hu
- Institute of Immunization and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,CONTACT Yu Hu Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, No. 3399 Binsheng Road, Binjiang District, Hangzhou, China
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Runngren E, Eriksson M, Blomberg K. Parents' reasoning about HPV vaccination in Sweden. Scand J Caring Sci 2021; 36:1113-1122. [PMID: 34672006 DOI: 10.1111/scs.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to describe parents' reasoning in making decisions about vaccinating their daughters against human papilloma virus (HPV), a part of the Swedish vaccination programme. METHOD Twenty parents whose daughter had been offered HPV vaccination participated. Semi-structured individual interviews were conducted and analysed using thematic analysis. RESULTS The findings reveal that the decision-making process is complex. The parents trusted the vaccination programme and saw it as beneficial to society. They also described using different resources to decide about HPV vaccination, but they did not include their daughters in making the decision. DISCUSSION Parents need better vaccine and health literacy to be able to decide, based on evidence and in consultation with their daughters, on HPV vaccination. School nurses can play an important role in evidence-based decision-making about HPV vaccination and introducing children to this health-promoting intervention.
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Affiliation(s)
- Eva Runngren
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Shahbari NAE, Gesser-Edelsburg A, Davidovitch N, Brammli-Greenberg S, Grifat R, Mesch GS. Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel. Int J Equity Health 2021; 20:201. [PMID: 34493294 PMCID: PMC8423338 DOI: 10.1186/s12939-021-01523-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01523-1.
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Affiliation(s)
- Nour Abed Elhadi Shahbari
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.,School of Public Health, Founding Director of the Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, Faculty of Health Sciences, Ben Gurion University of the Negev, 84105, Beer Sheva, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, P.O. Box 12272, 9112102, Jerusalem, Israel
| | - Rami Grifat
- Ziv Medical Center, 1 Derech HaRambam, 13100, Safed, Israel
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel
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Yih WK, Kulldorff M, Dashevsky I, Maro JC. A Broad Safety Assessment of the 9-Valent Human Papillomavirus Vaccine. Am J Epidemiol 2021; 190:1253-1259. [PMID: 33558897 PMCID: PMC8245868 DOI: 10.1093/aje/kwab022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 12/14/2022] Open
Abstract
Parents indicate that safety is their top concern about human papillomavirus (HPV) vaccination. A data-mining method not requiring prespecification of health outcome(s) or postexposure period(s) of potentially increased risk can be used to identify possible associations between an exposure and any of thousands of medically attended health outcomes; this method was applied to data on the 9-valent HPV vaccine (HPV9) to detect potential safety problems. Data on 9- to 26-year-olds who had received HPV9 vaccine between November 4, 2016, and August 5, 2018, inclusive, were extracted from the MarketScan database and analyzed for statistically significant clustering of incident diagnoses within the hierarchy of diagnoses coded using the International Classification of Diseases and temporally within the 1 year after vaccination, using the self-controlled tree-temporal scan statistic and TreeScan software. Only 56 days of postvaccination enrollment was required; subsequent follow-up was censored at disenrollment. Multiple testing was adjusted for. The analysis included 493,089 doses of HPV9. Almost all signals resulted from temporal confounding, not unexpected with a 1-year follow-up period. The only plausible signals were for nonspecific adverse events (e.g., injection-site reactions, headache) on days 1–2 after vaccination, with attributable risks as low as 1 per 100,000 vaccinees. Considering the broad scope of the evaluation and the high statistical power, the findings of no specific serious adverse events should provide reassurance about this vaccine’s safety.
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Affiliation(s)
- W Katherine Yih
- Correspondence to Dr. W. Katherine Yih, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 (e-mail: )
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Zimet GD, Osazuwa-Peters N. There's Much Yet to be Done: Diverse Perspectives on HPV Vaccination. Hum Vaccin Immunother 2020; 15:1459-1464. [PMID: 31365327 PMCID: PMC6746479 DOI: 10.1080/21645515.2019.1640559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Gregory D Zimet
- a Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
| | - Nosayaba Osazuwa-Peters
- b Department of Otolaryngology-Head and Neck Surgery, Saint Louis University , St Louis , MO , USA
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