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Konstantinou P, Georgiou K, Kumar N, Kyprianidou M, Nicolaides C, Karekla M, Kassianos AP. Transmission of Vaccination Attitudes and Uptake Based on Social Contagion Theory: A Scoping Review. Vaccines (Basel) 2021; 9:607. [PMID: 34198885 PMCID: PMC8229666 DOI: 10.3390/vaccines9060607] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/28/2022] Open
Abstract
Vaccine hesitancy is a complex health problem, with various factors involved including the influence of an individual's network. According to the Social Contagion Theory, attitudes and behaviours of an individual can be contagious to others in their social networks. This scoping review aims to collate evidence on how attitudes and vaccination uptake are spread within social networks. Databases of PubMed, PsycINFO, Embase, and Scopus were searched with the full text of 24 studies being screened. A narrative synthesis approach was used to collate the evidence and interpret findings. Eleven cross-sectional studies were included. Participants held more positive vaccination attitudes and greater likelihood to get vaccinated or vaccinate their child when they were frequently exposed to positive attitudes and frequently discussing vaccinations with family and friends. We also observed that vaccination uptake was decreased when family and friends were hesitant to take the vaccine. Homophily-the tendency of similar individuals to be connected in a social network-was identified as a significant factor that drives the results, especially with respect to race and ethnicity. This review highlights the key role that social networks play in shaping attitudes and vaccination uptake. Public health authorities should tailor interventions and involve family and friends to result in greater vaccination uptake.
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Affiliation(s)
- Pinelopi Konstantinou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus; (P.K.); (K.G.); (M.K.); (M.K.)
| | - Katerina Georgiou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus; (P.K.); (K.G.); (M.K.); (M.K.)
| | - Navin Kumar
- Yale Institute for Network Science, Yale University, New Haven, CT 06520, USA;
| | - Maria Kyprianidou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus; (P.K.); (K.G.); (M.K.); (M.K.)
| | - Christos Nicolaides
- Department of Business and Public Administration, University of Cyprus, Nicosia 1678, Cyprus;
- Initiative on the Digital Economy, MIT Sloan School of Management, Cambridge, MA 02142, USA
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus; (P.K.); (K.G.); (M.K.); (M.K.)
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus; (P.K.); (K.G.); (M.K.); (M.K.)
- Department of Applied Health Research, UCL, London WC1E 6BT, UK
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Karasu AFG, Adanir I, Aydin S, Ilhan GK, Ofli T. Nurses' Knowledge and Opinions on HPV Vaccination: a Cross-Sectional Study from Istanbul. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:98-104. [PMID: 28822089 DOI: 10.1007/s13187-017-1272-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Implementing a HPV vaccination program is currently under evaluation by the Turkish health ministry. For screening and vaccination programs to be successful, the cooperation of nurses is essential. We aimed to evaluate (1) basic knowledge of nurses and nursing interns regarding HPV infection and cervical cancer, (2) their attitudes towards smear testing and HPV vaccination, and (3) their viewpoint on vaccination of school age children. This cross-sectional study was undertaken at Bezmialem Vakif University. The survey was designed to assess knowledge about HPV infection, Pap smear testing, cervical cancer, HPV vaccine, attitudes towards HPV vaccination, and school-based vaccination programs. Validity content was determined by expert gynecologists, and a pilot study was performed on 10 nurses. A total of 550 questionnaires were handed out; 499 were completed. Our response rate was 90.7%. Fifty-nine participants answered all the knowledge questions correctly. The calculated knowledge score of the female participants was 6.99 ± 2.22, the male participants was 5.89 ± 2.92. Female participants were more knowledgeable (p < 0.0001). Out of the 353 female participants, 18.6% (n = 66) had undergone smear testing. There were 20 (5.6%) female and 6 (4%) male participants who were vaccinated against HPV. The leading answer for not having a HPV vaccine was "I'm not at risk for a HPV infection" (n = 106, 34.9%). There was a statistical relationship between "HPV knowledge score" and answering "Yes" to "Do you want your children/future children to be vaccinated? (p = 0.001) and "Do you think including the vaccine in the Turkish immunization program is necessary?" (p = 0.001). Nurses in our cohort seem to have satisfactory basic knowledge regarding HPV infection; however, their viewpoints on vaccination were not favorable. Strategies and intervention materials for HPV vaccination will be necessary if a national immunization program will be initiated.
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Affiliation(s)
- Ayse Filiz Gokmen Karasu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi, Fatih, 34093, İstanbul, Turkey.
| | - Ilknur Adanir
- Faculty of Medicine, Department of Obstetrics and Gynecology, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi, Fatih, 34093, İstanbul, Turkey
| | - Serdar Aydin
- Faculty of Medicine, Department of Obstetrics and Gynecology, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi, Fatih, 34093, İstanbul, Turkey
| | - Gulsah Keskin Ilhan
- Department of Obstetrics and Gynecology, Suleymaniye Maternity Training and Research Hospital, Istanbul, Turkey
| | - Tugba Ofli
- Faculty of Medicine, Department of Obstetrics and Gynecology, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi, Fatih, 34093, İstanbul, Turkey
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Abstract
Despite comprising 0.7% of the world population, South Africa is home to 18% of the global human immunodeficiency virus (HIV) prevalence. Unyielding HIV subepidemics among adolescents threaten national attempts to curtail the disease burden. Should an HIV vaccine become available, establishing its point of entry into the health system becomes a priority. This study assesses the impact of school-based HIV vaccination and explores how variations in vaccine characteristics affect cost-effectiveness. The cost per quality adjusted life year (QALY) gained associated with school-based adolescent HIV vaccination services was assessed using Markov modeling that simulated annual cycles based on national costing data. The estimation was based on a life expectancy of 70 years and employs the health care provider perspective. The simultaneous implementation of HIV vaccination services with current HIV management programs would be cost-effective, even at relatively higher vaccine cost. At base vaccine cost of US$ 12, the incremental cost effectiveness ratio (ICER) was US$ 43 per QALY gained, with improved ICER values yielded at lower vaccine costs. The ICER was sensitive to duration of vaccine mediated protection and variations in vaccine efficacy. Data from this work demonstrate that vaccines offering longer duration of protection and at lower cost would result in improved ICER values. School-based HIV vaccine services of adolescents, in addition to current HIV prevention and treatment health services delivered, would be cost-effective.
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Affiliation(s)
- Nishila Moodley
- From the Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg (NM, GG); South African HVTN AIDS Vaccine Early Stage Investigator Program (SHAPe) (NM); The South African Department of Science and Technology/National Research Foundation (DST/NRF), Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa (NM); and Health Systems Governance and Finance, World Health Organization, Geneva (MB)
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van Bogaert LJ. Are the currently existing anti-human papillomavirus vaccines appropriate for the developing world? Ann Med Health Sci Res 2013; 3:306-12. [PMID: 24116304 PMCID: PMC3793430 DOI: 10.4103/2141-9248.117924] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cervical cancer prevention is expected to be achieved by vaccination of girls 2-3 years before sexual debut, and cervical smear cytology follow-up. The existing human papillomavirus (HPV) vaccines target the low-risk 6 and 11, and the high-risk 16 and 18 subtypes, the most common agents of ano-genital pre-invasive and invasive lesions. We conducted the review by searching PubMed using the terms "HPV," "HPV subtypes," "developing world," and "HPV-vaccine" to retrieve articles published between 2000 and 2011. We focused on studies that were relevant to the developing world. The proposed vaccination policy is currently unachievable in the developing world because of the cost of the vaccine, the lack of adequate cytology and follow-up infrastructures. Moreover, the subtypes of HPV involved in cervical pathology, their associations, and natural history (clearance and persistence rates) differ from the industrialized world. Therefore, the current bivalent and quadrivalent anti-HPV vaccines are unlikely to achieve their target in the developing world. It follows from published data that there is an obligation of the pharmaceutical industry and of the public-health policy makers not to embark on mass vaccination campaigns without thorough information and investigation of the local relevance.
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Affiliation(s)
- LJ van Bogaert
- Department Histopathology, National Health Laboratory, Service and University of Limpopo, Polokwane, South Africa
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van Keulen HM, Otten W, Ruiter RAC, Fekkes M, van Steenbergen J, Dusseldorp E, Paulussen TWGM. Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study. BMC Public Health 2013; 13:111. [PMID: 23388344 PMCID: PMC3570492 DOI: 10.1186/1471-2458-13-111] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 01/24/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Dutch government recently added universal Human Papilloma Virus (HPV) vaccination for 12-year-old girls to the existing national immunization program. The participation rate for the initial catch-up campaign for girls aged 13 to 16 years in 2009 was lower (47%) than expected (70%). To inform future HPV information campaigns, this paper examines the social and psychological determinants of the HPV vaccination intentions of girls aged 13 to 16 years and their mothers who were targeted by the Dutch catch-up campaign of 2009. METHODS A random sample of girls and their mothers was chosen from the Dutch vaccination register and received a letter inviting them to participate (n = 5,998 mothers and daughters). In addition, a random sample was recruited via an online panel by a marketing research company (n = 650 mothers; n = 350 daughters). Both groups were asked to complete a web-based questionnaire with questions on social demographic characteristics, social-psychological factors and HPV vaccination intention. Backward linear regression analyses were conducted to examine which social-psychological factors were most dominantly associated with vaccination intention. RESULTS Data from 952 mothers (14%) and 642 daughters (10%) were available for the intended analyses. The contribution of social demographic variables to the explained variance of HPV vaccination intention was small but significant for mothers (ΔR² = .01; p = .007), but not significant for daughters (ΔR² = .02; p = .17) after controlling for HPV vaccination uptake and the sample. In addition, social-psychological determinants largely contributed to the explained variance of HPV vaccination intention of mothers (ΔR² = .35; p < .001) and daughters (ΔR² = .34; p < .001). Attitudes, beliefs, subjective norms and habit strength were significantly associated with participants' HPV vaccination intentions. CONCLUSIONS Because of the large contribution of social-psychological variables to the explained variance of HPV vaccination intentions among the mothers and daughters, future communication strategies targeting HPV vaccination uptake should address attitudes, beliefs, subjective norms and habit strength. There is a need for longitudinal research to confirm the causality of the association between these determinants and HPV vaccination behavior indicated by this study.
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Affiliation(s)
- Hilde M van Keulen
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Wilma Otten
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Robert AC Ruiter
- Department of Work and Social Psychology, Maastricht University, PO Box 616, Maastricht, 6200 MD, the Netherlands
| | - Minne Fekkes
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Jim van Steenbergen
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, PO Box 1, Bilthoven, 3720 BA, the Netherlands
- Leiden University Medical Center, Center for Infectious Diseases, PO Box 9600, Leiden, 2300 RC, the Netherlands
| | - Elise Dusseldorp
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
| | - Theo WGM Paulussen
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands
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Mishra A. Implementing HPV Vaccines: Public Knowledge, Attitudes, and the Need for Education. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2011; 31:71-98. [DOI: 10.2190/iq.31.1.f] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article reviews qualitative research on public knowledge and attitudes to HPV vaccines, focusing on socio-economically challenged populations. Keyword searches were conducted on MEDLINE and ISI Web of Science for relevant peer-reviewed literature in English. A high acceptance of HPV vaccines was found despite low knowledge about HPV (types, prevalence, transmission, health risks, and cervical screening). Facilitators of HPV vaccine uptake included fear of cancer and desire to protect children's health. Barriers included low knowledge levels, perception of HPV vaccines as potential causes of sexual disinhibition, concerns about vaccine costs, social stigma, adverse effects, and parental unwillingness to permit vaccination of pre-adolescent children. Despite acceptance of HPV vaccines, implementation in low-resource settings faces social and economic difficulties. To pursue and strengthen cervical screening in these settings, public education about HPV is key.
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Wong LP. Issues surrounding HPV vaccine delivery in a multi-ethnic country in Asia: the physician's perspective. J Community Health 2011; 36:14-22. [PMID: 20431926 DOI: 10.1007/s10900-010-9275-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The study was conducted to investigate issues surrounding human papillomavirus (HPV) vaccine delivery in a multi-ethnic, multi-religious and multi-cultural society. A qualitative in-depth interview study was conducted with a sample of 20 physicians. Physicians described the success of HPV vaccines recommendation as very poor. Many expressed reluctance to offer the vaccine to preadolescents. The most notable barrier to vaccination was the vaccine's high cost. Parents of eligible vaccinees were concerned about the efficacy and side effects of the new vaccine, while adult women have low risk perception for HPV infection. Promoters and inhibitors of HPV vaccination in our multi-ethnic, multi-religious and multi-cultural community were identified. This study suggests the need to strengthen the infrastructure necessary for HPV vaccine delivery and to specifically target poor underserved women.
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Affiliation(s)
- Li Ping Wong
- Medical Education and Research Development Unit, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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8
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How sexual history and knowledge of cervical cancer and screening influence Chinese women's screening behavior in mainland China. Cancer Nurs 2011; 33:445-53. [PMID: 20697268 DOI: 10.1097/ncc.0b013e3181e456dc] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Accurate information and knowledge about cervical cancer and screening importantly influence women's cervical screening participation. Sexual behavior plays a crucial role in human papillomavirus transmission and the subsequent development of cervical cancer. Indeed, the uptake of cervical screening among Chinese women is relatively low compared with other populations. OBJECTIVE To understand women's attendance pattern of cervical screening, knowledge about cervical cancer and screening, and factors influencing their utilization of cervical screening in mainland China. METHODS A cross-sectional survey was conducted to collect women's participation pattern for cervical screening, knowledge about cervical cancer and screening, sociodemographic information and sexual history, and barriers to participating in cervical screening. RESULTS Married women and women who had had their first intercourse after the age of 21 years were significantly more likely to participate in screening. Screened women demonstrated a higher level of knowledge about the cervical screening procedure compared with nonscreened women (P = .002). Also, the scores of individual items such as women's knowledge of cervical screening and risk factors were significantly different between the 2 groups. CONCLUSION The current system of free physical examinations for women in mainland China is a major motivator for women's utilization of cervical screening services. Chinese women's marital status and sexual history influence their screening behavior. IMPLICATIONS FOR PRACTICE Unmarried women who have ever had sex should be encouraged to have cervical screening, and consistent and appropriate information about the preventive nature of cervical screening and risk factors associated with cervical cancer should be provided to the general public.
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Rowhani-Rahbar A, Mao C, Hughes JP, Alvarez FB, Bryan JT, Hawes SE, Weiss NS, Koutsky LA. Longer term efficacy of a prophylactic monovalent human papillomavirus type 16 vaccine. Vaccine 2009; 27:5612-9. [PMID: 19647066 DOI: 10.1016/j.vaccine.2009.07.027] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Revised: 07/07/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
Abstract
We conducted an extended follow-up study (March 2006-May 2008) to assess the longer term efficacy of a prophylactic monovalent human papillomavirus (HPV) type 16 L1 virus-like particle vaccine in women (n=290) who had enrolled in a randomized controlled trial of this vaccine (October 1998-November 1999) in Seattle and remained HPV-16 DNA negative during the course of that trial. During the extended follow-up period, in the per-protocol susceptible population, none of the vaccine recipients was found to be infected with HPV-16 or developed HPV-16-related cervical lesions; among placebo recipients, 6 women were found to be infected with HPV-16 (vaccine efficacy [VE]=100%; 95% confidence interval [CI]: 29-100%) and 3 women developed HPV-16-related cervical lesions (VE=100%; 95% CI: <0-100%). Approximately 86% of vaccine recipients remained HPV-16 competitive Luminex immunoassay seropositive at an average of 8.5 years of follow-up. During the combined original trial and extended follow-up period, in the intention-to-treat population, 20 and 22 women developed any cervical lesion regardless of HPV type among the vaccine and placebo recipients, respectively (VE=15%; 95% CI: <0-56%). The results suggest that this monovalent HPV-16 vaccine remains efficacious through 8.5 years after its administration.
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Affiliation(s)
- Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington, Seattle, WA 98125, USA.
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Wong LP. HPV information needs, educational messages and channel of delivery preferences: views from developing country with multiethnic populations. Vaccine 2009; 27:1410-5. [DOI: 10.1016/j.vaccine.2008.12.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 12/01/2008] [Accepted: 12/20/2008] [Indexed: 11/25/2022]
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Harries J, Moodley J, Barone MA, Mall S, Sinanovic E. Preparing for HPV vaccination in South Africa: Key challenges and opinions. Vaccine 2009; 27:38-44. [PMID: 18977271 DOI: 10.1016/j.vaccine.2008.10.033] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 10/13/2008] [Indexed: 11/26/2022]
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12
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Wong LP. Physicians' experiences with HPV vaccine delivery: evidence from developing country with multiethnic populations. Vaccine 2008; 27:1622-7. [PMID: 19100803 DOI: 10.1016/j.vaccine.2008.11.107] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 11/24/2008] [Accepted: 11/28/2008] [Indexed: 11/30/2022]
Abstract
Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use.
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Affiliation(s)
- Li Ping Wong
- Medical Education & Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Zimet GD, Liddon N, Rosenthal SL, Lazcano-Ponce E, Allen B. Chapter 24: Psychosocial aspects of vaccine acceptability. Vaccine 2008; 24 Suppl 3:S3/201-9. [PMID: 16950008 DOI: 10.1016/j.vaccine.2006.06.017] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Accepted: 06/01/2006] [Indexed: 10/24/2022]
Abstract
In this chapter we identify psychosocial issues that have been raised with respect to human papillomavirus (HPV) vaccination and review the research literature on HPV vaccine acceptability. Many women and physicians have relatively poor knowledge about HPV, but despite this, most healthcare providers are willing to recommend HPV vaccination and parents are interested in having their children vaccinated. Concerns about post-vaccination sexual behavior change do not appear to be justified, but can certainly be addressed through anticipatory guidance. Most research studies have come out of the United States and other English-speaking industrialized countries. More psychosocial research regarding HPV vaccination is therefore needed from developing countries.
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Affiliation(s)
- Gregory D Zimet
- Section of Adolescent Medicine, Indiana University School of Medicine, 575 N. West Drive, Indianapolis, IN 46202, USA.
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Casper MJ, Carpenter LM. Sex, drugs, and politics: the HPV vaccine for cervical cancer. SOCIOLOGY OF HEALTH & ILLNESS 2008; 30:886-899. [PMID: 18761509 DOI: 10.1111/j.1467-9566.2008.01100.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
HPV is the most common sexually transmitted infection in the world. While most strains are relatively harmless, some increase a woman's risk of developing cervical cancer. This article explores the intimate, contested relationships among etiologies of cervical cancer, development and use of the new HPV vaccine, and contested notions of sexuality. We particularly focus on shifts in US health care and sexual politics, where the vaccine has animated longstanding concerns about vaccination (e.g. parental rights, cost, specialisation) and young women's bodies and behaviour. We conclude that vaccines are a distinctive kind of pharmaceutical, invoking notions of contagion and containment, and that politics shape every aspect of the pharmaceutical life course.
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Affiliation(s)
- Monica J Casper
- Department of Sociology, Vanderbilt University, Nashville, TN 37235, USA.
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Fazekas KI, Brewer NT, Smith JS. HPV Vaccine Acceptability in a Rural Southern Area. J Womens Health (Larchmt) 2008; 17:539-48. [PMID: 18370586 DOI: 10.1089/jwh.2007.0489] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karah I. Fazekas
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Noel T. Brewer
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer S. Smith
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
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Scarinci IC, Garcés-Palacio IC, Partridge EE. An Examination of Acceptability of HPV Vaccination among African American Women and Latina Immigrants. J Womens Health (Larchmt) 2007; 16:1224-33. [DOI: 10.1089/jwh.2006.0175] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel C. Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Edward E. Partridge
- Division of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
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Jones HE, Allan BR, van de Wijgert JHHM, Altini L, Taylor SM, de Kock A, Coetzee N, Williamson AL. Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa. J Clin Microbiol 2007; 45:1679-83. [PMID: 17409209 PMCID: PMC1933028 DOI: 10.1128/jcm.02369-06] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had high agreement with clinician-obtained brushes when the Roche Reverse Line Blot Assay (RLBA) was used (for swabs, 86% concordance, with a kappa statistic [kappa] of 0.71; for tampons, 89% concordance, with kappa of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with kappa higher for swabs than for tampons (for swabs, 81% concordance, with kappa of 0.61; for tampons, 82% concordance, with kappa of 0.55). Low-risk HPV types were nearly two times more common in self-collected specimens than in clinician-collected specimens tested by RLBA. All 15 women diagnosed with high-grade lesions by cytology tested positive for high-risk HPV with clinician-collected specimens tested by RLBA and HC2, while 11 out of 15 tested positive with self-collected specimens by HC2 and 5 out of 6 tested positive by RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.
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Wheeler CM. Advances in primary and secondary interventions for cervical cancer: human papillomavirus prophylactic vaccines and testing. ACTA ACUST UNITED AC 2007; 4:224-35. [PMID: 17392713 DOI: 10.1038/ncponc0770] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Accepted: 11/20/2006] [Indexed: 11/09/2022]
Abstract
Cytologic screening has greatly reduced the incidence of invasive cervical cancer in many industrialized nations. State-of-the-art cervical cancer prevention is costly, however, and includes cytologic screening at repeat intervals, confirmation of abnormalities by colposcopic biopsy, and treatment of precancerous lesions. In resource-limited settings, accessibility to prevention programs for cervical cancer is often poor, or such programs are simply unavailable or inadequately supported. This disease, therefore, remains a leading form of cancer among women living in low-resource regions, and over 250,000 women worldwide die from cervical cancer each year. Persistent cervical infection with one of approximately 15 carcinogenic human papillomavirus (HPV) types causes virtually all invasive cervical cancer and its precursor abnormalities, which can be detected by cytologic screening. Genital HPV infections are primarily transmitted via sexual intercourse. One promising prophylactic HPV vaccine is available and others continue in development as primary cervical cancer prevention strategies in younger women. As secondary interventions, HPV tests are simultaneously evolving for use in cervical cancer screening programs, including routine screening of older women. HPV testing is more sensitive and reproducible than cytology with colposcopy for the detection of cervical precancer and cancer. This article presents current advances and perspectives on HPV vaccines and HPV testing.
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Affiliation(s)
- Cosette M Wheeler
- Department of Molecular Genetics and Microbiology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology, Building 191, 1816 Sigma Chi Road, Albuquerque, NM 87131, USA.
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de Melo-Martín I. The promise of the human papillomavirus vaccine does not confer immunity against ethical reflection. Oncologist 2006; 11:393-6. [PMID: 16614235 DOI: 10.1634/theoncologist.11-4-393] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The recent announcement of an experimental vaccine against human papillomavirus (HPV) has raised great hopes and expectations. Promising trial results, however, should not obscure ethical issues related to a vaccine's ultimate dissemination. Although lay media might view an HPV vaccine as a panacea, a more complicated ethical reality exists, touching upon public knowledge, health care disparities, and parental consent for childhood vaccination.
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