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Sono S, Sukhanonsawat N, Naknuan N, Auttasongkroh P, Suwanno R, Kiratikosol K, Sookpong K, Sukpornsinchai N, Sirikornpinyo L, Nakarae W, Laomanachareon S. Human papillomavirus vaccination status among university students in Southern Thailand: A cross-sectional study. Prev Med Rep 2024; 46:102857. [PMID: 39253725 PMCID: PMC11381746 DOI: 10.1016/j.pmedr.2024.102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/11/2024] Open
Abstract
Objective Human papillomavirus (HPV) commonly causes transmissible diseases worldwide; however, HPV vaccines are not available among some at-risk populations. Since 2017, HPV vaccination has been recommended for females aged 11-12 years in Thailand. However, studies on the coverage and HPV vaccination prevalence are limited. This study aimed to explore the prevalence and factors associated with HPV vaccination among Thai university students. Methods Data for this cross-sectional study were randomly collected using paper-based questionnaires from university students aged 18-26 years during October 17-27, 2023. Results Of 1,093 participants, 57.6 % were female, and 53.5 % were from non-urban areas. The median age was 20 years. One-third of the participants were from low-income families. The overall HPV vaccine coverage rates were 7.51 % and 0.87 % in female and male students, respectively. Female sex, being from a high-income family, studying in health science faculties, originating from an urban area, having one or both parents completing university educations, and having healthcare providers as family members increased the odds of receiving the HPV vaccine. The accuracy of HPV vaccine literacy among participants who reported that they "know about the HPV vaccine" was adequate, except for the fact that HPV vaccine was sex-neutral. Conclusions The HPV vaccine coverage rate among Thai university students was low owing to several factors. HPV and HPV vaccine education should be provided to populations that can still benefit from receiving the HPV vaccine.
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Affiliation(s)
- Supinya Sono
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Natthapong Sukhanonsawat
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Nuttida Naknuan
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Pitchaya Auttasongkroh
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Rinrada Suwanno
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Karunyapas Kiratikosol
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Kanatad Sookpong
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Nichakarn Sukpornsinchai
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Ladapa Sirikornpinyo
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Witchaya Nakarae
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
| | - Suchawadee Laomanachareon
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, Songkhla, 90110, Thailand
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Kobayashi M, Nakagawa S, Ueda Y, Yagi A, Kakuda M, Hiramatsu K, Kimura T. Estimation of self-funded human papillomavirus vaccine recipients from Japan's previously assumed "unvaccinated generation". Cancer Sci 2024. [PMID: 38992919 DOI: 10.1111/cas.16272] [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: 04/30/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024] Open
Abstract
Precise vaccination data is essential to accurately estimate the effectiveness of the human papillomavirus (HPV) vaccine against HPV-related cancers. In Japan, the number of subsidized HPV vaccinations can be tracked through registries, but the number of self-funded vaccinations has not been tracked. The number of individuals who chose to receive the vaccine at their own expense, despite being ineligible for public subsidies due to their age, is unknown and has been nominally considered to be zero. Our aim is to produce a more accurate estimate of this number using recently released proprietary data. First, we estimated the total number of self-funded HPV vaccinations occurring from 2010 to 2012 using public data from the Ministry of Health, Labour and Welfare and our previously reported data on the number of HPV vaccinations eligible for public subsidy. Second, using proprietary data from the vaccine manufacturer, we calculated the distribution of self-funded vaccination shots by age. Finally, we combined these data to estimate the number of self-funded HPV vaccinations by birth fiscal year (FY) relative to a yearly reference population. We found that 78,264 individuals born in FY1993 and 58,190 born in FY1992 self-funded their vaccinations, representing 13.6% and 10.0% of the reference population, respectively. Additionally, we found that 5%-10% of individuals born from FY1986 to FY1991 self-funded their vaccinations. Our study revealed for the first time that a certain number of individuals from the "HPV unvaccinated generation," ineligible for subsidies due to age restrictions, chose to self-fund their vaccinations.
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Affiliation(s)
- Mariya Kobayashi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Satoshi Nakagawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Asami Yagi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Mamoru Kakuda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Kosuke Hiramatsu
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Osaka, Suita-City, Osaka, Japan
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Yim VWC, Wang Q, Li Y, Qin C, Tang W, Tang S, Jit M, Smith JS, Larson HJ, Tucker JD, Li J, Lin L, Wu D. Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China. BMC Public Health 2024; 24:183. [PMID: 38225563 PMCID: PMC10790461 DOI: 10.1186/s12889-024-17697-6] [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: 05/25/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls. METHODS Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use. RESULTS A total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active. CONCLUSION In urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.
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Affiliation(s)
| | - Qianyun Wang
- Department of Social Welfare, University of California, Los Angeles, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Yifan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanyun Qin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weiming Tang
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Shenglan Tang
- Global Health Research Centre, Duke Kunshan University, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK
| | - Jennifer S Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joseph D Tucker
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
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Palmer C, Tobe K, Negishi Y, You X, Chen YT, Abe M. Health impact and cost effectiveness of implementing gender-neutral HPV vaccination in Japan. J Med Econ 2023; 26:1546-1554. [PMID: 37962015 DOI: 10.1080/13696998.2023.2282912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To assess the public health impact and cost effectiveness of gender-neutral vaccination (GNV) versus female-only vaccination (FOV) with human papillomavirus (HPV) vaccination in Japan. METHODS We modeled the public health impact and cost effectiveness of GNV versus FOV to prevent HPV-associated diseases in Japan over the next 100 years. We used one-way sensitivity analyses to examine the impact of varying key model input parameters and conducted scenario analyses to explore the effects of varying the vaccination coverage rate (VCR) of each cohort. RESULTS In the base-case analysis, GNV averted additional cancer cases (17,228 female/6,033 male) and deaths (1,892 female/1,849 male) compared to FOV. When all HPV-associated diseases were considered, GNV had an incremental cost-effectiveness ratio of ¥4,732,320 (US$35,987)/quality-adjusted life year gained compared to FOV. The model was most sensitive to the discount rate and the disutility associated with HPV-related diseases. GNV had greater relative public health benefits when the female VCR was lower and was cost effective at a female VCR of 30%. CONCLUSIONS Immediate implementation of GNV would reduce the disease burden and mortality associated with HPV in Japan, and would be cost effective compared to FOV if the female VCR remains low (30%).
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Affiliation(s)
- Cody Palmer
- Biostatistics & Research Decision Sciences, Merck & Co., Inc, Rahway, NJ, USA
| | | | | | - Xuedan You
- Center for Observational & Real-world Evidence (CORE), Merck & Co., Inc, Rahway, NJ, USA
| | - Ya-Ting Chen
- Center for Observational & Real-world Evidence (CORE), Merck & Co., Inc, Rahway, NJ, USA
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