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Cebollero J, Walton SM, Cavendish L, Quairoli K, Cwiak C, Kottke MJ. Evaluation of Human Papillomavirus Vaccination After Pharmacist-Led Intervention: A Pilot Project in an Ambulatory Clinic at a Large Academic Urban Medical Center. Public Health Rep 2020; 135:313-321. [PMID: 32228133 PMCID: PMC7222962 DOI: 10.1177/0033354920914340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objectives Despite the safety and efficacy of the human papillomavirus (HPV) vaccine,
many persons are still not receiving it. The purpose of this pilot project
was to evaluate the number of first doses of the 9-valent HPV (9vHPV)
vaccination administered after a pharmacist-led intervention in the Adult
Family Planning Clinic at Grady Health System (GHS), a large academic urban
medical center in Atlanta, Georgia. Methods The pilot project had 3 phases: pre-intervention (November 15, 2016, through
March 31, 2017), active intervention (November 15, 2017, through December
29, 2017), and post-intervention (December 30, 2017, through March 31,
2018). The pre-intervention phase was used as a historical control. The
active intervention phase consisted of pharmacist interventions in the
clinic and patient and health care provider education. The post-intervention
phase evaluated the durability of pharmacist-led interventions performed and
education provided during the active phase. Results Eighty-nine first-dose 9vHPV vaccines (of the 3-dose series) were
administered to young adults aged 18-26 during the project period (November
15, 2017, through March 31, 2018); none were administered during the
pre-intervention phase. Of 89 patients who received a first 9vHPV vaccine
dose, 20 patients also received a second 9vHPV vaccine dose. During the
project period, 166 doses of 9vHPV vaccine (first, second, or third doses)
were administered. Conclusion This pharmacist-led intervention led to an increase in the number of young
adult patients receiving their first dose of the 9vHPV vaccination series.
With the support of other health care providers, pharmacist-led initiatives
can expand vaccine-related health literacy and facilitate access to
immunization services.
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Affiliation(s)
| | | | | | | | - Carrie Cwiak
- 1365 Grady Health System, Atlanta, GA, USA.,23033 Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
| | - Melissa J Kottke
- 1365 Grady Health System, Atlanta, GA, USA.,23033 Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
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Ruiz-Sternberg ÁM, Moreira ED, Restrepo JA, Lazcano-Ponce E, Cabello R, Silva A, Andrade R, Revollo F, Uscanga S, Victoria A, Guevara AM, Luna J, Plata M, Dominguez CN, Fedrizzi E, Suarez E, Reina JC, Ellison MC, Moeller E, Ritter M, Shields C, Cashat M, Perez G, Luxembourg A. Efficacy, immunogenicity, and safety of a 9-valent human papillomavirus vaccine in Latin American girls, boys, and young women. Papillomavirus Res 2018; 5:63-74. [PMID: 29269325 PMCID: PMC5887018 DOI: 10.1016/j.pvr.2017.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/11/2017] [Accepted: 12/15/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND A 9-valent human papillomavirus (HPV6/11/16/18/31/33/45/52/58; 9vHPV) vaccine was developed to expand coverage of the previously developed quadrivalent (HPV6/11/16/18; qHPV) vaccine. METHODS Efficacy, immunogenicity, and safety outcomes were assessed in Latin American participants enrolled in 2 international studies of the 9vHPV vaccine, including a randomized, double-blinded, controlled with qHPV vaccine, efficacy, immunogenicity, and safety study in young women aged 16-26 years, and an immunogenicity and safety study in girls and boys aged 9-15 years. Participants (N=5312) received vaccination at Day 1, Month 2, and Month 6. Gynecological swabs were collected regularly in young women for cytological and HPV DNA testing. Serum was analyzed for HPV antibodies in all participants. Adverse events (AEs) were also monitored in all participants. RESULTS The 9vHPV vaccine prevented HPV 31-, 33-, 45-, 52-, and 58-related high-grade cervical, vulvar, and vaginal dysplasia with 92.3% efficacy (95% confidence interval 54.4, 99.6). Anti-HPV6, 11, 16, and 18 geometric mean titers at Month 7 were similar in the 9vHPV and qHPV vaccination groups. Anti-HPV antibody responses following vaccination were higher among girls and boys than in young women. Most (>99%) 9vHPV vaccine recipients seroconverted for all 9 HPV types at Month 7. Antibody responses to the 9 HPV types persisted over 5 years. The most common AEs were injection-site related, mostly of mild to moderate intensity. CONCLUSIONS The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Latin American young women, girls, and boys. These data support 9vHPV vaccination programs in Latin America, a region with substantial cervical cancer burden.
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Affiliation(s)
| | - Edson D Moreira
- Associação Obras Sociais Irmã Dulce and Oswaldo Cruz Foundation, Brazilian Ministry of Health, Bahia, Brazil
| | | | - Eduardo Lazcano-Ponce
- Research Center on Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | - Rosires Andrade
- Departamento de Tocoginecologia da Universidade Federal do Paraná, Curitiba, Brazil
| | - Francisco Revollo
- Centro de Investigaciones, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Santos Uscanga
- Arké Estudios Clínicos S.A. de C.V., Mexico City, Mexico
| | - Alejandro Victoria
- Department of Obstetrics and Gynecology, Fundacion Valle del Lili, Cali, Colombia
| | | | - Joaquín Luna
- Departamento de Ginecología y Obstetricia Clínica Colsanitas, Fundación Universitaria Sanitas, Bogotá, Colombia
| | - Manuel Plata
- Department of Gynecology, Fundación Cardioinfantil, Bogotá, Colombia
| | | | - Edison Fedrizzi
- Department of Gynecology and Obstetrics, University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eugenio Suarez
- Gynecological Oncology Division Hospital Clinico San Borja Arriaran Universidad de Chile Campus Centro, Santiago, Chile
| | - Julio C Reina
- Department of Pediatrics, Universidad del Valle and Centro Medico Imbanaco, Cali, Colombia
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Moreira ED, Giuliano AR, de Hoon J, Iversen OE, Joura EA, Restrepo J, Van Damme P, Vandermeulen C, Ellison MC, Krick A, Shields C, Heiles B, Luxembourg A. Safety profile of the 9-valent human papillomavirus vaccine: assessment in prior quadrivalent HPV vaccine recipients and in men 16 to 26 years of age. Hum Vaccin Immunother 2017; 14:396-403. [PMID: 29211620 PMCID: PMC5806635 DOI: 10.1080/21645515.2017.1403700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 9-valent HPV (9vHPV) vaccine has been developed to protect against HPV type 6/11/16/18/31/33/45/52/58-related infection and disease. Previous safety analyses from 7 clinical trials conducted in 9vHPV vaccine recipients 9–26 years of age, including comparisons of 9vHPV and quadrivalent HPV (qHPV) vaccines in girls and women 16–26 years of age, showed that the 9vHPV vaccine was generally well tolerated. Additional safety analyses were conducted to include the results of new clinical studies. The safety profile of the 9vHPV vaccine in prior qHPV vaccine recipients (n = 3756 from 1 randomized controlled trial and 2 open-label extension studies) and young men (n = 248 9vHPV and n = 248 qHPV vaccine recipients from 1 randomized controlled trial) was evaluated. Vaccine was administered as a 3-dose regimen (at Day 1 and Months 2 and 6), and adverse events (AEs) were monitored. The most common AEs were injection-site events (91.1% and 79.0% in prior qHPV vaccine recipients and young men, respectively), the majority of which were mild. Discontinuations due to an AE were rare (0.2% and 0.0% among prior qHPV vaccine recipients and young men, respectively). In young men, the AE profile of the 9vHPV vaccine was generally similar to that of the qHPV vaccine. Overall, the 9vHPV vaccine was generally well tolerated in prior qHPV vaccine recipients and in young men, with an AE profile generally consistent with that previously reported with the broader clinical program.
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Affiliation(s)
- E D Moreira
- a Centro de Pesquisa Clínica, Associação Obras Sociais Irmã Dulce and Oswaldo Cruz Foundation, Brazilian Ministry of Health , Salvador , Bahia , Brazil
| | - A R Giuliano
- b Department of Cancer Epidemiology , Center for Infection Research (CIRC), Moffitt Cancer Center , Tampa , Florida , USA
| | - J de Hoon
- c Center for Clinical Pharmacology, Department of Pharmaceutical and Pharmacological Sciences , KU Leuven , Leuven , Belgium
| | - O-E Iversen
- d Department of Clinical Science , University of Bergen/Womens Clinic, Haukeland University Hospital , Bergen , Norway
| | - E A Joura
- e Department of Gynecology , Comprehensive Cancer Center, Medical University of Vienna , Vienna , Austria
| | - J Restrepo
- f Fundación Centro de Investigación Clínica CIC , Medellín , Colombia
| | - P Van Damme
- g University of Antwerp, Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination , Antwerp , Belgium
| | - C Vandermeulen
- h Leuven University Vaccinology Center, Department of Pharmaceutical and Pharmacological Sciences , KU Leuven , Leuven , Belgium
| | - M C Ellison
- i Merck & Co. Inc., Kenilworth , New Jersey , USA
| | - A Krick
- i Merck & Co. Inc., Kenilworth , New Jersey , USA
| | - C Shields
- i Merck & Co. Inc., Kenilworth , New Jersey , USA
| | - B Heiles
- i Merck & Co. Inc., Kenilworth , New Jersey , USA
| | - A Luxembourg
- i Merck & Co. Inc., Kenilworth , New Jersey , USA
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