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Brewington MK, Queen TL, Heisler-MacKinnon J, Calo WA, Weaver S, Barry C, Kong WY, Kennedy KL, Shea CM, Gilkey MB. Who are vaccine champions and what implementation strategies do they use to improve adolescent HPV vaccination? Findings from a national survey of primary care professionals. Implement Sci Commun 2024; 5:28. [PMID: 38520032 PMCID: PMC10958944 DOI: 10.1186/s43058-024-00557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Implementation science researchers often cite clinical champions as critical to overcoming organizational resistance and other barriers to the implementation of evidence-based health services, yet relatively little is known about who champions are or how they effect change. To inform future efforts to identify and engage champions to support HPV vaccination, we sought to describe the key characteristics and strategies of vaccine champions working in adolescent primary care. METHODS In 2022, we conducted a national survey with a web-based panel of 2527 primary care professionals (PCPs) with a role in adolescent HPV vaccination (57% response rate). Our sample consisted of pediatricians (26%), family medicine physicians (22%), advanced practice providers (24%), and nursing staff (28%). Our survey assessed PCPs' experience with vaccine champions, defined as health care professionals "known for helping their colleagues improve vaccination rates." RESULTS Overall, 85% of PCPs reported currently working with one or more vaccine champions. Among these 2144 PCPs, most identified the champion with whom they worked most closely as being a physician (40%) or nurse (40%). Almost all identified champions worked to improve vaccination rates for vaccines in general (45%) or HPV vaccine specifically (49%). PCPs commonly reported that champion implementation strategies included sharing information (79%), encouragement (62%), and vaccination data (59%) with colleagues, but less than half reported that champions led quality improvement projects (39%). Most PCPs perceived their closest champion as being moderately to extremely effective at improving vaccination rates (91%). PCPs who did versus did not work with champions more often recommended HPV vaccination at the earliest opportunity of ages 9-10 rather than later ages (44% vs. 33%, p < 0.001). CONCLUSIONS Findings of our national study suggest that vaccine champions are common in adolescent primary care, but only a minority lead quality improvement projects. Interventionists seeking to identify champions to improve HPV vaccination rates can expect to find them among both physicians and nurses, but should be prepared to offer support to more fully engage them in implementing interventions.
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Affiliation(s)
- Micaela K Brewington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tara L Queen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer Heisler-MacKinnon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Sandra Weaver
- UNC Family Medicine and Pediatrics, UNC Health, Chapel Hill, NC, USA
| | | | - Wei Yi Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathryn L Kennedy
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Christopher M Shea
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Giuliano AR, Palefsky JM, Goldstone SE, Dubin B, Saah A, Luxembourg A, Velicer C, Tota JE. High Risk of New HPV Infection Acquisition Among Unvaccinated Young Men. J Infect Dis 2024; 229:707-718. [PMID: 38012959 PMCID: PMC10938197 DOI: 10.1093/infdis/jiad485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/28/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND International data on anogenital HPV infection incidence among men are limited. METHODS Incidence of incident-persistent (IP) anogenital HPV infections was evaluated among 295 men who have sex with men (MSM) and 1576 heterosexual men (HM) aged 16-27 years in the placebo arm of a global, multicenter 4-valent (4v) HPV vaccine trial. We estimated IP incidence (penile/scrotal, perineal/perianal, anal) for 4vHPV and 9-valent (9v) HPV vaccine types and cumulative IP incidence over 36 months. RESULTS IP infection incidence per 100 person-years (95% CI) among HM for 4vHPV and 9vHPV types was 4.1 (3.5-4.9) and 6.8 (5.9-7.6) at penile/scrotal, and 1.2 (.8-1.6) and 1.9 (1.5-2.4) at perineal/perianal sites, respectively; and among MSM, IP infection incidence was 2.3 (1.3-3.8) and 3.2 (2.0-4.9) at penile/scrotal, 6.8 (4.9-9.2) and 9.0 (6.9-11.6) at perineal/perianal, and 12.0 (9.4-15.1) and 16.8 (13.7-20.2) at anal sites, respectively. Cumulative IP incidence over 36 months (excluding anal canal; any 9vHPV type) was higher among MSM versus HM (24.1% vs 18.4%). CONCLUSIONS A substantial proportion of unvaccinated men of catch-up vaccination age developed IP 9vHPV-related infections. Gender-neutral vaccination could decrease male HPV infection, contribute to herd protection, and reduce disease burden. Clinical Trials Registration. NCT00090285.
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Affiliation(s)
- Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida, USA
| | - Joel M Palefsky
- University of California SanFrancisco, San Francisco, California, USA
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3
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Mirhassani R, Seyedjafari E, Vaziri B. A validated polyclonal antiserum-based immunoassay for assessment of HPV 16 L1 relative potency. Biologicals 2024; 85:101742. [PMID: 38340596 DOI: 10.1016/j.biologicals.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/28/2022] [Accepted: 12/16/2023] [Indexed: 02/12/2024] Open
Abstract
Vaccine potency is typically evaluated using an assay that acts as a surrogate for biological activity. Although in vivo vaccines better represent human immunological responses, in vitro assays are preferred due to lower variability, higher throughput, easier validation and ethical considerations. In in vitro determination of Human Papillomavirus (HPV), Virus-like particle (VLP) vaccine potency currently depends on monoclonal antibody assays. However, these reagents are hard to obtain and currently are not available commercially. In this work, a polyclonal antiserum-based immunoassay was developed to evaluate the relative potency of Alhydrogel formulated HPV 16 VLPs. The repeatability and specificity were evaluated, and found that the assay was sensitive to small amounts of non-VLP HPV 16 L1 proteins. Finally, the assay was tested in comparison to the mouse effective dose 50 (ED50) assay on a limited number of batches. The agreement between these results suggests this test as a suitable surrogate for the in vivo test.
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Affiliation(s)
- Reihaneh Mirhassani
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
| | - Ehsan Seyedjafari
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran.
| | - Behrouz Vaziri
- Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.
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Saxena K, Kathe N, Sardana P, Yao L, Chen YT, Brewer NT. HPV vaccine initiation at 9 or 10 years of age and better series completion by age 13 among privately and publicly insured children in the US. Hum Vaccin Immunother 2023; 19:2161253. [PMID: 36631995 DOI: 10.1080/21645515.2022.2161253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The US Advisory Committee on Immunization Practice recommends routine human papillomavirus (HPV) vaccination at 11-12 years of age, but states that vaccination may be initiated as early as 9 years. Our primary goal was to assess whether initiating HPV vaccination at 9-10 years of age, compared to 11-12, was associated with a higher rate of series completion by 13 years of age, and to identify factors associated with series completion by age 13. The study used vaccine claims and other data from the IBM MarketScan Commercial Claims and Encounters (privately insured) and IBM MarketScan Multi-State Medicaid (publicly insured) databases. Participants were 9-12 years of age and initiated HPV vaccination between January 2006 and December 2018 (publicly insured) or February 2019 (privately insured). Among 100,117 privately insured individuals, those initiating the HPV vaccination series at 9-10 years of age had a significantly higher series completion rate by 13 years of age than did those initiating at 11-12 years of age (76.2% versus 48.1%; p < .001). The same pattern was observed for 115,863 publicly insured individuals (70.4% versus 40.0%; p < .001). Provider and health care plan type, female sex, race/ethnicity, and wellness checks or non-HPV vaccinations during the baseline period were significantly associated with series completion by 13 years of age. Proactive initiation of HPV vaccination at 9-10 years of age was associated with higher rates of series completion by 13 years of age. These findings can inform provider education and other interventions to encourage timely HPV vaccination series completion.
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Buttà M, Serra N, Panzarella V, Fasciana TMA, Campisi G, Capra G. Orogenital Human Papillomavirus Infection and Vaccines: A Survey of High- and Low-Risk Genotypes Not Included in Vaccines. Vaccines (Basel) 2023; 11:1466. [PMID: 37766142 PMCID: PMC10535452 DOI: 10.3390/vaccines11091466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Knowledge of human papillomavirus transmission from the genital tract to the oral mucosa remains unsatisfactory, with poor and often inconsistent literature results. The increase in HPV-associated oral malignancies prompts further analysis of the simultaneous detection of the virus in the two anatomical areas and on the identification of genotypes to be included in future vaccines. Therefore, in this retrospective study, we evaluated orogenital HPV concurrence, hrHPV, lrHPV and type-concordance in 337 samples, as well as the prevalence of the most common genotypes not included in HPV vaccines. Concurrence was found in 12.5% (31/248) of cases, hr-concordance in 61.3% (19/31) and lr-concordance in 12.9% (4/31). Finally, type-concordance was found in 32.3% (10/31) of concurrent infections. Regarding the identification of non-vaccine genotypes, the significantly prevalent genotypes in the anogenital area were HPV66 (12.6%, p < 0.0001), HPV53 (11.1%, p < 0.0001), HPV51 (8.7%, p < 0.0001), HPV42 (8.2%, p < 0.0001) and HPV68 (5.6%, p = 0.0034) in women and HPV66 (14.6%, p = 0.0058), HPV42 (12.2%, p = 0.0428), HPV51 (12.2%, p = 0.0428), HPV53 (12.2%, p = 0.0428), HPV70 (12.2%, p = 0.0428) and HPV73 (12.2%, p = 0.0428) in men. Considering the results of our study, we recommend including the high-risk genotypes HPV51, HPV68, HPV53 and HPV66 in future HPV vaccine formulations.
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Affiliation(s)
- Michela Buttà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (M.B.); (T.M.A.F.)
- Department of Surgical, Oncological and Oral Sciences (Dichirons), University of Palermo, 90133 Palermo, Italy; (V.P.); (G.C.)
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, 80138 Napoli, Italy;
| | - Vera Panzarella
- Department of Surgical, Oncological and Oral Sciences (Dichirons), University of Palermo, 90133 Palermo, Italy; (V.P.); (G.C.)
| | - Teresa Maria Assunta Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (M.B.); (T.M.A.F.)
- Microbiology and Virology Unit, Polyclinic Hospital “P. Giaccone”, 90133 Palermo, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences (Dichirons), University of Palermo, 90133 Palermo, Italy; (V.P.); (G.C.)
- Oral Medicine with Dentistry for Fragile Patients Unit, Polyclinic Hospital “P. Giaccone”, 90133 Palermo, Italy
| | - Giuseppina Capra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (M.B.); (T.M.A.F.)
- Microbiology and Virology Unit, Polyclinic Hospital “P. Giaccone”, 90133 Palermo, Italy
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Ferreccio C. How Did We Get Here: The Best Vaccines Ever Facing the Highest Public Hesitancy? Vaccines (Basel) 2023; 11:1323. [PMID: 37631891 PMCID: PMC10458189 DOI: 10.3390/vaccines11081323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
mRNA vaccine technology is the most interesting final product of decades of research. This new platform for public health is simple to transfer to low-income countries and can be used against diverse agents, including cancer. It is environmentally clean, relatively low-cost, and does not use animals for its production. Most importantly, mRNA vaccines have been highly efficacious in avoiding serious disease and death from COVID-19. Yet, at the highest point of the pandemic, many voices, including some from prominent positions, opposed their use. Similarly, the Human Papillomavirus (HPV) vaccines, which are highly effective, very safe, and probably confer long life protection against its HPV types, faced strong parents' hesitancy. Vaccine hesitancy has been the subject of extensive research, focusing primarily on factors associated with the public, the political environment, and messaging strategies. However, the issue of unfair worldwide access to the COVID-19 vaccines has recently sparked significant debate about the vaccine industry's role. Recent data demonstrated that the system's perceived unfairness with the masses is behind the growing populist anti-vaccine movements worldwide. The association between populism and antivaccine attitudes has been reported at country and individual levels. The anti-science attitudes behind vaccine hesitancy emerge when the scientist is not found credible due to the suspicion that they had monetary investments in pharmaceutical companies. Here, I argue that the obscurity of the vaccine market, but also its unfairness, are important factors contributing to vaccine hesitancy. The purpose of this commentary is to stimulate a review of current market regulations and to improve its transparency and fairness, particularly in the context of public health emergencies. By doing so, a new pandemic would find us better prepared. The general population and much of the healthcare community often ignore the years of dedicated work and substantial public funding that enabled the discovery and design of vaccines. Conversely, pharmaceutical companies often over-emphasize their investments in research and development. A decade ago, Marcia Angell provided a detailed breakdown of pharmaceutical expenses, revealing that marketing and administration costs were 2.5 times higher than research and development expenses; recently, Olivier Wouters confirmed the high expenditures of the pharmaceutical industry in lobbying and political campaign contributions. In this commentary, I will present the cases of HPV and COVID-19 vaccines as examples of when vaccines, instead of being public health goods, became market goods, creating large inequities and health costs. This failure is a structural cause behind more ideological vaccine hesitancy, less studied so far.
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Affiliation(s)
- Catterina Ferreccio
- Advanced Center for Chronic Diseases (ACCDIS), School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 362, Santiago 8330077, Chile
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Cappelletti-Montano B, Demuru G, Laconi E, Musio M. A comparative analysis on serious adverse events reported for COVID-19 vaccines in adolescents and young adults. Front Public Health 2023; 11:1145645. [PMID: 37377545 PMCID: PMC10291619 DOI: 10.3389/fpubh.2023.1145645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
This study aims to assess the safety profile of COVID-19 vaccines (mRNA and viral vector vaccines) in teenagers and young adults, as compared to Influenza and HPV vaccines, and to early data from Monkeypox vaccination in United States. Methods We downloaded data from the Vaccine Adverse Event Reporting System (VAERS) and collected the following Serious Adverse Events (SAEs) reported for COVID-19, Influenza, HPV and Monkeypox vaccines: deaths, life-threatening illnesses, disabilities, hospitalizations. We restricted our analysis to the age groups 12-17 and 18-49, and to the periods December 2020 to July 2022 for COVID-19 vaccines, 2010-2019 for Influenza vaccines, 2006-2019 for HPV vaccines, June 1, 2022 to November 15, 2022 for Monkeypox vaccine. Rates were calculated in each age and sex group, based on an estimation of the number of administered doses. Results Among adolescents the total number of reported SAEs per million doses for, respectively, COVID-19, Influenza and HPV vaccines were 60.73, 2.96, 14.62. Among young adults the reported SAEs rates for, respectively, COVID-19, Influenza, Monkeypox vaccines were 101.91, 5.35, 11.14. Overall, the rates of reported SAEs were significantly higher for COVID-19, resulting in a rate 19.60-fold higher than Influenza vaccines (95% C.I. 18.80-20.44), 4.15-fold higher than HPV vaccines (95% C.I. 3.91-4.41) and 7.89-fold higher than Monkeypox vaccine (95% C.I. 3.95-15.78). Similar trends were observed in teenagers and young adults with higher Relative Risks for male adolescents. Conclusion The study identified a risk of SAEs following COVID-19 vaccination which was markedly higher compared to Influenza vaccination and substantially higher compared to HPV vaccination, both for teenagers and young adults, with an increased risk for the male adolescents group. Initial, early data for Monkeypox vaccination point to significantly lower rates of reported SAEs compared to those for COVID-19 vaccines. In conclusion these results stress the need of further studies to explore the bases for the above differences and the importance of accurate harm-benefit analyses, especially for adolescent males, to inform the COVID-19 vaccination campaign.
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Affiliation(s)
| | - Giuseppe Demuru
- Department of Mathematics and Computer Sciences, University of Cagliari, Cagliari, Italy
| | - Ezio Laconi
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Monica Musio
- Department of Mathematics and Computer Sciences, University of Cagliari, Cagliari, Italy
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8
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Okuhara T, Kagawa Y, Okada H, Tsunezumi A, Kiuchi T. Intervention studies to encourage HPV vaccination using narrative: A scoping review. Patient Educ Couns 2023; 111:107689. [PMID: 36868003 DOI: 10.1016/j.pec.2023.107689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/23/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This review aimed to provide an overview of intervention studies that aimed to encourage HPV vaccination using narratives. METHODS We searched MEDLINE, CINAHL, PsycINFO, and PsycARTICLES for English language articles that quantitatively examined the persuasive effect of narratives on encouraging HPV vaccination through interventions. RESULTS A total of 25 studies were identified. Most studies were conducted in the United States of America, adopted a convenient sampling of university students, measured vaccination intention as the primary outcome, and used text messages in the interventions. A minority of the studies measured vaccination behavior and examined the long-term effects of persuasion. Narratives were as effective as didactics and statistics in encouraging HPV vaccination in most included studies. The findings were mixed or scarce for the effect of combining narratives and statistics, and the person (the first vs. third), narrator, framing, and content of narratives. CONCLUSION More findings from a broader range of well-designed studies are needed to determine which narratives can encourage HPV vaccination across different populations. PRACTICE IMPLICATIONS Findings indicated using narratives can be a part of repertoire of messages encouraging HPV vaccination.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Yumi Kagawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Aiko Tsunezumi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
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9
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Gidengil CA, Parker AM, Markowitz LE, Gedlinske AM, Askelson NM, Petersen CA, Meites E, Lindley MC, Scherer AM. Health care provider knowledge around shared clinical decision-making regarding HPV vaccination of adults aged 27-45 years in the United States. Vaccine 2023; 41:2650-2655. [PMID: 36990828 PMCID: PMC10337214 DOI: 10.1016/j.vaccine.2023.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The Advisory Committee on Immunization Practices (ACIP) recommends shared clinical decision-making (SCDM) regarding HPV vaccination for adults aged 27-45 years who are not adequately vaccinated. The objective of this survey was to understand physician knowledge, attitudes, and practices regarding HPV vaccination in this age group. METHODS An online survey was administered in June 2021 to physicians who reported practicing internal medicine, family medicine, or obstetrics and gynecology (targeted N = 250 in each practice specialty), selected randomly from potentially eligible physicians from a panel of 2 million U.S. health care providers. RESULTS In total, 753 physicians participated in the survey: 33.3% practiced internal medicine, 33.1% practiced family medicine, and 33.6% practiced obstetrics/gynecology; 62.5% were male and mean physician age was 52.7 years. Despite the COVID-19 pandemic, at least a third of participating physicians in each practice specialty reported having more HPV vaccine SCDM discussions with patients aged 27-45 years in the past 12 months. While a majority of physicians (79.7%) reported being aware of the SCDM recommendation for adults in this age group, only half of physicians answered an objective knowledge question about SCDM recommendations correctly. CONCLUSIONS Findings suggest that there are physician knowledge gaps related to SCDM for HPV vaccination. To improve access to HPV vaccination for people most likely to benefit, increasing availability and use of decision aids to support SCDM discussions might help healthcare providers and patients jointly make the most informed decisions about HPV vaccination.
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Affiliation(s)
| | | | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Megan C Lindley
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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10
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Sypień P, Marek W, Zielonka TM. Awareness and Attitude of Polish Gynecologists and General Practitioners towards Human Papillomavirus Vaccinations. Healthcare (Basel) 2023; 11:healthcare11081076. [PMID: 37107910 PMCID: PMC10137407 DOI: 10.3390/healthcare11081076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Human papillomavirus (HPV) leads to diseases of the skin and mucous membranes of the anogenital and upper gastrointestinal tract, especially neoplasia. HPV vaccinations effectively protect against the development of HPV-related diseases. However, despite the wide availability of vaccination for patients, only a few percent of Polish children are vaccinated. The reasons for this are certainly complex. Therefore, the aim of the study was to evaluate gynecologists' and general practitioners' knowledge, awareness and attitudes towards HPV vaccination and analyze their opinions about the interest in HPV vaccinations among children and parents. An anonymous, voluntary, cross-sectional survey study was conducted among 300 Polish gynecologists and general practitioners. Participants were from a diverse group with a wide range of work experience and different workplaces. Most of the respondents (83%), especially the gynecologists (p = 0.03), declared informing and discussing with parents the HPV-related diseases and prevention methods. Only 8% of the participants reported a negative reaction from parents when talking about HPV vaccines. However, in practice, physicians very rarely recommend this vaccine. HPV vaccination was recommended more often by female physicians (p = 0.03), general practitioners (p < 0.001), physicians working over five years (p < 0.001), doctors who regularly vaccinated themselves against influenza (p = 0.01) and those who vaccinated their children against HPV (p =0.001). The availability of educational materials for parents and/or patients encouraged physicians to provide this information (p < 0.001). Polish gynecologists and general practitioners declared a positive attitude regarding HPV vaccines; however, they rarely recommended this vaccine. Physicians who vaccinate themselves against influenza and their own children against HPV are more likely to provide information and encourage HPV vaccination in others. Additionally, the availability of educational material for parents and adolescents plays an essential role in the popularization of this vaccination. Knowledge alone is not enough for physicians to recommend the vaccination to patients.
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Affiliation(s)
- Piotr Sypień
- Sebastian Petrycy Health Care Facility, 33-200 DąbrowaTarnowska, Poland
| | - Weronika Marek
- Department of Obstetrics and Gynecology, Jagiellonian University Medical College, 31-501 Cracow, Poland
| | - Tadeusz M Zielonka
- Department of Family Medicine, Medical University of Warsaw, 02-005 Warsaw, Poland
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11
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Wang H, Wang X, Chen P, Xu H, Liu Y, Kang R, Zheng L, Sun X, Sun X, Zhang S. Effect of Health Intervention via Web-Based Education on Improving Information-Motivation-Behavioral Skills Related to HPV Vaccination Among Chinese Female College Students. Int J Public Health 2023; 68:1605596. [PMID: 36816834 PMCID: PMC9935583 DOI: 10.3389/ijph.2023.1605596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Objectives: The human papillomavirus (HPV) vaccination rate is generally low in China. This study aimed to assess the effect of web-based education on improving information-motivation-behavior skills related to HPV vaccination among Chinese female college students. Methods: From February to May 2020, female students were recruited from a university and divided into intervention and control groups. The intervention group received 7 days of HPV-related web-based education. Related information were collected using questionnaires in the baseline, 7 days, 1 month, and 3 months after the intervention. Chi-square test and repeated ANOVA were used to compare the differences between the two groups in the four surveys. Results: A total of 449 students (235 in the intervention and 214 in the control group) were included in the analysis. There were no statistical differences in demographic information between the two groups. Compared with the control group, students in the intervention group showed a richer knowledge and subjective norms of HPV vaccination (p < 0.05). Conclusion: The study provides preliminary support for a health intervention via web-based education in increasing HPV vaccination information among female college students.
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Affiliation(s)
- Hong Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xiaoyang Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Peipei Chen
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Huifang Xu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Yin Liu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Ruihua Kang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Liyang Zheng
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xingyuan Sun
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xibin Sun
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
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12
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Osaghae I, Darkoh C, Chido-Amajuoyi OG, Chan W, Padgett Wermuth P, Pande M, Cunningham SA, Shete S. Healthcare Provider's Perceived Self-Efficacy in HPV Vaccination Hesitancy Counseling and HPV Vaccination Acceptance. Vaccines (Basel) 2023; 11:300. [PMID: 36851178 PMCID: PMC9965421 DOI: 10.3390/vaccines11020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND HPV vaccine hesitancy is a key contributor to the sub-optimal HPV vaccination uptake in the United States. We aimed to determine the association between healthcare providers' self-efficacy in HPV vaccination hesitancy counseling and HPV vaccination acceptance after initial and follow-up counseling sessions. METHODS Population-based cross-sectional study of healthcare providers (HCPs) practicing in Texas. Logistic regression analyses were used to determine the odds of HPV vaccination acceptance by vaccine-hesitant patients. Additionally, generalized estimating equations were used to compare HPV vaccination acceptance by hesitant patients after follow-up versus initial counseling sessions. RESULTS 1283 HCPs completed the survey with a mean (SD) age of 47.1 (11.3) years. HCPs who believed that they were very/completely confident in counseling HPV-vaccine-hesitant parents had higher odds of observing HPV vaccination acceptance very often/always after an initial counseling session (adjusted odds ratio (AOR): 3.50; 95% CI: 2.25-5.44) and after follow-up counseling sessions (AOR: 2.58; 95% CI: 1.66-4.00) compared to HCPs that perceived they were not at all/somewhat/moderately confident. The odds of HPV vaccination being accepted very often/always by vaccine-hesitant parents was 61% (AOR: 1.61; 95% CI: 1.32-1.95) higher after follow-up counseling sessions compared to an initial counseling session. The results were similar for the counseling of HPV-vaccine-hesitant adult patients. CONCLUSIONS The confidence level of HCPs in counseling hesitant parents and adult patients impacts HPV vaccination acceptance. Importantly, acceptance was higher after follow-up counseling sessions than initial counseling sessions. HCPs should receive training in HPV vaccination counseling to enhance their confidence in counseling hesitant patients and should utilize every visit to counsel hesitant patients.
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Affiliation(s)
- Ikponmwosa Osaghae
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX 77030, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX 77030, USA
| | | | - Wenyaw Chan
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Paige Padgett Wermuth
- Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Mala Pande
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sonia A. Cunningham
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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13
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Froidevaux L, Fiorini-Bernasconi C, Campiche V, Gehri M, Jacto-Guillarmod M, Crisinel PA. School-based HPV Vaccination: Variation in Inter-school Vaccine Uptake not Influenced by the Introduction of a New Information Brochure. Asian Pac J Cancer Prev 2023; 24:249-255. [PMID: 36708574 PMCID: PMC10152852 DOI: 10.31557/apjcp.2023.24.1.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Switzerland, with an adolescent HPV vaccination coverage at 59%, remains far from reaching the crucial swiss national goal of 80% coverage. Our objective was to implement a new information brochure in schools to increase HPV vaccination uptake. METHODS We designed a public health quality project. A new information brochure was produced and was distributed to a test group of 9th grade students from the Canton of Vaud, in Switzerland during the 2019-2020 school year. Vaccine uptake of the test group was compared to those of all other students in 2019-2020 and of students in the same schools in 2017-2018. RESULTS 12,143 electronic records were analyzed. 713 students were enrolled in 6 schools where the new brochure was distributed. Median age was 13 years (IQR 12-13), and 6,031 (49.7%) were female. Vaccine uptake was 52% (6,299/12,143). The new brochure did not result in increased uptake. Age ≥ 13 years (aOR 1.39, 95% CI 1.22-1.58) was significantly associated with uptake. Uptake increased between 2017-2018 (51%, 3,216/6,307) and 2019-2020 (52.8%, 3,083/5,836, p=0.04) due to increased acceptance among boys. The only determinant of uptake in 2019-2020 was uptake in the same schools in 2017-2018. CONCLUSION The introduction of a new information brochure was insufficient to increase HPV vaccination coverage. More innovative strategies are needed.
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Affiliation(s)
| | - Cristina Fiorini-Bernasconi
- Specialized Education and Training Support Service, Health Promotion and prevention in Schools, Community Health Department of the Canton of Vaud, Lausanne, Vaud, Switzerland
| | - Valérie Campiche
- Specialized Education and Training Support Service, Health Promotion and prevention in Schools, Community Health Department of the Canton of Vaud, Lausanne, Vaud, Switzerland
| | - Mario Gehri
- Service of Pediatrics, Department Woman Mother Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Pierre Alex Crisinel
- Unit of Pediatric Infectious Diseases and Vaccinology, Department Women Mother Child, Lausanne University, Hospital and University of Lausanne, Lausanne, Switzerland
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Babi A, Issa T, Issanov A, Akhanova S, Udalova N, Koktova S, Balykov A, Sattarkyzy Z, Imankulova B, Kamzayeva N, Almawi WY, Aimagambetova G. Knowledge and attitudes of mothers toward HPV vaccination: A cross-sectional study in Kazakhstan. Womens Health (Lond) 2023; 19:17455057231172355. [PMID: 37184051 DOI: 10.1177/17455057231172355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Although recommended for all member states of World Health Organization, there is no national human papillomavirus vaccination program in Kazakhstan. Furthermore, there are no studies in Kazakhstan that evaluate the mothers' perception of human papillomavirus vaccines. OBJECTIVES This study aims to assess the knowledge and attitudes toward human papillomavirus vaccination among mothers in Kazakhstan and the factors associated with their attitudes. DESIGN A cross-sectional study was performed during the period of December 2021-February 2022. The STROBE guideline for cross-sectional studies was applied. METHODS Paper-based structured questionnaires were filled out by 191 mothers, 141 of whom had daughters. The attitude score was assessed as per the Likert-type scale. The Chi-square and Fisher's exact tests, with a significance value of < 0.05 were used to analyze the relationships between the characteristics of mothers and their attitude scores. RESULTS The following factors were significantly associated with mothers' attitudes toward human papillomavirus vaccination: a place of residence, family income, number of children, and refusal of vaccination for themselves (p < 0.005). Of all participants, only 45% of all mothers, 41% of mothers with a female, and 46% of mothers with male children had positive attitudes toward human papillomavirus vaccination. The child's gender was not a significant determinant. Overall, the level of knowledge about human papillomavirus vaccination was found to be low. The median total score is 0 out of 12 for women who have negative and neutral attitudes toward human papillomavirus vaccines. Among women who have positive attitudes toward HPV vaccines, the median score is around 3 points. CONCLUSION Before the implementation of the human papillomavirus vaccination program into the Kazakhstani national vaccination calendar, comprehensive and adequate information and education campaigns are required on the national level for parents and the population in general.
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Affiliation(s)
- Aisha Babi
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Torgyn Issa
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Alpamys Issanov
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Sholpan Akhanova
- Obstetrics and Gynecology Department, "Keruen Medicus" Clinic, Almaty, Kazakhstan
| | - Natalya Udalova
- Obstetrics and Gynecology Department, East-Kazakhstan Regional Hospital, Oskemen, Kazakhstan
| | | | | | - Zhanna Sattarkyzy
- Obstetrics and Gynecology Department, City polyclinic #6, Astana, Kazakhstan
| | - Balkenzhe Imankulova
- Clinical Academic Department of Women's Health, CF University Medical Center, Astana, Kazakhstan
| | - Nazira Kamzayeva
- Clinical Academic Department of Women's Health, CF University Medical Center, Astana, Kazakhstan
| | - Wassim Y Almawi
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Faculty of Sciences, El-Manar University, Tunis, Tunisia
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15
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Osaghae I, Darkoh C, Chido-Amajuoyi OG, Chan W, Wermuth PP, Pande M, Cunningham SA, Shete S. Association of provider HPV vaccination training with provider assessment of HPV vaccination status and recommendation of HPV vaccination. Hum Vaccin Immunother 2022; 18:2132755. [PMID: 36265005 PMCID: PMC9746413 DOI: 10.1080/21645515.2022.2132755] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/15/2022] Open
Abstract
The delivery of strong HPV vaccine recommendations hinges on the expertise of healthcare providers (HCPs) in assessing patients' status and recommending HPV vaccination. We conducted a population-based cross-sectional study of HCPs practicing in Texas to examine the relationship between HPV vaccination training of HCPs and HPV vaccination status assessment and recommendation. Logistic regression analyses were used to assess the association between HCPs' formal training and recency of training in HPV vaccination promotion or counseling with HPV vaccination status assessment and recommendation. Of the 1,283 HCPs who completed the online survey, 43% had received training in HPV vaccination promotion or counseling, 47% often/always assess HPV vaccination status, and 59% often/always recommend HPV vaccination. Compared with HCPs who received no training, those who received training had over four times higher odds (adjusted odds ratio [AOR]: 4.32; 95% CI: 3.06-6.10) of often/always assessing HPV vaccination status and over three and half times higher odds (AOR: 3.66; 95% CI: 2.73-4.90) of often/always recommending HPV vaccination. Furthermore, HCPs who recently received HPV vaccination training had higher odds of HPV vaccination status assessment and recommendations than those without training. Hispanic HCPs had higher odds of often/always assessing HPV vaccination status and recommending vaccination than did non-Hispanic White HCPs. Also, nurses and physician assistants had lower odds of often/always assessing HPV vaccination status and recommending HPV vaccination than did physicians. Targeted and continuous training of HCPs in HPV vaccination promotion or counseling is needed to increase HPV vaccination status assessment, recommendation, and uptake rates.
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Affiliation(s)
- Ikponmwosa Osaghae
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | | | - Wenyaw Chan
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX, USA
| | - Paige Padgett Wermuth
- Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - Mala Pande
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sonia a Cunningham
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,CONTACT Sanjay Shete Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center1400 Pressler Dr. FCT4.6002, Houston, TX77030, USA
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16
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Suzuki T, Ota Y, Sakata N, Fujita N, Kamatsuka M, Nagashima K, Hirayama J, Fujita N, Shiga K, Oyama N, Terada Y, Nomura K. HPV vaccine intention among university students during suspension of active recommendation in Japan. Hum Vaccin Immunother 2022; 18:2116900. [PMID: 36108286 DOI: 10.1080/21645515.2022.2116900] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In Japan, active recommendation of the human papillomavirus vaccine was withheld between 2013 and 2021 due to adverse reaction reports. This resulted in low vaccine coverage with reports from less than 1%. This study aimed to investigate if knowledge and health-belief related factors associated with vaccine intention among young adolescents with the hope that our findings may be helpful in promotion campaigns. We recruited students in four colleges and universities in Akita Prefecture from 2020 to 2021 who had never been vaccinated. A total of 318 students (male 54%, mean age 21 years) responded to a self-administered questionnaire; only 6% reported immediate vaccine intention, and 61% reported no such intention or "do not know." The correct percentages of 20-item knowledge about HPV vaccine-related morbidity, mortality, and prevention were very low regardless of gender (average males 41.4% vs. females 39.6%). Multivariable logistic regression models demonstrated that in males, higher levels of literacy, perceived susceptibility, and place for vaccination (logistical barrier) were associated with HPV vaccine intention, whereas "no need now" was associated with less intention. In females, a higher level of knowledge was significantly associated with vaccine intention, whereas "concerns of adverse effects" were associated with less intention.
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Affiliation(s)
- Tomoya Suzuki
- School of Medicine, Faculty of Medicine, Akita University, Akita, Japan
| | - Yu Ota
- School of Medicine, Faculty of Medicine, Akita University, Akita, Japan
| | - Natsuya Sakata
- School of Medicine, Faculty of Medicine, Akita University, Akita, Japan
| | - Nozomi Fujita
- School of Medicine, Faculty of Medicine, Akita University, Akita, Japan
| | - Makoto Kamatsuka
- School of Medicine, Faculty of Medicine, Akita University, Akita, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Naoko Fujita
- Laboratory of Plant Physiology, Department of Biological Production, Faculty of Bioresource Science, Akita Prefectural University, Akita City, Akita, Japan
| | - Kuniko Shiga
- Department of Nursing, Faculty of Nursing, Japanese Red Cross Akita College of Nursing, Akita, Japan
| | - Noriaki Oyama
- Department of Gynecology, Akita Red Cross Hospital, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
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17
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Osaghae I, Darkoh C, Chido-Amajuoyi OG, Chan W, Padgett Wermuth P, Pande M, Cunningham SA, Shete S. HPV Vaccination Training of Healthcare Providers and Perceived Self-Efficacy in HPV Vaccine-Hesitancy Counseling. Vaccines (Basel) 2022; 10:vaccines10122025. [PMID: 36560435 PMCID: PMC9781563 DOI: 10.3390/vaccines10122025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
HPV vaccine hesitancy is a key barrier to HPV vaccination. Using a population-based survey of HCPs practicing in Texas we determined the association between formal training of HCPs and perceived self-efficacy in counseling HPV vaccine-hesitant parents and adult patients. A total of 1283 HCPs completed the survey, with 879 providing vaccination services to pediatric patients and 1018 providing vaccination services to adult patients. Among HCPs included in this study, 405 of 577 (70%) and 315 of 505 (62%) perceived they were very/completely confident in counseling HPV vaccine-hesitant parents and adult patients, respectively. Compared to HCPs who received no training, those who received formal training in HPV vaccination promotion or counseling had 2.56 (AOR: 2.56; 95% CI:1.69-3.86) and 2.84 times higher odds (AOR: 2.84; 95% CI:1.87-4.33) of perceiving that they were very/completely confident in counseling HPV vaccine-hesitant parents and adult patients, respectively. Additionally, increasing years of practice and volume of patients seen were positively associated with being very/completely confident in counseling HPV vaccine-hesitant parents and adult patients. On the other hand, nurses were less likely than physicians to be very/completely confident in counseling HPV vaccine-hesitant parents. To increase HPV vaccination uptake, HCPs should receive tailored training to improve their self-efficacy in addressing HPV vaccine-hesitancy.
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Affiliation(s)
- Ikponmwosa Osaghae
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX 77030, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX 77030, USA
| | | | - Wenyaw Chan
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX 75207, USA
| | - Paige Padgett Wermuth
- Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Mala Pande
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sonia A. Cunningham
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-(713)-745-2483; Fax: +1-(713)-563-4243
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18
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Brown DR, Castellsagué X, Ferris D, Garland SM, Huh W, Steben M, Wheeler CM, Saah A, Luxembourg A, Li S, Velicer C. Human papillomavirus seroprevalence and seroconversion following baseline detection of nine human papillomavirus types in young women. Tumour Virus Res 2022; 13:200236. [PMID: 35525430 PMCID: PMC9172167 DOI: 10.1016/j.tvr.2022.200236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 12/08/2021] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background Estimates of the humoral immune response to incident human papillomavirus (HPV) infections are limited. Methods In this post hoc analysis of 3875 women aged 16–23 years from a 4-valent HPV vaccine trial (NCT00092482), HPV seroprevalence on day 1 was measured with a 9-valent HPV (HPV 6/11/16/18/31/33/45/52/58) competitive Luminex immunoassay and compared with cervical/external genital HPV detection by polymerase chain reaction. In the control group, among women who were HPV DNA‒negative on day 1, seroconversion following initial HPV detection was estimated using Kaplan-Meier methods. Results Type-specific HPV seropositivity among women with no day 1 cervical/external genital HPV detection was 0.6%–3.6%. Women with any 9-valent HPV (9vHPV) cervical/external genital detection (796/3875; 20.5%) had concordant seropositivity ranging from 13.4% (HPV 45) to 38.5% (HPV 6). Among women in the control group who were negative for all HPV types on day 1, seroconversion by month 30 after initial detection ranged from 29% (HPV 45) to 75% (HPV 16). Conclusions Humoral immune response to HPV is variable and dynamic, depending on type-specific exposure. This longitudinal analysis provides insight into the relationship between incident infection and seropositivity. ClinicalTrials.gov; NCT00092482 https://clinicaltrials.gov/ct2/show/NCT00092482. Research on humoral immune responses to HPV infection are limited. HPV-related serologic responses were analyzed in women aged 16–23 years. Type-specific HPV seropositivity was low in women without initial HPV DNA detection. Concordant seropositivity in women with any 9vHPV DNA detection ranged from 13% to 40%. Seroconversion to the same genotype within 30 months of an infection was common.
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Affiliation(s)
- Darron R Brown
- Department of Medicine, Indiana University School of Medicine, Van Nuys Med Science Building, Suite 224, 635 Barnhill Drive, Indianapolis, IN, 46202, USA.
| | - Xavier Castellsagué
- Institut Catala D'Oncologia, IDIBELL, CIBERESP, L'Hospitalet de Llobregat, Granvia de L'Hospitalet 199-203, Barcelona, Catalonia, 08908, Spain
| | - Daron Ferris
- Clinica CerviCusco, Calle Los Saucos B-8-2, Larapa, Curco, Peru
| | - Suzanne M Garland
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Infection and Immunity, Murdoch Children's Research Institute, Department of Obstetrics and Gynaecology, The University of Melbourne, Murdoch Children's Research Institute, The Royal Women's Hospital, Locked Bag 300
- Corner Grattan Street and Flemington Road, Parkville, VIC, 3052, Australia
| | - Warner Huh
- Division of Gynecologic Oncology, University of Alabama, 1700 6th Avenue South, Birmingham, AL, 35233, USA
| | - Marc Steben
- Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, 1851 East Sherbrooke Street, Montréal, Quebec, H2K 4L5, Canada
| | - Cosette M Wheeler
- Departments of Pathology and Obstetrics and Gynecology, University of New Mexico Comprehensive Cancer Center, 1201 Camino de Salud NE, Albuquerque, NM, 87102, USA
| | - Alfred Saah
- Merck & Co., Inc., 126 E Lincoln Ave, Rahway, NJ, 07065, USA
| | | | - Se Li
- Merck & Co., Inc., 126 E Lincoln Ave, Rahway, NJ, 07065, USA
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Okuhara T, Okada H, Goto E, Tsunezumi A, Kagawa Y, Kiuchi T. Encouraging HPV Vaccination via an Evolutionary Theoretical Approach: A Randomized Controlled Study in Japan. Vaccines (Basel) 2022; 10:vaccines10050701. [PMID: 35632459 PMCID: PMC9143842 DOI: 10.3390/vaccines10050701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 02/15/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 02/01/2023] Open
Abstract
In recent years, researchers have discussed the introduction of an evolutionary perspective into public health and health behavior research. We aimed to examine the effects of messages that target the fundamental human motive of kin care on HPV vaccination recommendations among mothers with daughters, based on an evolutionary theoretical approach. This study consisted of a three-arm parallel-group single-blinded randomized controlled study. A web-based survey was conducted from 7 to 8 October 2021 in Japan. Mothers with daughters (n = 969) were randomly assigned either to a group that received an intervention message that targeted the fundamental motive of kin care, or that targeted the fundamental motive of disease avoidance, or a control message. Intention to have daughter(s) receive HPV vaccination was assessed both before and right after reading the messages. A one-way ANOVA with Tukey’s or Games−Howell test was conducted. An intervention message targeting the fundamental motive of kin care and disease avoidance significantly increased intention of vaccination versus a control message (p < 0.001, respectively). There was no significant difference between the two intervention groups. The evolutionary theoretical approach that focuses on fundamental human motives may have the potential to extend the communication strategy for HPV vaccination recommendations. Health professionals may be recommended to deliver messages that target the fundamental motive of kin care as well as messages about the susceptibility and severity of cervical cancer and vaccine efficacy (e.g., “Getting cervical cancer can prevent childbirth. To protect your daughter and your future grandchildren, get your daughter vaccinated against HPV”). However, the present study only evaluated HPV vaccination intentions in Japanese mothers with daughters. Future studies should evaluate vaccination behavior in a wider range of subjects to confirm that the evolutionary theoretical approach promotes HPV vaccination.
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Vujovich-Dunn C, Wand H, Brotherton JML, Gidding H, Sisnowski J, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Measuring school level attributable risk to support school-based HPV vaccination programs. BMC Public Health 2022; 22:822. [PMID: 35468743 PMCID: PMC9036743 DOI: 10.1186/s12889-022-13088-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/24/2022] [Indexed: 12/27/2022] Open
Abstract
Background In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation. Methods A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence). Results The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1–14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7–8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9–3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7–3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6–4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3–2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76–82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31–44) and lower attendance rate (PAR = 37%, 95%CI: 29–46). Conclusion This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13088-x.
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Affiliation(s)
- C Vujovich-Dunn
- University of New South Wales, Kirby Institute, Kensington, Australia.
| | - H Wand
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - J M L Brotherton
- Australian Centre for the Prevention of Cervical Cancer, Population Health, East Melbourne, Victoria, Australia.,University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - H Gidding
- University of Sydney, Northern Clinical School, Sydney, Australia.,Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia.,School of Population Health, University of New South Wales, Kensington, Australia.,National Centre for Immunisation Research and Surveillance, Sydney, Australia
| | - J Sisnowski
- University of New South Wales, Kirby Institute, Kensington, Australia.,Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia
| | - R Lorch
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - M Veitch
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - V Sheppeard
- Communicable Diseases Branch, NSW Health, St Leonards, New South Wales, Australia.,University of Sydney, Sydney School of Public Health, Camperdown, NSW, Australia
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - S R Skinner
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia
| | - C Davies
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.,Menzies School of Health Research, Charles Darwin University, Cairns, QLD, Australia
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Sydney, Australia.,University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, NSW, Australia
| | - K Canfell
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Smith
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - M Kang
- University of Sydney, Westmead Clinical School, Sydney, New South Wales, Australia
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, Bedford Park, South Australia, Australia
| | - S Burns
- Curtin University, School of Population Health, Bentley, WA, Australia
| | - L Selvey
- University of Queensland, School of Public Health, St Lucia, QLD, Australia
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - N Lane
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - J Kaldor
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - R Guy
- University of New South Wales, Kirby Institute, Kensington, Australia
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21
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Tota JE, Giuliano AR, Goldstone SE, Dubin B, Saah A, Luxembourg A, Velicer C, Palefsky JM. Anogenital Human Papillomavirus (HPV) Infection, Seroprevalence, and Risk Factors for HPV Seropositivity Among Sexually Active Men Enrolled in a Global HPV Vaccine Trial. Clin Infect Dis 2022; 74:1247-1256. [PMID: 34265048 DOI: 10.1093/cid/ciab603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In men, the incidence of human papillomavirus (HPV)-related cancer is rising, but data regarding male HPV infection and seroprevalence are available from only a few countries. METHODS This analysis of a global HPV vaccine trial evaluated baseline data from 1399 human immunodeficiency virus-negative heterosexual men (HM) and men who have sex with men (MSM). Key objectives included assessment of HPV prevalence and risk factors for seropositivity to 9-valent HPV (9vHPV) vaccine types (6, 11, 16, 18, 31, 33, 45, 52, and 58), and concordance between seropositivity and prevalent HPV type. RESULTS Overall, 455 of 3463 HM (13.1%) and 228 of 602 MSM (37.9%) were HPV DNA positive for any 9vHPV vaccine type at baseline. Infection prevalence and seroprevalence (≥1 9vHPV vaccine type) were 13.2% and 8.1%, respectively, among 333 HM from Europe, and 37.9% and 29.9%, respectively, among 335 MSM from Europe or North America. Among men with baseline infection, MSM had higher seroprevalence for concordant HPV types (39.5% vs 10.8% in HM). The seropositivity risk (irrespective of baseline infection status) was higher among MSM versus HM (age-adjusted odds ratio, 3.0 [95% confidence interval, 2.4-6.4]). Among MSM, statistically significant seropositivity risk factors included younger age at sexual debut, higher number of receptive anal sex partners, and less frequent condom use. No factors assessed were associated with seropositivity in HM. CONCLUSIONS Higher proportions of MSM than HM were HPV DNA positive and seropositive, and concordance between HPV DNA positivity and seropositivity, a potential marker of true infection versus carriage, was higher in MSM. Most MSM and HM were seronegative for all 9vHPV vaccine types, suggesting the potential benefit of catch-up vaccination after sexual debut.Clinical Trials Registration. NCT00090285.
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Affiliation(s)
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | | | | | | | | | - Joel M Palefsky
- Department of Infectious Diseases, University of California, San Francisco, San Francisco, California, USA
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22
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Abuduxike G, Asut O, Cali S, Vaizoglu S. Knowledge and Awareness of Parents Towards Human Papillomavirus (HPV) and HPV Vaccines, and Vaccine Acceptability in Northern Cyprus. J Prev (2022) 2022; 43:225-240. [PMID: 35286543 DOI: 10.1007/s10935-021-00657-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
The human papillomavirus (HPV) vaccine is one of the most cost-effective public health measures for preventing cervical cancer and other HPV-related diseases. However, the vaccine uptake in many countries remains suboptimal. This cross-sectional study aimed to assess the knowledge and awareness of parents towards HPV, related diseases, and HPV vaccines, as well as to examine the effect of brief educational information on parents' vaccine acceptability. We used a structured interviewer-administered questionnaire to collect information from 227 outpatient visitors to a healthcare center who had children under the age of 19 years. We asked parents again about their acceptance of HPV vaccines after being provided brief educational information. Of all the parents, 43% were aware of HPV and related diseases, and 59% of those had sufficient knowledge regarding HPV while 45% of them reported that they were aware of HPV vaccines. Being Northern Cypriot was a predictor of having good knowledge, whilst being a female, having a higher education level, being 35 years or older, and being employed were the significant predictors of having greater awareness of HPV and related diseases. The HPV vaccine acceptance of the parents increased substantially in all sociodemographic groups after the provision of the educational information. The findings demonstrated that the vaccination rates of children of parents who have insufficient knowledge and awareness of HPV and vaccines are also very low. Effective educational interventions based on the specific sociodemographic characteristics of the patients should be given a stronger focus to improve vaccine acceptability among this population.
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Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus.
| | - Ozen Asut
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Songul Vaizoglu
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
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23
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Silva TMRD, Nogueira de Sá ACMG, Beinner MA, Abreu MNS, Matozinhos FP, Sato APS, Vieira EWR. Impact of the COVID-19 Pandemic on Human Papillomavirus Vaccination in Brazil. Int J Public Health 2022; 67:1604224. [PMID: 35431762 PMCID: PMC9008128 DOI: 10.3389/ijph.2022.1604224] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: To analyze the number of applied HPV vaccine doses before (from April 2019 to March 2020) and after (from April 2020 to September 2020) social distancing measures in response to the COVID-19 pandemic in states and regions of Brazil. Methods: Ecological time-series study, using data from the Brazilian National Immunization Program (PNI). Using the Mann-Whitney test, we evaluated the difference between the median number of applied doses during the periods April 2019 to March 2020 and from April 2020 to September 2020. Spatial analysis identified clusters with a high or low percentage reduction in the median applied doses. Prais-Winsten regression models identified temporal trends in the applieddoses from both periods. Results: There was a significant reduction in the median HPV vaccine doses applied, formation of spatial clusters and, after a sharp drop in the number of applieddoses during the months following social distancing. There was a tendency to increase the applied vaccines doses. Conclusion: The COVID-19 pandemic resulted in reduction of the number of HPV vaccine doses applied as a possible effect of restrictive measures caused by the pandemic.
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Affiliation(s)
- Tércia Moreira Ribeiro Da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Mark Anthony Beinner
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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24
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Thanasas I, Lavranos G, Gkogkou P, Paraskevis D. The Effect of Health Education on Adolescents' Awareness of HPV Infections and Attitudes towards HPV Vaccination in Greece. Int J Environ Res Public Health 2022; 19:ijerph19010503. [PMID: 35010763 PMCID: PMC8744639 DOI: 10.3390/ijerph19010503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/30/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 02/04/2023]
Abstract
Background: The purpose of this paper is to evaluate the role of health education among young adolescents, regarding their level of knowledge about the HPV and the acceptance of the HPV vaccination, with the aim of increasing vaccination coverage, in Trikala city, mainland of Greece. Methods: This study included high school students from all public and private schools of Trikala city. Questionnaires related to knowledge regarding the HPV infection and HPV vaccination were administered in three phases. In the first phase of the study, the questionnaires were completed by the entire study population. During the second and third phases, the completion of the questionnaires concerned only the population that received the intervention (interactive seminars). The second and third phase questionnaires were completed immediately after the interactive seminar and three months later, respectively. The statistical analysis of the results was performed using IBM SPSS 20.0 statistical program. Results: A total of 434 female students completed the questionnaire (response rate 76.26%). Most participants (66.6%) were females. The questionnaires evaluated the respondents’ awareness of the HPV infection. The results show that the percentage of the participants who stated that they “do not know” what HPV is decreased from 44.4% (first phase), to 1.6% (second phase), and 8.1% (third phase). Similarly, the willingness to accept the HPV vaccine increased from 71% (first phase), to 89.1% (second phase), and 83.5% (third phase). Conclusions: The present study shows that targeted interactive informational interventions in the school environment leads to a statistically significant increase in both the level of knowledge about HPV and the willingness of young adolescent students to be vaccinated against cervical cancer.
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Affiliation(s)
- Ioannis Thanasas
- Department of Obstetrics & Gynecology, General Hospital in Trikala, 42100 Trikala, Greece
- Correspondence: ; Tel.: +30-243-1029-103 or +30-694-4766-469
| | - Giagkos Lavranos
- Department of Health Sciences, Medical School, European University Cyprus, 2404 Nicosia, Cyprus;
| | - Pinelopi Gkogkou
- Clinical Oncology Department, Norfolk and Norwich University Hospital, Norwich NR4 7UY, Norfolk, UK;
| | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
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25
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Horn S, Chapman GB, Chouhan K. Doctor recommendations and parents' HPV vaccination intentions in Kenya: A randomized survey. Prev Med Rep 2021; 25:101659. [PMID: 34917466 PMCID: PMC8666573 DOI: 10.1016/j.pmedr.2021.101659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 06/08/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023] Open
Abstract
The causal effect of a doctor’s recommendation for Human Papillomavirus (HPV) vaccination on parents’ decisions in low-resource settings is not well understood. This study investigates how doctors’ endorsement of the HPV vaccine communicated through a public health poster affects parents’ decisions to vaccinate their daughters in Kenya. In January and February 2021, 600 parents of daughters eligible for the HPV vaccine but not yet vaccinated were recruited and completed a randomized survey. Participants saw a poster from a national campaign about HPV vaccination and either nothing further (Control) or an additional poster containing an HPV vaccine recommendation from a female (FDR) or male doctor (MDR). Primary outcomes are intentions to vaccinate and perceived safety of the HPV vaccine. Both recommendation arms increased the likelihood that participants reported the highest levels of vaccine intentions compared to control (FDR: 33.7% p = 0.01; MDR: 30.5%, p = 0.05, compared to Control (22.4%)) and safety perceptions (FDR: 24.2%. p = 0.09; MDR: 28.0%, p = 0.01, compared to Control (17.1%)) but there was no statistically significant increase in the likelihood to report above moderate vaccine intentions (FDR: 72.6%, p = 0.76; MDR: 72.5%, p = 0.77, compared to Control (71.4%)) or safety perceptions (FDR: 68.9%, p = 0.91; MDR: 75.0%, p = 0.17, compared to Control (68.6%)). We find no differential treatment effect by the recommending doctor’s gender. In conclusion, our results suggest that visual communication of a doctor’s support for the HPV vaccine can strengthen above-moderate intentions and safety perceptions but may not be enough to persuade the vaccine hesitant to vaccinate.
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Affiliation(s)
- Samantha Horn
- Department of Social and Decision Sciences, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States
- Corresponding author.
| | - Gretchen B. Chapman
- Department of Social and Decision Sciences, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States
| | - Kriti Chouhan
- Busara Center for Behavioral Economics, 5th Floor, Daykio Plaza, Lane, Ngong Ln, Nairobi, Kenya
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26
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Giraldo PC, Sanches JM, Sparvolli LG, Amaral R, Migliorini I, Gil CD, Taddei CR, Witkin SS, Discacciati MG. Relationship between Papillomavirus vaccine, vaginal microbiome, and local cytokine response: an exploratory research. Braz J Microbiol 2021; 52:2363-71. [PMID: 34628621 DOI: 10.1007/s42770-021-00616-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 09/19/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION The influence of vaccination on composition of the human microbiome at distinct sites has been recognized as an essential component in the development of new vaccine strategies. The HPV vaccine is widely used to prevent cervical cancer; however, the influence of HPV vaccine on the vaginal microbiota has not been previously investigated. In his study, we performed an initial characterization of the microbiome and cytokine composition in the vagina following administration of the bivalent vaccine against HPV 16/18. MATERIAL AND METHODS In this exploratory study, fifteen women between 18 and 40 years received three doses of the HPV-16/18 AS04-adjuvanted vaccine (Cervarix®). Cervicovaginal samples were collected before the first dose and 30 days after the third dose. HPV genotyping was performed by the XGEN Flow Chip technique. The cytokines IFN-γ, IL-2, IL-12p70, TNF-α, GM-CSF, IL-4, IL-5, IL-10, and IL-13 were quantitated by multiplex immunoassay. The vaginal microbiome was identified by analysis of the V3/V4 region of the bacterial 16S rRNA gene. RESULTS The most abundant bacterial species in the vaginal microbiome was Lactobacillus crispatus, followed by L. iners. Bacterial diversity and dominant organisms were unchanged following vaccination. Small decreases in levels of pro and anti-inflammatory cytokines were observed following HPV vaccination, but there was no association between vaginal cytokine levels and microbiome composition. CONCLUSION Vaginal microbiome is not altered following administration of the standard three-dose HPV-16/18 AS04-adjuvanted (Cervarix®) vaccine.
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27
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Sisnowski J, Vujovich-Dunn C, Gidding H, Brotherton J, Wand H, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states. Vaccine 2021; 39:6117-6126. [PMID: 34493408 DOI: 10.1016/j.vaccine.2021.08.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.
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Affiliation(s)
- J Sisnowski
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia; Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.
| | - C Vujovich-Dunn
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - H Gidding
- University of New South Wales, School of Public Health and Community Medicine, Kensington, Australia; National Centre for Immunisation Research and Surveillance, Westmead, Australia; The University of Sydney Northern Clinical School, St Leonards, Australia.
| | - J Brotherton
- Population Health, VCS Foundation, East Melbourne, Victoria, Australia; University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - H Wand
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Lorch
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - M Veitch
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - V Sheppeard
- Communicable Diseases Branch, Health Protection NSW, St Leonards, New South Wales, Australia; University of Sydney, Sydney School of Public Health, Camperdown, New South Wales, Australia.
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - S R Skinner
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia.
| | - C Davies
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia; Menzies School of Health Research, Charles Darwin University, Cairns, Queensland, Australia.
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Westmead, Australia; University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - K Canfell
- Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Smith
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia; Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - M Kang
- University of Sydney, Westmead Clinical School, New South Wales, Australia.
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, South Australia, Australia.
| | - S Burns
- Curtin University, School of Population Health, Western Australia, Australia.
| | - L Selvey
- University of Queensland, School of Public Health, Queensland, Australia.
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - N Lane
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - J Kaldor
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Guy
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
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Lukic A, De Vincenzo R, Ciavattini A, Ricci C, Senatori R, Ruscito I, Frega A. Are We Facing a New Colposcopic Practice in the HPV Vaccination Era? Opportunities, Challenges, and New Perspectives. Vaccines (Basel) 2021; 9:vaccines9101081. [PMID: 34696189 PMCID: PMC8538171 DOI: 10.3390/vaccines9101081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 08/13/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/24/2022] Open
Abstract
The combination of primary and secondary prevention has already influenced the colposcopic practice by reduction in HPV (human papillomavirus) vaccine-type HSIL (HIGH-GRADE SIL), colposcopy referral numbers, colposcopic positive predictive value (PPV) for CIN2+, and by modification of referral pattern, colposcopic performance, and procedures. Different strategies, both isolated and combined, have been proposed in order to maintain the diagnostic accuracy of colposcopy: patient risk stratification based on immediate or future risk of CIN3+ or on HPV genotyping after a positive screening test. Data are needed to support alternative colposcopic strategies based on vaccination status and on the application of artificial intelligence where the patient’s risk stratification is implicit in precision medicine which involves the transition from an operator-dependent morphology-based to a less-operator dependent, more biomolecular management. The patient’s risk stratification based on any combination of “history” and “test results” to decrease colposcopy workload further reduce colposcopic and histologic morphological approaches, while adding genotyping to the risk stratification paradigm means less cytologic morphologic diagnosis. In Italy, there is a strong colposcopic tradition and there is currently no immediate need to reduce the number of colposcopies. Instead, there is a need for more accredited colposcopists to maintain the diagnostic accuracy of colposcopy in the vaccination era.
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Affiliation(s)
- Ankica Lukic
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy; (A.L.); (I.R.); (A.F.)
- Italian Society of Colposcopy and Cervicovaginal Pathology (SICPCV), 00186 Rome, Italy; (R.D.V.); (A.C.); (R.S.)
| | - Rosa De Vincenzo
- Italian Society of Colposcopy and Cervicovaginal Pathology (SICPCV), 00186 Rome, Italy; (R.D.V.); (A.C.); (R.S.)
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, 00168 Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Ciavattini
- Italian Society of Colposcopy and Cervicovaginal Pathology (SICPCV), 00186 Rome, Italy; (R.D.V.); (A.C.); (R.S.)
- Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciencies, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Caterina Ricci
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-30154979
| | - Roberto Senatori
- Italian Society of Colposcopy and Cervicovaginal Pathology (SICPCV), 00186 Rome, Italy; (R.D.V.); (A.C.); (R.S.)
| | - Ilary Ruscito
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy; (A.L.); (I.R.); (A.F.)
| | - Antonio Frega
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy; (A.L.); (I.R.); (A.F.)
- Italian Society of Colposcopy and Cervicovaginal Pathology (SICPCV), 00186 Rome, Italy; (R.D.V.); (A.C.); (R.S.)
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Oh NL, Biddell CB, Rhodes BE, Brewer NT. Provider communication and HPV vaccine uptake: A meta-analysis and systematic review. Prev Med 2021; 148:106554. [PMID: 33857561 DOI: 10.1016/j.ypmed.2021.106554] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 04/06/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
Provider communication can be critically important to families as they consider HPV vaccination. We sought to characterize the association of provider communication and HPV vaccine uptake, and when communication better motivates vaccination. We searched four databases for studies published between 2006 and 2019. Eligible studies examined health care provider communication (defined as recommendation or discussion) and HPV vaccine uptake (defined as initiation, completion, or follow-through) in the US. Two coders independently identified eligible studies and coded effect sizes and study characteristics. We pooled effect sizes using random-effects meta-analysis. We identified 59 eligible studies of 265,083 patients. Receiving a provider recommendation was associated with higher HPV vaccine initiation (pooled OR = 10.1, 95% CI: 7.6-13.4). HPV vaccine initiation was 24% for patients without and 60% for patients with a provider recommendation. The pooled effect size for provider recommendation and initiation was smaller for probability samples, clinical records, and NIS-Teen (all p < 0.002). Recommendations were equally effective for males and females, for different patient ages, and over time. Provider recommendation was also associated with higher HPV vaccine series completion and follow-through. Provider discussion was similarly associated with higher HPV vaccine initiation (OR = 12.4, 95% CI: 6.3-24.3). In summary, provider communication was robustly associated with HPV vaccination initiation, completion, and follow-through. These findings suggest that US public health efforts to increase HPV vaccine coverage should continue to emphasize provider communication.
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Affiliation(s)
- N Loren Oh
- University of North Carolina School of Medicine, United States of America; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Caitlin B Biddell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Blythe E Rhodes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America.
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Carnalla M, Torres-Ibarra L, Barrientos-Gutiérrez T, Cruz-Valdez A, Muñoz N, Herrero R, Stanley M, Nyitray A, Salmerón J, Lazcano-Ponce E. Reduction of HPV16/18 prevalence in young women after eight years of three- and two-dose vaccination schemes. Vaccine 2021; 39:4419-4422. [PMID: 34183205 DOI: 10.1016/j.vaccine.2021.06.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 06/07/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recommendations for human papillomavirus vaccination have relied on immunogenicity studies and efficacy results derived from adult women. Insufficient information exists regarding HPV effectiveness in vaccinated girls as they become sexually active, regardless of dose scheme. We aimed to compare the prevalence of high-risk HPV between unvaccinated and vaccinated young women eight years after immunization. METHODS After eight years, we recontacted women who received two-dose of bivalent or three-dose-either bivalent or quadrivalent-, HPV vaccine when aged 9-10 years-old as part of a clinical trial. Additionally, we recruited a contemporaneous unvaccinated woman group for comparison. Only those sexually active were included. High-risk HPV DNA was determined in urine samples and compared across groups. RESULTS The prevalence of HPV16/18 types was 6.8% (95 %CI 3.2-14.1%) in the unvaccinated (n = 6/88), 1.1% (95 %CI 0.2-5.8%) in the three-dose (n = 1/93), and 0.0% (95 %CI 0.0-7.0%) in the two-dose group (n = 0/51). CONCLUSION HPV vaccination, with two-dose of bivalent or three-dose schemes-either with the bivalent or quadrivalent vaccine-, was associated with a lower prevalence of HPV16/18 types eight years after primary immunization.
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Affiliation(s)
- Martha Carnalla
- Center for Population Health Research, National Institute of Public Health, Av. Universidad 655, Cuernavaca, Morelos 62100, Mexico.
| | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Av. Universidad 655, Cuernavaca, Morelos 62100, Mexico.
| | - Tonatiuh Barrientos-Gutiérrez
- Center for Population Health Research, National Institute of Public Health, Av. Universidad 655, Cuernavaca, Morelos 62100, Mexico.
| | - Aurelio Cruz-Valdez
- Center for Population Health Research, National Institute of Public Health, Av. Universidad 655, Cuernavaca, Morelos 62100, Mexico.
| | - Nubia Muñoz
- National Institute of Cancer, Calle 1 No.9-85, Bogotá, Colombia.
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas. Complejo SOLARIUM, bodega C8, San José, Costa Rica.
| | - Margaret Stanley
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, United Kingdom.
| | - Alan Nyitray
- Center for AIDS Intervention Research, Clinical Cancer Center, Medical College of Wisconsin, 2071 N. Summit Ave, Milwaukee 53202, USA.
| | - Jorge Salmerón
- Centro de Investigación en Políticas, Población y Salud. Facultad de Medicina, Universidad Nacional Autónoma de México, Unidad Universitaria Edificio CIPPS, Centro Cultural SN, Mexico City, Mexico.
| | - Eduardo Lazcano-Ponce
- Escuela de Salud Pública de México, Instituto Nacional de Salud Pública, Av. Universidad 655, Cuernavaca, Morelos 62100, México.
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RESZKA KONRAD, MOSKAL ŁUKASZ, REMIORZ AGATA, WALAS AGATA, SZEWCZYK KRZYSZTOF, STASZEK-SZEWCZYK URSZULA. Should men be exempted from vaccination against human papillomavirus? Health disparities regarding HPV: the example of sexual minorities in Poland. J Prev Med Hyg 2021; 62:E386-E391. [PMID: 34604578 PMCID: PMC8451346 DOI: 10.15167/2421-4248/jpmh2021.62.2.1863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
Introduction Social campaigns concerning vaccinations against human papillomavirus (HPV) in Poland are mainly addressed to women. In addition to cervical cancer, anal, penile, and oropharyngeal cancers can be caused by the virus, which clearly affects men as well. HPV vaccinations are voluntary and mostly not refunded in Poland. Methods A survey was published on social media’s group gathering males and contained questions concerning epidemiological data, knowledge about HPV, and opinions of HPV vaccination. A questionnaire was enriched with educational note regarding HPV-dependent cancers and available vaccines against HPV in Poland. Results Because of age limitations, 169 males (115 heterosexuals, 48 homosexuals) aged 14-39 were chosen for the study. Seventyfive percent of straight and 88% of gay men were aware of HPV, but less than 4 and 17% (respectively) were vaccinated against the virus. Main sources of knowledge about HPV were the Internet (61%), media (28%) and relatives (27%). HPV infection was linked with the development of anal and oropharyngeal cancers by 28, and 37% of heterosexual males, compared with 56.3 and 43.8% of homosexual males. The majority of respondents (88%) indicated that all genders should be vaccinated, although only 57% were aware of HPV vaccination availability in Poland. Conclusions The men are at risk of HPV-related cancers and the danger is poorly understood amongst Polish men. Despite awareness of HPV vaccines, the vaccination rate is low. Consequently, there is a serious need to broaden educational campaignes with a special attention to LGBTQ+ communities.
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Affiliation(s)
- KONRAD RESZKA
- Wroclaw Medical University, Wroclaw, Poland
- Correspondence: Konrad Reszka, Wroclaw Medical University, 50-367 Wroclaw, Poland - Tel.: 0048 71 368 93 91 - E-mail:
| | | | | | | | - KRZYSZTOF SZEWCZYK
- Wroclaw Medical University, Department of Oncology, Division of Surgical Oncology, Wroclaw, Poland
| | - URSZULA STASZEK-SZEWCZYK
- Wroclaw Medical University, Department of Oncology, Division of Surgical Oncology, Wroclaw, Poland
- Wroclaw Regional Comprehensive Cancer Center, Department of Brachytherapy, Wroclaw, Poland
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Kovar CL, Pestaner M, Webb Corbett R, Rose CL. HPV vaccine promotion: Snapshot of two health departments during the COVID-19 pandemic. Public Health Nurs 2021; 38:715-719. [PMID: 33938032 PMCID: PMC8242765 DOI: 10.1111/phn.12900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID-19 pandemic.
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Affiliation(s)
- Cheryl L Kovar
- Advanced Nursing Practice & Education Department, College of Nursing, East Carolina University, Greenville, NC, USA
| | - Mitzi Pestaner
- College of Nursing, East Carolina University, Greenville, NC, USA
| | - Robin Webb Corbett
- Chair Advanced Nursing Practice & Education Department, College of Nursing, East Carolina University, Greenville, NC, USA
| | - Carol Lynn Rose
- Training Program, Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA
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Koskan A, Vizcaino M, Brennhofer SA, Lee CD, Roberto AJ. Human papillomavirus vaccine administration behaviors and influences among Arizona pharmacists and pharmacy interns. Hum Vaccin Immunother 2021; 17:3090-3095. [PMID: 33886423 DOI: 10.1080/21645515.2021.1905469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
This study assessed 27 Arizona community pharmacists' and pharmacy interns' human papillomavirus (HPV) vaccine administration behaviors and influences. We recruited community pharmacists and pharmacy interns from a statewide pharmacy conference to complete a 40-item cross-sectional survey. Informed by the Theory of Planned Behavior, the survey assessed pharmacists' HPV vaccine-related behaviors, intentions, attitudes, subjective norms, and perceived behavioral control to vaccinate against HPV. We analyzed all data using descriptive statistics and correlations. Overall, most pharmacists held positive attitudes about the HPV vaccine. However, the majority rarely administered the HPV vaccine. Intentions to vaccinate and subjective norms positively correlated with vaccine administration behavior. Pharmacists' positive attitudes about the vaccine, subjective norm to vaccinate, and behavioral control or self-efficacy to recommend the vaccine impacted their intentions to vaccinate against HPV. Most surveyed pharmacists believed that the most substantial HPV vaccine administration barriers include parental consent and parental stigma against the vaccine. The most common pharmacy-related barrier was the lack of a tracking and reminder system to encourage patients to return for additional HPV vaccine doses. This work highlights the need to increase public awareness that pharmacists can administer vaccines to adolescents. Study authors recommend offering communication training to increase pharmacists' perceived behavioral control to recommend the HPV vaccine.
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Affiliation(s)
- Alexis Koskan
- Arizona State University College of Health Solutions, Phoenix, AZ, USA
| | | | | | - Chong D Lee
- Arizona State University College of Health Solutions, Phoenix, AZ, USA
| | - Anthony J Roberto
- Hugh Downs School of Human Communication, Arizona State University, Tempe, AZ, USA
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Chiozzini C, Manfredi F, Ferrantelli F, Leone P, Giovannelli A, Olivetta E, Federico M. The C-Terminal Domain of Nef mut Is Dispensable for the CD8 + T Cell Immunogenicity of In Vivo Engineered Extracellular Vesicles. Vaccines (Basel) 2021; 9:vaccines9040373. [PMID: 33921215 PMCID: PMC8068889 DOI: 10.3390/vaccines9040373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 03/19/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/19/2022] Open
Abstract
Intramuscular injection of DNA vectors expressing the extracellular vesicle (EV)-anchoring protein Nefmut fused at its C-terminus to viral and tumor antigens elicit a potent, effective, and anti-tolerogenic CD8+ T cell immunity against the heterologous antigen. The immune response is induced through the production of EVs incorporating Nefmut-derivatives released by muscle cells. In the perspective of a possible translation into the clinic of the Nefmut-based vaccine platform, we aimed at increasing its safety profile by identifying the minimal part of Nefmut retaining the EV-anchoring protein property. We found that a C-terminal deletion of 29-amino acids did not affect the ability of Nefmut to associate with EVs. The EV-anchoring function was also preserved when antigens from both HPV16 (i.e., E6 and E7) and SARS-CoV-2 (i.e., S1 and S2) were fused to its C-terminus. Most important, the Nefmut C-terminal deletion did not affect levels, quality, and diffusion at distal sites of the antigen-specific CD8+ T immunity. We concluded that the C-terminal Nefmut truncation does not influence stability, EV-anchoring, and CD8+ T cell immunogenicity of the fused antigen. Hence, the C-terminal deleted Nefmut may represent a safer alternative to the full-length isoform for vaccines in humans.
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Affiliation(s)
- Chiara Chiozzini
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
| | - Francesco Manfredi
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
| | - Flavia Ferrantelli
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
| | - Patrizia Leone
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
| | - Andrea Giovannelli
- National Center for Animal Experimentation and Welfare, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Eleonora Olivetta
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
| | - Maurizio Federico
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (C.C.); (F.M.); (F.F.); (P.L.); (E.O.)
- Correspondence: ; Tel.: +39-06-4990-6016; Fax: +39-06-49903210
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Hollins A, Wardell D, Fernandez ME, Markham C, Guilamo-Ramos V, Santa Maria D. Human Papillomavirus Vaccination Status and Parental Endorsement Intentions among Undergraduate Student Nurses. Int J Environ Res Public Health 2021; 18:3232. [PMID: 33804788 DOI: 10.3390/ijerph18063232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022]
Abstract
We identified factors associated with student nurses’ Human Papillomavirus Vaccine (HPV) vaccination status and their intention to counsel parents on HPV vaccination. Undergraduate student nurses (N = 153) from a large university in the south participated. Descriptive statistics, chi-squared tests, and independent t-tests (p ≤ 0.05) were used to characterize the students’ vaccination status. Logistic regression was used to identify factors associated with vaccination status. HPV vaccination rates were low. Students who were older and married or living with a partner were less likely to have completed the HPV vaccine series. The most commonly cited reason for non-initiation and non-completion was the lack of provider endorsement. Vaccination status did not differ significantly according to race/ethnicity, religion, skills, or intention to counsel parents. While intentions to counsel parents on HPV vaccination are high among student nurses, interventions to improve vaccination rates among student nurses are needed.
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Diana G, Corica C. Human Papilloma Virus vaccine and prevention of head and neck cancer, what is the current evidence? Oral Oncol 2021; 115:105168. [PMID: 33730628 DOI: 10.1016/j.oraloncology.2020.105168] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/12/2020] [Accepted: 12/24/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Human Papilloma Virus is associated with the development of cancers in the head and neck region. We have witnessed, in the last decades, an increase in number of cases directly related to HPV infection, in particular in the Western Countries. Recently the FDA expanded the indications for Gardasil-9® to include the prevention of head and neck cancer. Objective of this paper is to review the evidence supporting its use. MATERIALS AND METHODS Bibliographic review enquiring Medline, Web of Science and the Cochrane Library to assess the efficacy of vaccination against oncogenic HPV in the prevention of head and neck squamous cell carcinoma. RESULTS Two prospective and 4 retrospective studies have evaluated vaccination in prevention of head and neck cancer, using persistent oral infection as surrogate of efficacy. All studies showed lower prevalence of oral infection up to 4 years following vaccination. Vaccine efficacy was estimated between 88 and 93.3%. Because of low vaccine coverage the estimated population-level effect against oral HPV16/18/6/11 infections was only 17.0%. CONCLUSIONS Antibodies concentration in the oral fluid correlate with serum level, but the threshold to ensure protection is unknown. Duration of protection has not been established. HPV vaccination can provide protection from re-infection (at different mucosal sites) in previously exposed individuals, suggesting possible use of HPV vaccine later in life. Other studies should focus on confirming causal relationship between vaccination and prevention of persistent oral infection and investigate the duration of efficacy, which is crucial in its effectiveness against HNSCC.
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Affiliation(s)
- Giovanni Diana
- Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow G51 4TF, UK.
| | - Clementina Corica
- Universidad Europea, Passeig de l'Albereda, 7, 46010 València, Spain
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Ohareri B, Adefolaju AO, Onyeneho CA. Knowledge, attitudes and perceptions of Nigerian parents towards human papilloma virus (HPV) vaccines. Eur J Midwifery 2021; 4:2. [PMID: 33537604 PMCID: PMC7839110 DOI: 10.18332/ejm/114886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 06/28/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Human papilloma virus (HPV) is a renowned cause of cervical cancer, which has resulted in high mortality of individuals. Cervical cancer could be reduced by screening and HPV vaccination. This study investigated knowledge, attitudes and perceptions of parents towards HPV vaccines in Ibadan, South-West L.G.A, Oyo State, Nigeria. METHODS A cross-sectional descriptive design was used with a multi-stage sampling technique to select 186 parents from Ibadan South-West local government area of Oyo state. A validated structured questionnaire (r=0.78) was used for data collection. RESULTS The mean age of the respondents was 30.2 years. The parents had good knowledge of the HPV vaccine (mean=3.12) and most had a high level of knowledge (98.9%). Parents demonstrated negative attitude (mean=2.97) and positive perception to HPV vaccines. Major factors affecting their attitude towards the uptake of HPV vaccines were: finance (86%), level of education (81%), distance to health facilities (83%), inadequate knowledge about the vaccine (89%), fear of promiscuity (82%), and concern about adverse effect (80%). CONCLUSIONS Factors responsible for a negative attitude were the high cost, distance from vaccination site, inadequate knowledge, fear of subsequent adolescent promiscuity and concern about adverse effects. In light of the benefits of HPV vaccination, the Nigerian government should make HPV vaccines available, affordable, and accessible to the public.
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Affiliation(s)
- Beatrice Ohareri
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Chiemerigo Anne Onyeneho
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Du J, Ährlund-Richter A, Näsman A, Dalianis T. Human papilloma virus (HPV) prevalence upon HPV vaccination in Swedish youth: a review based on our findings 2008-2018, and perspectives on cancer prevention. Arch Gynecol Obstet 2021; 303:329-335. [PMID: 33247317 PMCID: PMC7858554 DOI: 10.1007/s00404-020-05879-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/04/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Three human papillomavirus (HPV) vaccines are available against up to nine HPV types. In Sweden, from 2012, Gardasil was offered to 10-12 year old girls through the school-based vaccination program, and as catchup vaccination for women up to 26 years. To obtain a baseline, and follow HPV vaccination effects, during 2008-2018, cervical and oral HPV prevalence were followed at a youth clinic in Stockholm, and in 2013 for comparison oral HPV prevalence was examined in high-school youth in a middle-sized county in Sweden. METHODS In this review, we discuss all our data with cervical and oral mouthwash samples that were collected and tested for 24-27 HPV types by a bead-based multiplex assay from 2008. RESULTS Compared with 2008-2011, with ~ 35% HPV16 and > 60% high risk (HR) HPV cervical prevalence at the youth clinic, a decrease of vaccine HPV types was observed between 2013 and 2018, with e.g., HPV16 falling to 5% in catchup vaccinated women and 15-18% in nonvaccinated women. Most common cervical HR-HPV types were HPV39, 51, 52, 56, and 59 together accounting for ~ 10% of cervical cancer, and where only HPV52 is included in Gardasil-9. At baseline 2009-2011, oral HPV prevalence was ~ 10% in unvaccinated youth at the youth clinic, but after 2013 it dropped to < 2% at the youth clinic and high schools. CONCLUSION To conclude, Gardasil HPV types have decreased, but it is still important to follow remaining HR-HPV types and cancer development, since there is an ongoing increase in the incidence of HPV-associated tonsillar and base of tongue cancer, and cervical cancer in Sweden.
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Affiliation(s)
- Juan Du
- Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Stockholm, Sweden.
| | | | - Anders Näsman
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Tina Dalianis
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
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Jelinek K, Harding L, Briceno R, Li Z, Niezgoda A, Sergent S, Etchebarne B. Prevalence of high-risk human papillomavirus genotypes in two regions of Peru. Int J Gynaecol Obstet 2021; 154:544-549. [PMID: 33507540 DOI: 10.1002/ijgo.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/30/2020] [Accepted: 01/25/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aims to discover the most prevalent high-risk (hr) HPV genotypes in the regions of Loreto and La Libertad, Peru. METHODS In 2015, cervical cell samples were collected during pelvic examinations from women in the geographically distinct regions of Loreto and La Libertad, Peru. In 2017, additional samples were collected in La Libertad. A total of 429 women between the ages of 18 and 65 years living in these regions were enrolled in the study. All samples were analyzed by polymerase chain reaction for the hrHPV genotypes 16, 18, and 35. RESULTS Sample collection from 126 women in 2015 in Loreto revealed an hrHPV incidence of 15.9% (20 of 126), with 60% (12 of 126) of HPV infections due to hrHPV 16. Samples from La Libertad revealed an hrHPV incidence of 14.5% incidence (44 of 303) (among 303 women). Of these infections, 38% (17) were attributable to hrHPV type 35 and 20% (9) were due to hrHPV type 16. CONCLUSION The prevalence of hrHPV genotypes in Peru may differ from those observed in North America and Europe. Loreto appears to follow the prevalence trend observed in North America, with hrHPV type 16 accounting for the majority of cases. However, hrHPV type 35 may account for a greater contribution to the cervical cancer burden in La Libertad. Further research, specifically on cervical tumor specimens, is needed.
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Affiliation(s)
- Kayla Jelinek
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
| | - Laura Harding
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
| | - Ruben Briceno
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA.,Universidad Cesar Vallejo, Trujillo, Peru
| | - Zenggang Li
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
| | - Angela Niezgoda
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
| | - Shane Sergent
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
| | - Brett Etchebarne
- Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine Faculty, Michigan State University, East Lansing, MI, USA
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40
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Wieland U, Oellig F, Kreuter A. Anal dysplasia and anal cancer. English version. Hautarzt 2020; 71:74-81. [PMID: 32303769 DOI: 10.1007/s00105-020-04562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Anal intraepithelial neoplasia (AIN) and 89-100% of anal cancers are caused by persistent infections with high-risk (HR) human papillomaviruses (HPV). In HIV-positive patients, anal HPV infection and AIN are very common and these patients have a significantly increased risk for anal cancer. However, a continuous increase in the incidence of anal cancer has also been observed in the general population in recent decades. AIN can clinically present in diverse manners. In HIV-positive patients AIN can be hidden in condylomas. Approximately 3-14% of high-grade AIN progress to anal cancer within 5 years. Therefore, screening examinations should be offered to patients with an increased risk for anal cancer. The treatment options for AIN are similar to those for condylomas. HIV-positive patients with controlled immune status and HIV-negative patients with anal cancer respond comparably well to combined radiochemotherapy. A German-language S3 guideline for anal cancer will be available in 2020. In HIV-positive patients over 26 years of age, HPV vaccination showed no effect in a controlled phase‑3 study. To prevent AIN and anal cancer in the future, HPV vaccination rates need to be increased in HPV-naïve girls and boys.
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Pattyn J, Panicker G, Willhauck‐Fleckenstein M, Van Keer S, Téblick L, Pieters Z, Tjalma WAA, Matheeussen V, Van Damme P, Waterboer T, Unger ER, Vorsters A. Comparison of a VLP-based and GST-L1-based multiplex immunoassay to detect vaccine-induced HPV-specific antibodies in first-void urine. J Med Virol 2020; 92:3774-3783. [PMID: 32266996 PMCID: PMC7687076 DOI: 10.1002/jmv.25841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 12/22/2022]
Abstract
Vaccine-induced human papillomavirus (HPV) antibodies originating from cervicovaginal secretions were recently shown to be detectable in first-void (FV) urine. This presents a novel opportunity for noninvasive sampling to monitor HPV antibody status in women participating in large epidemiological studies and HPV vaccine trials. With a view towards method optimization, this study compared the measurement of HPV antibodies in FV urine using a multiplex L1/L2 virus-like particles (VLP)-based ELISA (M4ELISA) with previously reported results using a glutathione S-transferase (GST)-L1-based immunoassay (GST-L1-MIA). We tested 53 paired FV urine and serum samples from 19- to 26-year-old healthy women, unvaccinated (n = 17) or vaccinated with either the bivalent or quadrivalent HPV-vaccine during adolescence (n = 36). HPV6/11/16/18 antibodies were measured using M4ELISA and compared with GST-L1-MIA results. Inter-assay and inter-specimen correlations were examined using the Spearman's rank test (rs). As expected, lower HPV antibody concentrations were found in FV urine than in serum. Vaccinated women had significantly higher HPV6/11/16/18 antibody levels in both FV urine and serum compared with those unvaccinated (M4ELISA; FV urine P = .0003; serum P ≤ .0001). HPV antibody levels in FV urine and serum showed a significant positive correlation (M4ELISA anti-HPV6/11/16/18, rs = 0.85/0.86/0.91/0.79, P ≤ .001). Despite assay differences, there was moderate to good correlation between M4ELISA and GST-L1-MIA (FV urine anti-HPV6/11/16/18, rs = 0.86/0.83/0.89/0.53, P ≤ .0001; serum anti-HPV6/11/16/18, rs = 0.93/0.89/0.94/0.75, P ≤ .0001). FV urine HPV antibody detection is comparable with both assays, further supporting this noninvasive sampling method as a possible option for HPV vaccine assessment. Approaches to improve the sensitivity and larger studies are warranted to determine the feasibility of FV urine for vaccine-induced HPV antibody detection.
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Affiliation(s)
- Jade Pattyn
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
| | - Gitika Panicker
- Division of High‐Consequence Pathogens and PathologyNational Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC)AtlantaGeorgia
| | - Martina Willhauck‐Fleckenstein
- Infections and Cancer Epidemiology Group, Infections, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Severien Van Keer
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
| | - Laura Téblick
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
| | - Zoë Pieters
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
- Centre for Statistics, I‐Biostat, Hasselt UniversityHasseltBelgium
| | - Wiebren A. A. Tjalma
- Multidisciplinary Breast Clinic, Unit Gynaecologic Oncology, Department of Obstetrics and GynaecologyAntwerp University HospitalAntwerpBelgium
- Molecular Imaging, Pathology, Radiotherapy, Oncology (MIPRO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
| | - Veerle Matheeussen
- Department of MicrobiologyAntwerp University Hospital (UZA)AntwerpBelgium
- Department of Medical Microbiology (LMM)Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
- Department of Medical BiochemistryFaculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of AntwerpAntwerpBelgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, Infections, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Elizabeth R. Unger
- Division of High‐Consequence Pathogens and PathologyNational Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC)AtlantaGeorgia
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of AntwerpAntwerpBelgium
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Zhang L, Fan H, Peng C, Rao G, Cong Q. Sentiment Analysis Methods for HPV VaccinesRelated Tweets Based on Transfer Learning. Healthcare (Basel) 2020; 8:healthcare8030307. [PMID: 32872330 PMCID: PMC7551482 DOI: 10.3390/healthcare8030307] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Received: 06/13/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
The widespread use of social media provides a large amount of data for public sentiment analysis. Based on social media data, researchers can study public opinions on human papillomavirus (HPV) vaccines on social media using machine learning-based approaches that will help us understand the reasons behind the low vaccine coverage. However, social media data is usually unannotated, and data annotation is costly. The lack of an abundant annotated dataset limits the application of deep learning methods in effectively training models. To tackle this problem, we propose three transfer learning approaches to analyze the public sentiment on HPV vaccines on Twitter. One was transferring static embeddings and embeddings from language models (ELMo) and then processing by bidirectional gated recurrent unit with attention (BiGRU-Att), called DWE-BiGRU-Att. The others were fine-tuning pre-trained models with limited annotated data, called fine-tuning generative pre-training (GPT) and fine-tuning bidirectional encoder representations from transformers (BERT). The fine-tuned GPT model was built on the pre-trained generative pre-training (GPT) model. The fine-tuned BERT model was constructed with BERT model. The experimental results on the HPV dataset demonstrated the efficacy of the three methods in the sentiment analysis of the HPV vaccination task. The experimental results on the HPV dataset demonstrated the efficacy of the methods in the sentiment analysis of the HPV vaccination task. The fine-tuned BERT model outperforms all other methods. It can help to find strategies to improve vaccine uptake.
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Affiliation(s)
- Li Zhang
- School of Economics and Management, Tianjin University of Science and Technology, Tianjin 300457, China; (L.Z.); (H.F.)
| | - Haimeng Fan
- School of Economics and Management, Tianjin University of Science and Technology, Tianjin 300457, China; (L.Z.); (H.F.)
| | - Chengxia Peng
- College of Intelligence and Computing, Tianjin University, Tianjin 300350, China; (C.P.); (Q.C.)
| | - Guozheng Rao
- College of Intelligence and Computing, Tianjin University, Tianjin 300350, China; (C.P.); (Q.C.)
- Tianjin Key Laboratory of Cognitive Computing and Applications, Tianjin University, Tianjin 300350, China
- School of New Media and Communication, Tianjin University, Tianjin 300072, China
- Correspondence: ; Tel.: +86-1361-205-9239
| | - Qing Cong
- College of Intelligence and Computing, Tianjin University, Tianjin 300350, China; (C.P.); (Q.C.)
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Chen H, Zhang X, Wang W, Zhang R, Du M, Shan L, Li Y, Wang X, Liu Y, Zhang W, Li X, Qiao Y, Ma J, Zhou J, Li J. Effect of an educational intervention on human papillomavirus (HPV) knowledge and attitudes towards HPV vaccines among healthcare workers (HCWs) in Western China. Hum Vaccin Immunother 2020; 17:443-450. [PMID: 32692948 DOI: 10.1080/21645515.2020.1780093] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) play a key role in the recommendation of HPV vaccination. Our study aimed to understand to what extent a structured health intervention could change the knowledge and attitudes toward HPV and its vaccines among HCWs in Western China. METHODS This was a multi-center, questionnaire-based interventional study conducted across 12 cities of seven provinces in Western China, from November 2018 to July 2019. Participants were recruited from local health systems by e-invitation. Questionnaires were administered to participants before and after the intervention. RESULTS A total of 1448 HCWs attended the educational lectures and 1354 participants completed both pre- and post-study questionnaires. In general, HCWs had satisfactory baseline knowledge regarding HPV and its vaccines compared with other populations, and a significantly higher knowledge level was observed after the intervention. However, some more specific knowledge on the vaccination procedures, other HPV-related diseases and whether HPV testing was required before vaccination was relatively poor. Following the educational intervention, the correct responses to the above questions increased (P < .001). However, it was still lower compared with answers to other questions. Change was also detected regarding HCWs' willingness to recommend HPV vaccines to the appropriate population (P < .001). CONCLUSION Educational intervention on HPV and its vaccines is effective in improving HCWs' knowledge levels and willingness to recommend HPV vaccines. Future educational interventions should focus more on knowledge regarding HPV-related diseases and HPV vaccination. Education campaigns targeting rural HCWs are urgently needed in the near future.
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Affiliation(s)
- Hui Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute , Beijing, China
| | - Wei Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China , Chengdu, China
| | - Rong Zhang
- Postdoctoral Research Station, Xinjiang Center for Disease Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention , Urumqi, China
| | - Mei Du
- Dali Maternal & Child Health Hospital/Dali Children's Hospital , Dali, China
| | - Li Shan
- Northwest Women's and Children's Hospital , Shannxi, China
| | - Yucong Li
- Chongqing University Cancer Hospital , Chongqing, China
| | - Xiaohui Wang
- Gansu Provincial Cancer Hospital/Gansu Provincial Academic Institute for Medical Research , Lanzhou, China
| | - Yijun Liu
- Zunyi Medical University , Zunyi, China
| | - Wen Zhang
- Kunming Women and Children's Hospital , Kunming, China
| | - Xiaoling Li
- Yuxi Hospital of Traditional Chinese Medicine , Yuxi, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Jianqiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jing Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, Sichuan, China.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , London, UK
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Phuong NTN, Xuan LTT, Huong LT, Toan DTT, Oh JK, Won YJ, Choi KS. Knowledge of Cervical Cancer and Human Papillomavirus Vaccines among Child-Bearing Aged Women in Hanoi, Vietnam. Asian Pac J Cancer Prev 2020; 21:1951-1957. [PMID: 32711420 PMCID: PMC7573401 DOI: 10.31557/apjcp.2020.21.7.1951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives: The study sought to examine knowledge of cervical cancer and human papillomavirus (HPV) vaccines among child-bearing aged women in Hanoi, Vietnam. Methods: In 2016, 807 women aged 18 to 49 years were recruited from one urban area and one rural area in 2016 and were examined through face-to-face paper-based interviews. Pearson’s chi-square test and an independent t-test were utilized to compare awareness of cervical cancer and HPV vaccination among women according residential status. Results: Overall, 83.8% and 71.3% women had heard about cervical cancer and HPV vaccination, respectively. Mean knowledge scores for cervical cancer and HPV vaccination were 4.60±1.43 out of 7 and 1.53±1.35 out of 5, respectively. Women living in an urban area were more likely to be aware of cervical cancer and to be more knowledgeable of HPV vaccination than women in a rural area. Conclusions: Despite strong awareness, we found knowledge on cervical cancer and HPV vaccination to be alarmingly insufficient among Vietnamese women.
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Affiliation(s)
- Nguyen Thi Ngoc Phuong
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea.,Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Le Thi Thanh Xuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Le Thi Huong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Do Thi Thanh Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Jin Kyung Oh
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
| | - Young Joo Won
- Cancer Registration and Statistic Branch, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
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Donadio MD, Riechelmann RP. Anal canal cancer in Brazil: why should we pay more attention to the epidemiology of this rare disease? Ecancermedicalscience 2020; 14:1037. [PMID: 32565890 PMCID: PMC7289618 DOI: 10.3332/ecancer.2020.1037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Indexed: 11/21/2022] Open
Abstract
Anal canal cancer is one of the human papilloma virus (HPV)-associated diseases with increasing incidence. High-risk sexual behaviour and the resurgence of human immunodeficiency virus (HIV) infection, associated with low HPV vaccine coverage, are risk factors for the increased incidence of this cancer. In this paper, the authors point out pertinent questions regarding the greater exposure of the population to some risk factors and discuss the latest epidemiological data of these factors, particularly those of concern to emerging countries like Brazil. The authors also discuss policies adopted that have not been successful to combat the HIV and HPV rise and that have direct consequences on the incidence of anal canal cancer.
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46
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Wieland U, Oellig F, Kreuter A. [Anal dysplasia and anal cancer]. Hautarzt 2020; 71:284-292. [PMID: 32065247 DOI: 10.1007/s00105-020-04548-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Anal intraepithelial neoplasia (AIN) and 89-100% of anal cancers are caused by persistent infections with high-risk (HR) human papillomaviruses (HPV). In HIV-positive patients, anal HPV infection and AIN are very common and these patients have a greatly increased risk of developing anal cancer. However, a continuous increase in the incidence of anal cancer has also been observed in the general population in recent decades. AIN can clinically present in diverse manners. In HIV-positive patients AIN can be hidden in condylomas. Furthermore, 3-14% of high-grade AIN progress to anal cancer within 5 years. Therefore, screening examinations should be offered to patients with an increased risk for anal cancer. The treatment options for AIN are similar to those for condylomas. HIV-positive patients with controlled immune status and HIV-negative patients with anal cancer respond comparably well to combined radiochemotherapy. A German-language AWMF S3 guideline for anal cancer will be available in 2020. In HIV-positive patients over 26 years of age, HPV vaccination showed no effect in a controlled phase‑3 study. To prevent AIN and anal cancer in the future, HPV vaccination rates need to be increased in HPV-naïve girls and boys.
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Affiliation(s)
- Ulrike Wieland
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universität zu Köln, Köln, Deutschland
| | - Frank Oellig
- Institut für Pathologie, Mühlheim an der Ruhr, Deutschland
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland.
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Näsman A, Du J, Dalianis T. A global epidemic increase of an HPV-induced tonsil and tongue base cancer - potential benefit from a pan-gender use of HPV vaccine. J Intern Med 2020; 287:134-152. [PMID: 31733108 DOI: 10.1111/joim.13010] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 12/28/2022]
Abstract
In 2007, human papillomavirus (HPV) type 16 was finally recognized as a risk factor, besides smoking and alcohol, for oropharyngeal squamous cell carcinoma (OPSCC), including tonsillar squamous cell carcinoma (TSCC), by the International Agency for Research against Cancer. Just before, in 2006, the Food and Drug Administration had approved Gardasil, the first vaccine against HPV16, 18, 6 and 11, for preventive vaccination women against cervical cancer. Concurrently, some Western countries, where smoking was decreasing, disclosed an epidemic increase in the incidence of OPSCC, especially of TSCC and base of tongue cancer (BOTSCC), together accounting for 80-90% of all OPSCCs, and mainly affecting men. The epidemic was later revealed to be due to a rise in HPV-positive cases, and scientists in the field suggested HPV vaccination also of boys. Globally, there are roughly 96 000 incident OPSCC cases/year of which 20-24% are caused by HPV, thereby accounting for around 22 000 OPSCC cases annually. Of these cases, 80-90% are due to HPV16 infection and would be prevented with the presently registered HPV vaccines. In Western countries, such as Sweden (with almost 400 TSCC and BOTSCC cases per year) and the United States, HPV prevalence in OPSCC is higher and around 70%. HPV vaccination of girls has been initiated in many countries, and the vaccines have been efficient and their side effects limited. HPV vaccination of boys has, however, been the exception, but should definitely not be delayed any further. It would benefit both girls and boys directly, and result in better and more robust herd immunity. Today, we have the possibility to eliminate several high-risk HPV types in the younger generations and avoid more than 600 000 cancer cases annually worldwide, and this possibility should be embraced by offering global pan-gender HPV vaccination.
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Affiliation(s)
- A Näsman
- From the, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - J Du
- Department of Microbiology, Tumor Biology and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Stockholm, Sweden
| | - T Dalianis
- From the, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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Luisi MLR. Kansan Guardian Perceptions of HPV and the HPV Vaccine and the Role of Social Media. Kans J Med 2020; 13:9-18. [PMID: 32047583 PMCID: PMC7006828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/15/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination rates in Kansas historically have been low among children and adolescents. How Kansas parents and guardians perceive the HPV vaccine may influence vaccination rates among Kansas youth. Social media messages also may influence perceptions, suggesting implications for current and future disease and cancer burden. METHODS Eligible Kansas guardians of children aged 9 - 17 years completed an online survey. The survey assessed their perceptions about a) HPV and the HPV vaccine, b) HPV and HPV vaccine representation on social media, and c) the effects that social media has on their perceptions about HPV and the HPV vaccine. RESULTS Most Kansas guardians (n = 55, 57.9%) indicated seeing information about HPV and the HPV vaccine on social media. Kansas guardians who had reported seeing information on social media about the HPV vaccine were significantly more likely to perceive that the HPV vaccine could kill their child than those who had not seen information (t(79) = 0.019). Additionally, children of wealthier Kansan guardians were vaccinated more than children of less wealthy guardians. CONCLUSION Social media messages may be influencing Kansan guardians to think the HPV vaccine is lethal in their children. Future campaigns increasingly should be focused on HPV vaccine safety and effectiveness.
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Dochez C, Al Awaidy S, Mohsni E, Fahmy K, Bouskraoui M. Strengthening national teams of experts to support HPV vaccine introduction in Eastern Mediterranean countries: Lessons learnt and recommendations from an international workshop. Vaccine 2020; 38:1114-9. [PMID: 31771862 DOI: 10.1016/j.vaccine.2019.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 11/20/2022]
Abstract
Several countries have started to introduce the HPV vaccine into their national immunisation programme, with the majority of these countries being high or upper-middle income countries. Currently, 91 countries have introduced the HPV vaccine globally. One of the regions lagging behind in the introduction of the HPV vaccine is the Eastern Mediterranean Region, with currently only Libya and the United Arab Emirates having introduced the HPV vaccine. In order to support countries in the Eastern Mediterranean Region with their decision-making process for HPV vaccine introduction, a regional workshop was organised to explore the current status of HPV vaccine introduction plans in the Eastern Mediterranean countries, gaps in information about HPV disease burden in the region and the need for quality HPV data to make an informed decision to introduce the HPV vaccine, socio-cultural and religious challenges with HPV vaccine introduction, and the role of NITAGs in formulating recommendations for HPV vaccine introduction. Participating countries reflected on their respective status of decision making process about HPV vaccine introduction; they discussed any needs for operational research to support the decision-making process; and highlighed technical and financial support that might be required from partners to assist with HPV vaccine introduction. Recommendations were made on how to advance the decision-making process for HPV vaccine introduction. The workshop increased the awareness of the need of data on burden of disease and the associated benefits of HPV vaccination in Eastern Mediterranean countries. The importance of collaboration between different programmes including: immunisation, adolescent health, school health, sexual and reproductive health and cancer control programmes was clearly emphasized.
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Abstract
Cervical cancer is by far the most common HPV-related disease. About 99.7% of cervical cancer cases are caused by persistent genital high-risk human papillomavirus (HPV) infection. Worldwide, cervical cancer is one of the most common cancer in women with an estimated 528,000 new cases reported in 2012. Most HPV infections clear spontaneously but persistent infection with the oncogenic or high-risk types may cause cancer of the oropharynx and anogenital regions. The virus usually infects the mucocutaneous epithelium and produces viral particles in matured epithelial cells and then causes a disruption in normal cell-cycle control and the promotion of uncontrolled cell division leading to the accumulation of genetic damage. There are currently two effective prophylactic vaccines against HPV infection, and these comprise of HPV types 16 and 18, and HPV types 6, 11, 16 and 18 virus-like particles. HPV testing in the secondary prevention of cervical cancer is clinically valuable in triaging low-grade cytological abnormalities and is also more sensitive than cytology as a primary screening. If these prevention strategies can be implemented in both developed and developing countries, many thousands of lives could be saved.
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Affiliation(s)
- Kehinde Sharafadeen Okunade
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
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