Science.gov

Sample records for adolescent hpv vaccination

  1. HPV vaccine

    MedlinePlus

    Vaccine - HPV; Immunization - HPV; Gardasil; Cervarix; HPV2; HPV4; Vaccine to prevent cervical cancer ... HPV is a common virus that is spread through sexual contact. There are several types of HPV. ...

  2. HPV vaccine

    MedlinePlus

    Vaccine - HPV; Immunization - HPV; Gardasil; Cervarix; HPV2; HPV4; Vaccine to prevent cervical cancer ... and Gynecologists. Committee Opinion No. 588: Human Papillomavirus Vaccination. Obstet Gynecol . 2014;123(3):712-8. PMID: ...

  3. Parent Perception of Provider Interactions Influences HPV Vaccination Status of Adolescent Females.

    PubMed

    Clark, Sarah J; Cowan, Anne E; Filipp, Stephanie L; Fisher, Allison M; Stokley, Shannon

    2016-07-01

    Human papillomavirus (HPV) vaccination coverage among adolescent females is well below national public health goals. Many known barriers to HPV vaccine receipt can be addressed in parent-physician conversations. This study sought to explore parent experiences and attitudes related to HPV vaccination of adolescent girls, focused on interactions with providers. We conducted a cross-sectional survey of parents using a nationally representative online panel. Among parents with ≥1 daughter aged 11 to 17 years, provider recommendations for HPV vaccine and specified age to begin the HPV vaccine series were associated with HPV vaccine status. Parents who reported their daughters were unlikely to complete the HPV series were more likely to have had no discussion of HPV vaccine with the provider. Efforts to increase HPV vaccination rates among adolescent females should continue to focus on improving provider discussion of HPV vaccine. PMID:26450982

  4. Discussions of adolescent sexuality in news media coverage of the HPV vaccine.

    PubMed

    Casciotti, Dana M; Smith, Katherine C; Tsui, Amy; Klassen, Ann C

    2014-02-01

    Given the sexually transmitted nature of human papillomavirus (HPV), some worry the HPV vaccine will create a false sense of security and promote adolescent sexual activity. Media coverage of vaccines can influence social norms, parental attitudes, and vaccine acceptance; in this paper we examine U.S. news media messages related to sexuality and HPV vaccination. Drawing on a structured analysis of 447 articles published during 2005-2009, we qualitatively analyzed a purposive sample of 49 articles discussing adolescent health behaviors related to HPV vaccination. Commonly, articles discussed vaccination in the context of abstinence-only versus comprehensive sexual health education; cited research findings to support vaccination or sex education; argued against connecting vaccination to promiscuous behavior; but included fear-inducing messages. Media messages concerning health behaviors related to HPV vaccination tended to support government and parental involvement in sex education, and dismiss concerns linking vaccination to sexual activity, while also presenting the vaccine as lifesaving. PMID:24439619

  5. Adolescents' intention and self-efficacy to follow Pap testing recommendations after receiving the HPV vaccine.

    PubMed

    Higgins, Lisa M; Dirksing, Kelsie N; Ding, Lili; Morrow, Charlene D; Widdice, Lea A; Kahn, Jessica A

    2016-06-01

    Human papillomavirus (HPV) vaccines are recommended in the US for girls and women 11-26 y of age. Because these vaccines do not prevent all cervical cancers, Papanicolaou (Pap) screening is still recommended after vaccination. Young women who have been vaccinated may perceive themselves at lower risk for HPV infection and cervical cancer, which could lead to lower intention and self-efficacy to follow cervical cancer screening guidelines, and subsequent nonadherence to Pap testing. The aim of this study was to examine whether perceived risk of human papillomavirus (HPV) after vaccination and other factors are associated with adolescents' intention and self-efficacy to get Pap testing after HPV vaccination. Women 13-21 y of age (N = 339) receiving their first HPV vaccine dose completed a survey. Multivariable logistic regression examined associations between perceived risk of HPV and intention/self-efficacy to get a Pap test while adjusting for other factors. Approximately half of participants reported high intention and half reported high self-efficacy to get a Pap test. Factors significantly associated with high intention were Pap testing history and knowledge about HPV/HPV vaccines; factors significantly associated with high self-efficacy included insurance plan, Pap testing history, communication with clinician about needing a Pap test after vaccination, lifetime number of male sexual partners, and recent smoking. In conclusion, educating adolescents about HPV/HPV vaccines and the need for Pap testing may increase self-efficacy/intention to get a Pap test after vaccination. PMID:26934107

  6. Provider recommendation mediates the relationship between parental human papillomavirus (HPV) vaccine awareness and HPV vaccine initiation and completion among 13–17 year old US adolescent children

    PubMed Central

    Rahman, Mahbubur; Laz, Tabassum H.; McGrath, Christine J.; Berenson, Abbey B.

    2015-01-01

    Objectives To examine the association between parental human papillomavirus (HPV) awareness and HPV vaccine initiation/completion based on 13–17 year old US adolescent children and to explore whether these associations were mediated by provider recommendation. Methods We used publicly available National Immunization Survey-Teen 2011 data (11,236 adolescent girls and 12,328 boys). Results Weighted logistic regression analysis showed that parental HPV awareness and provider recommendation predicted HPV vaccine initiation and completion separately among both girls and boys, after adjusting for demographic and healthcare utilization variables. When provider recommendation and parental HPV awareness were entered in the model simultaneously, only provider recommendation independently associated with HPV vaccine initiation and completion, demonstrating a mediation effect of provider recommendation. Conclusions Future studies are needed to better understand why physicians may not provide a recommendation for the HPV vaccine as well as to identify strategies to improve the provider’s ability to effectively communicate their recommendation. PMID:25238779

  7. Examining Future Adolescent HPV Vaccine Uptake With and Without a School Mandate

    PubMed Central

    Dempsey, Amanda F.; Mendez, David

    2009-01-01

    Purpose To develop a model of adolescent HPV vaccine utilization that explored future HPV vaccination rates with and without a school mandate for the vaccine at middle school entry. Methods A dynamic, population-based, compartmental model was developed that estimated over a 50 year time horizon HPV vaccine uptake among female adolescents living in the U.S. The model incorporated data on parental attitudes about this vaccine and adolescent health care utilization levels. Results Without a mandate, our model predicted that 70% coverage, a lower threshold value used in many previous modeling studies of HPV vaccination, would not be achieved until a mean of 23 years after vaccine availability. Maximal coverage of 79% was achieved after 50 years. With a school mandate in place, utilization increased substantially, with 70% vaccination coverage achieved by year 8 and maximal vaccination coverage, 90%, achieved by year 43. Conclusions Our results suggest that vaccine utilization is likely to be low for several years, though strong school mandates might improve HPV vaccine uptake. These results impact the interpretation of previous modeling studies that estimated the potential clinical impacts of HPV vaccination under assumptions of very high vaccine utilization rates. PMID:20708562

  8. Development and initial feedback about a human papillomavirus (HPV) vaccine comic book for adolescents

    PubMed Central

    Katz, Mira L.; Oldach, Benjamin R.; Goodwin, Jennifer; Reiter, Paul L.; Ruffin, Mack T.; Paskett, Electra D.

    2014-01-01

    Human papillomavirus (HPV) vaccination rates do not meet the Healthy People 2020 objective of 80% coverage among adolescent females. We describe the development and initial feedback about an HPV vaccine comic book for young adolescents. The comic book is one component of a multi-level intervention to improve HPV vaccination rates among adolescents. Parents suggested and provided input into the development of a HPV vaccine comic book. Following the development of the comic book, we conducted a pilot study to obtain initial feedback about the comic book among parents (n=20) and their adolescents ages 9 to 14 (n=17) recruited from a community-based organization. Parents completed a pre-post test including items addressing HPV knowledge, HPV vaccine attitudes, and about the content of the comic book. Adolescents completed a brief interview after reading the comic book. After reading the comic book, HPV knowledge improved (2.7 to 4.6 correct answers on a 0–5 scale; p<0.01) and more positive attitudes toward HPV vaccination (p<0.05) were reported among parents. Parents confirmed that the comic book’s content was acceptable and adolescents liked the story, found it easy to read, and thought the comic book was a good way to learn about being healthy. Parents provided valuable information in the development of a theoretically-based comic book and the comic book appears to be an acceptable format for providing HPV vaccine information to adolescents. Future research will include the comic book in an intervention study to improve HPV vaccination rates. PMID:24420004

  9. Development and initial feedback about a human papillomavirus (HPV) vaccine comic book for adolescents.

    PubMed

    Katz, Mira L; Oldach, Benjamin R; Goodwin, Jennifer; Reiter, Paul L; Ruffin, Mack T; Paskett, Electra D

    2014-06-01

    Human papillomavirus (HPV) vaccination rates do not meet the Healthy People 2020 objective of 80% coverage among adolescent females. We describe the development and initial feedback about an HPV vaccine comic book for young adolescents. The comic book is one component of a multilevel intervention to improve HPV vaccination rates among adolescents. Parents suggested and provided input into the development of a HPV vaccine comic book. Following the development of the comic book, we conducted a pilot study to obtain initial feedback about the comic book among parents (n = 20) and their adolescents ages 9 to 14 (n = 17) recruited from a community-based organization. Parents completed a pre-post test including items addressing HPV knowledge, HPV vaccine attitudes, and about the content of the comic book. Adolescents completed a brief interview after reading the comic book. After reading the comic book, HPV knowledge improved (2.7 to 4.6 correct answers on a 0-5 scale; p < 0.01) and more positive attitudes toward HPV vaccination (p < 0.05) were reported among parents. Parents confirmed that the comic book's content was acceptable and adolescents liked the story, found it easy to read, and thought the comic book was a good way to learn about being healthy. Parents provided valuable information in the development of a theoretically-based comic book and the comic book appears to be an acceptable format for providing HPV vaccine information to adolescents. Future research will include the comic book in an intervention study to improve HPV vaccination rates. PMID:24420004

  10. Cervical, Anal and Oral HPV in an Adolescent Inner-City Health Clinic Providing Free Vaccinations

    PubMed Central

    Schlecht, Nicolas F.; Burk, Robert D.; Nucci-Sack, Anne; Shankar, Viswanathan; Peake, Ken; Lorde-Rollins, Elizabeth; Porter, Richard; Linares, Lourdes Oriana; Rojas, Mary; Strickler, Howard D.; Diaz, Angela

    2012-01-01

    Objectives Published human papillomavirus (HPV) vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure. Methods We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models. Results The majority of subjects reported being of non-Caucasian (92%) and/or Hispanic ethnicity (61%). Median age was 18 years (range:14–20). All had practiced vaginal sex, a third (33%) practiced anal sex, and most (77%) had also engaged in oral sex. At enrollment, 21% had not received the vaccine and 51% had received three doses. Prevalent HPV infection at enrollment was detected in 54% of cervical, 42% of anal and 20% of oral specimens, with vaccine types present in 7%, 6% and 1% of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95%CI:0.06–0.75), HPV16 (OR = 0.31, 95%CI:0.11–0.88) and HPV18 (OR = 0.14, 95%CI:0.03–0.75). For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95%CI:0.10–0.72) and HPV18(OR = 0.12, 95%CI:0.01–1.16) were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95%CI:0.18–2.20). Conclusion HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required

  11. HPV Vaccine

    MedlinePlus

    ... can cause problems like genital warts and some kinds of cancer, a vaccine is an important step in preventing infection and protecting against the spread of HPV. That's why doctors recommend that all girls and guys get the vaccine at these ages: ...

  12. Parental intention regarding the administration of the HPV vaccine for adolescent daughters in Taiwan.

    PubMed

    Wang, Mei-Chin; Chou, Cheng-Yang; Ma, Mi-Chia; Hsu, Yu-Yun Alice

    2016-01-01

    This study aimed to investigate parental intention regarding the human papilloma virus (HPV) vaccination for adolescent daughters. Parents or guardians of adolescent girls, aged 12-14 years, from junior high schools in Taiwan participated and completed a HPV vaccination intention survey based on the Theory of Planned Behavior. The survey was conducted from October to November, 2009. Most, 78%, of the respondents reported a high intention to vaccinate daughters against HPV. A high intention of vaccination was associated with a family history of gynecological tumors (adjusted odds ratio [OR]: 2.22, 95% confidence interval [CI]: 1.10-4.51) and HPV awareness (adjusted OR: 2.33, 95% CI: 1.45-3.76). Higher parental intention was reported by respondents with a positive attitude toward the HPV vaccine (adjusted OR: 6.83, 95% CI: 4.16-11.22), perceived greater influence of subjective norms (adjusted OR: 121.23, 95% CI: 42.69-344.21), greater perceived behavioral control (adjusted OR: 67.69, 95% CI: 16.40-279.41), and perceived that the vaccine had limited influence on adolescent sexual behavior (adjusted OR: 2.24, 95% CI: 1.41-3.78). Health-care professionals must be knowledgeable about the HPV and actively promote vaccination among adolescent girls. Improvements in vaccination can be achieved through recommendations by physicians and nurses. PMID:26495864

  13. Factors Associated with Medicaid Providers Recommendation of the HPV Vaccine to Low-Income Adolescent Girls

    PubMed Central

    Bynum, Shalanda A.; Staras, Stephanie A. S.; Malo, Teri L.; Giuliano, Anna R.; Shenkman, Elizabeth; Vadaparampil, Susan T.

    2013-01-01

    Background HPV vaccination in the US remains a public health challenge with vaccine rates of 50%. Although health care providers can facilitate HPV vaccination, several factors may impede their ability to universally recommend the vaccine. To maximize the potential of HPV vaccines, it is important to understand challenges providers face in the clinical environment. Purpose The study sought to identify factors associated with recommendation of the HPV vaccine for low-income adolescents in the early (9–10), target (11–12), early adolescent catch-up (13–14), and late adolescent catch-up (15–17) vaccination groups. Methods Surveys were mailed from October 2009-April 2010 to a random sample of Florida-based physicians serving Medicaid-enrolled adolescents. Data were analyzed in 2013. Results Among early adolescents, discomfort discussing sexually transmitted infections (STIs) with teens (odds ratio [OR]=1.75), difficulty ensuring vaccine completion (OR=0.73), and discomfort discussing STIs with parents (OR=0.44) were associated with recommendation. For target adolescents, discomfort discussing STIs with teens (OR=2.45), time constraints (OR=0.70), vaccine efficacy concerns (OR=0.65), discomfort discussing STIs with parents (OR=0.33), obstetrics/gynecology (OR=0.25) and family medicine (OR=0.24) specialty, and non-Hispanic Black patient (OR=0.15) were associated with recommendation. In early catch-up adolescents, concerns that teens will practice riskier behaviors (OR=0.57), discomfort discussing STIs with parents (OR=0.47), and family medicine specialty (OR=0.20) were associated with recommendation. For late catch-up adolescents, family medicine specialty (OR=0.13) was associated with recommendation. Conclusion Modifiable factors that impede or influence provider recommendations of HPV vaccines can be addressed through intervention. Overall, findings suggest that efforts should focus on sexuality communication and family medicine specialty. PMID:24064282

  14. School-located vaccination for adolescents: Past, present, and future and implications for HPV vaccine delivery.

    PubMed

    Middleman, Amy

    2016-06-01

    Adolescents were first specifically targeted for school-located vaccination (SLV) in the 1990s when hepatitis B catch-up vaccination was recommended for all adolescents. SLV affords the opportunity to access adolescents at a time when their activities have developmental import and the patients have the capacity to decline repeatedly missing school and extracurricular events to get vaccinated. As noted above, SLV has been primarily reserved for brief catch-up interventions among youth, with routine vaccination recommendations quickly defaulting to the primary care provider. Now in 2016, with relatively disappointing adolescent immunization rates for the routinely recommended human papillomavirus (HPV) vaccine, the SLV option is one that could potentially help increase vaccination rates for a particularly effective, life-saving, 3-dose vaccination series. This article will serve as a brief review of the successful use of SLV in other countries, lessons learned when SLV was employed to immunize adolescents against hepatitis B in the United States in the late 1990s and early 2000s, and the current hopes and challenges for the future of adolescent SLV programming in the United States. Overall, the shift to the use of SLV to administer routinely recommend vaccine for adolescents will require careful planning to implement known strategies for accessing youth and in addition to new strategies designed to assure appropriate reimbursement for cost-effect SLV services. While not the best option for all adolescents, SLV provides an important opportunity to immunize youth with limited access to healthcare services in the community at large. PMID:27171022

  15. Age at HPV Vaccine Initiation and Completion among US Adolescent Girls: Trend from 2008 to 2012

    PubMed Central

    Rahman, Mahbubur; McGrath, Christine J.; Hirth, Jacqueline M.; Berenson, Abbey B.

    2015-01-01

    Objective To examine the trend of provider-verified HPV vaccine initiation (≥1 dose) and completion (≥3 doses) among adolescent girls at the Advisory Committee on Immunization Practices (ACIP) recommended age (11-12 years). Methods We analyzed National Immunization Survey of Teens 2008-2012 data and examined the trend of provider-verified HPV vaccine initiation and completion among <13 year old girls. Results Data on age at HPV vaccine initiation and completion were available for 24,466 and 15,972 girls, respectively. The weighted proportion of girls who initiated the vaccine at <13 years of age was 14.1%, 24.1%, 35.9%, 47.7% and 55.9% in 2008, 2009, 2010, 2011 and 2012, respectively (p for trend <.001). The similar trend was also observed for mean age at HPV vaccine initiation and completion (p <.001). Conclusions Additional efforts are needed to increase HPV vaccine uptake among adolescent girls as only half of them receive this vaccine at ACIP recommended age. PMID:25529289

  16. The new human papillomavirus (HPV) vaccine: pros and cons for pediatric and adolescent health.

    PubMed

    Thomas, Tami L

    2008-01-01

    The new human papillomavirus (HPV) vaccine is a research breakthrough for pediatric/adolescent health to prevent cervical cancer and related morbidity. The annual heath care cost for the treatment of cervical cancer and genital warts is estimated to be more than three billion dollars a year. The new HPV vaccine has incredible potential to improve reproductive health promotion, reduce health care costs, and close health care disparity gaps. However, issues both for and against the new HPV vaccine, including mandating vaccination, high cost of the vaccine, the short duration of protection offered, and the perceived promotion of sexual activity, cause confusion. Pediatric nurses, including those in advanced practice, benefit by understanding the pros and cons of these issues in advocating for their patients. PMID:19051848

  17. Current initiatives to protect Rhode Island adolescents through increasing HPV vaccination.

    PubMed

    Washburn, Tricia; Devi Wold, Anne; Raymond, Patricia; Duggan-Ball, Sue; Marceau, Kathy; Beardsworth, AnneMarie

    2016-06-01

    This commentary provides an overview of recent initiatives in Rhode Island to promote human papillomavirus (HPV) vac-30 cination with the goal of protecting Rhode Island adolescents against vaccine-preventable HPV-associated cancers. With the exception of the introduction of a recent school entry requirement, most of the initiatives and related activities described were conducted as part of a cooperative agreement between 35 RIDOH and CDC, and were supported by the Prevention and Public Health Fund. (1). PMID:27141954

  18. Promising alternative settings for HPV vaccination of US adolescents

    PubMed Central

    Shah, Parth D.; Gilkey, Melissa B.; Pepper, Jessica K.; Gottlieb, Sami L.; Brewer, Noel T.

    2014-01-01

    Vaccination in alternative settings, defined here as being outside of traditional primary care, can help address the pressing public health problem of low human papillomavirus vaccine coverage among adolescents in the United States. Pharmacies are promising because they are highly accessible and have well established immunization practices. However, pharmacies currently face policy and reimbursement challenges. School-located mass vaccination programs are also promising because of their high reach and demonstrated success in providing other vaccines, but control by local policymakers and challenges in establishing community partnerships complicate widespread implementation. Health centers in schools are currently too few to greatly increase access to human papillomavirus vaccine. Specialty clinics have experience with vaccination, but the older age of their patient populations limits their reach. Future steps to making alternative settings a success include expanding their use of statewide vaccine registries and improving their coordination with primary care providers. PMID:24405401

  19. Factors associated with early adoption of the HPV vaccine in US male adolescents include Hispanic ethnicity and receipt of other vaccines.

    PubMed

    Kepka, Deanna; Ding, Qian; Hawkins, Amy J; Warner, Echo L; Boucher, Kenneth M

    2016-12-01

    Adolescent males' HPV vaccine initiation and completion in the United States is far below the Healthy People 2020 goal of 80% 3-dose completion among boys. In 2012, less than 7% of males ages 13-17 years had completed the 3-dose series. The Diffusion of Innovations framework guided this investigation of factors related to early adoption of HPV vaccination among male adolescents. Provider-validated data from the 2012 National Immunization Survey-Teen (NIS-Teen) for male adolescents ages 13-17 years were analyzed via a multivariable Poisson regression to estimate prevalence ratios for factors associated with HPV vaccine initiation and completion. Adolescent males who are Hispanic and those who are up to date on other recommended adolescent vaccinations were most likely to complete the HPV vaccine. Public health interventions are needed to improve low HPV vaccination rates among adolescent males in the United States. Description of early adopters of the HPV vaccine provides historical context of HPV vaccination acceptance that is needed to inform the design of targeted vaccination interventions to prevent negative HPV-associated outcomes. PMID:27413668

  20. Does intention to recommend HPV vaccines impact HPV vaccination rates?

    PubMed Central

    Feemster, Kristen A; Middleton, Maria; Fiks, Alexander G; Winters, Sarah; Kinsman, Sara B; Kahn, Jessica A

    2014-01-01

    Despite recommendations for routine vaccination, HPV vaccination rates among adolescent females have remained low. The objective of this prospective cohort study was to determine whether clinician intention to recommend HPV vaccines predicts HPV vaccine series initiation among previously unvaccinated 11 to 18 year-old girls (N = 18,083) who were seen by a pediatric clinician (N = 105) from a large primary care network within 3 years of vaccine introduction. We used multivariable logistic regression with generalized estimating equations, Cox Regression and standardized survival curves to measure the association between clinician intention and time to and rate of first HPV vaccine receipt among eligible females. All models adjusted for patient age, race / ethnicity, payor category, visit type, and practice location. Eighty-5 percent of eligible 11 to 12 year-old and 95% of 13 to 18 year-old girls were seen by a provider reporting high intention to recommend HPV vaccines. However, only 30% of the cohort initiated the HPV vaccine series and the mean number of days from first eligible visit to series initiation was 190 (95% C.I. 184.2, 195.4). After adjusting for covariates, high clinician intention was modestly associated with girls’ likelihood of HPV vaccine series initiation (OR 1.36; 95 % C.I. 1.07, 1.71) and time to first HPV vaccination (HR 1.22; 95% 1.06, 1.40). Despite high intention to vaccinate among this cohort of pediatric clinicians, overall vaccination rates for adolescent girls remained low. These findings support ongoing efforts to develop effective strategies to translate clinician intention into timely HPV vaccine receipt. PMID:25483470

  1. Using HPV vaccination for promotion of an adolescent package of care: opportunity and perspectives

    PubMed Central

    2013-01-01

    Background Adolescents are a difficult population to access for preventive health care, particularly in less resourced countries. Evidence from developed countries indicates that the HPV vaccine schedule may be a useful platform from which to deliver other adolescent health care services. We conducted a qualitative cross sectional study to assess the potential for using the HPV vaccine in the South African public health care system as an opportunity for integrated health care services for adolescents. Methods Parents, young adolescents, community members and key informants participated in interviews and focus group discussions about feasibility and acceptability, particularly the use of the HPV vaccination as the basis for an integrated adolescent package of care. Health care providers in both provinces participated in focus group discussions and completed a pairwise ranking exercise to compare and prioritise interventions for inclusion in an adolescent package of care. Results Participants were in favour of integration and showed preference for detailed information about the HPV vaccine, general health information and specific sexual and reproductive health information. Among health care workers, results differed markedly by location. In North West, prioritisation was given to information, screening and referral for tobacco and alcohol abuse, and screening for hearing and vision. In Gauteng integration with referral for male circumcision, and information, screening and referral for child abuse were ranked most highly. Conclusions There is generally support for the delivery of adolescent preventive health services. Despite national priorities to address adolescent health needs, our data suggest that national policies might not always be appropriate for vastly different local situations. While decisions about interventions to include have traditionally been made at country level, our results suggest that local context needs to be taken account of. We suggest low

  2. Sources of HPV vaccine hesitancy in parents

    PubMed Central

    Patel, Pooja R; Berenson, Abbey B

    2013-01-01

    Despite strong national recommendations to vaccinate adolescents against the human papillomavirus (HPV), only 14% of teenage girls completed all 3 doses in 2010. Parental hesitancy may be one of the strongest reasons behind this low uptake rate. This review investigates sources of parental hesitancy including parental concerns associated with vaccinations in general, parental knowledge as a basis of HPV vaccine hesitancy, social qualms parents may have with regards to the HPV vaccine, and parental attitudes toward allowing their sons to be vaccinated against HPV. By better understanding these sources of hesitancy, we can focus research efforts towards addressing them in an attempt to improve HPV vaccine uptake. PMID:23982270

  3. Human Papillomavirus (HPV) Vaccination and Adolescent Girls' Knowledge and Sexuality in Western Uganda: A Comparative Cross-Sectional Study

    PubMed Central

    Turiho, Andrew Kampikaho

    2015-01-01

    The purpose of the study was to investigate the influence of human papillomavirus (HPV) vaccination on adolescent girls’ knowledge of HPV and HPV vaccine, perception of sexual risk and intentions for sexual debut. This cross-sectional comparative study was conducted in Ibanda and Mbarara districts. Data was collected using a standardized self-administered questionnaire and analyzed using the Statistical Package for the Social Sciences computer software. Univariate, bivariate, and logistic regression analyses were conducted with significance level set at p < .05. Results showed that HPV vaccination was associated with being knowledgeable (Crude OR: 5.26, CI: 2.32–11.93; p = 0.000). Vaccination against HPV did not predict perception of sexual risk. Knowledge was low (only 87/385 or 22.6% of vaccinated girls were knowledgeable), but predicted perception of a high sexual risk (Adjusted OR: 3.12, CI: 1.37–3.63; p = 0.008). HPV vaccination, knowledge and perceived sexual risk did not predict sexual behaviour intentions. High parental communication was associated with adolescent attitudes that support postponement of sexual debut in both bivariate and multiple regression analyses. In conclusion, findings of this study suggest that HPV vaccination is not likely to encourage adolescent sexual activity. Influence of knowledge on sexual behaviour intentions was not definitively explained. Prospective cohort studies were proposed to address the emerging questions. PMID:26327322

  4. Human Papillomavirus (HPV) Vaccination and Adolescent Girls' Knowledge and Sexuality in Western Uganda: A Comparative Cross-Sectional Study.

    PubMed

    Turiho, Andrew Kampikaho; Muhwezi, Wilson Winston; Okello, Elialilia Sarikiaeli; Tumwesigye, Nazarius Mbona; Banura, Cecil; Katahoire, Anne Ruhweza

    2015-01-01

    The purpose of the study was to investigate the influence of human papillomavirus (HPV) vaccination on adolescent girls' knowledge of HPV and HPV vaccine, perception of sexual risk and intentions for sexual debut. This cross-sectional comparative study was conducted in Ibanda and Mbarara districts. Data was collected using a standardized self-administered questionnaire and analyzed using the Statistical Package for the Social Sciences computer software. Univariate, bivariate, and logistic regression analyses were conducted with significance level set at p < .05. Results showed that HPV vaccination was associated with being knowledgeable (Crude OR: 5.26, CI: 2.32-11.93; p = 0.000). Vaccination against HPV did not predict perception of sexual risk. Knowledge was low (only 87/385 or 22.6% of vaccinated girls were knowledgeable), but predicted perception of a high sexual risk (Adjusted OR: 3.12, CI: 1.37-3.63; p = 0.008). HPV vaccination, knowledge and perceived sexual risk did not predict sexual behaviour intentions. High parental communication was associated with adolescent attitudes that support postponement of sexual debut in both bivariate and multiple regression analyses. In conclusion, findings of this study suggest that HPV vaccination is not likely to encourage adolescent sexual activity. Influence of knowledge on sexual behaviour intentions was not definitively explained. Prospective cohort studies were proposed to address the emerging questions. PMID:26327322

  5. Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

    PubMed Central

    Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

    2016-01-01

    Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827

  6. [Developments in HPV vaccination].

    PubMed

    de Melker, Hester; Kenter, Gemma; van Rossum, Tekla; Conyn-van Spaendonck, Marina

    2012-01-01

    Vaccination against the human papilloma virus (HPV) has been included in the national Vaccination Programme of the Netherlands for 12-year-old girls since 2010. Vaccination coverage for the birth cohort of 1997 was 56.; there is a gradual increase in uptake. Continuous safety monitoring brought no new unknown serious side effects to light; many girls suffered from transient symptoms such as painful arm, fatigue and headache. After the current vaccines that protect against HPV types 2 and 4 types, respectively and induce some cross protection, vaccines are being developed that can induce broader protection. HPV vaccination of 12-year-old girls is cost-effective, even for relatively low vaccination coverage. The potential protection of HPV vaccination extends beyond prevention of cervical cancer by preventing other oncological manifestations of HPV infection in women as well as men and genital warts. The preventive HPV vaccines do not appear to be effective in treating existing abnormalities. PMID:23171565

  7. Human Papillomavirus (HPV) Vaccine (Cervarix)

    MedlinePlus

    ... changes or ringing in the ears. Like all vaccines, HPV vaccines will continue to be monitored for unusual ... gov/std/hpv and http://www.cdc.gov/vaccines HPV Vaccine (Cervarix) Information Statement. U.S. Department of Health ...

  8. A Qualitative Analysis of Factors Influencing HPV Vaccine Uptake in Soweto, South Africa among Adolescents and Their Caregivers

    PubMed Central

    Katz, Ingrid T.; Nkala, Busisiwe; Dietrich, Janan; Wallace, Melissa; Bekker, Linda-Gail; Pollenz, Kathryn; Bogart, Laura M.; Wright, Alexi A.; Tsai, Alexander C.; Bangsberg, David R.; Gray, Glenda E.

    2013-01-01

    Background In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV) may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto. Methods The HPV vaccine was introduced to adolescents in low-income townships throughout South Africa as part of a nationwide trial to understand adolescent involvement in future vaccine research targeting human immunodeficiency virus (HIV). We performed in-depth semi-structured interviews with purposively-sampled adolescents and their care providers to understand what forces shaped HPV vaccine uptake. Interviews were recorded, transcribed, translated, and examined using thematic analysis. Results Of 224 adolescents recruited, 201 initiated the vaccine; 192 (95.5%) received a second immunization; and 164 (81.6%) completed three doses. In our qualitative study of 39 adolescent-caregiver dyads, we found that factors driving vaccine uptake reflected a socio-cultural backdrop of high HIV endemnicity, sexual violence, poverty, and an abundance of female-headed households. Adolescents exercised a high level of autonomy and often initiated decision-making. Healthcare providers and peers provided support and guidance that was absent at home. The impact of the HIV epidemic on decision-making was substantial, leading participants to mistakenly conflate HPV and HIV. Conclusions In a setting of perceived rampant sexual violence and epidemic levels of HIV, adolescents and caregivers sought to decrease harm by seeking a vaccine targeting a sexually transmitted infection (STI). Despite careful consenting, there was confusion regarding the vaccine’s target. Future

  9. Prophylactic HPV vaccination: past, present, and future.

    PubMed

    Castle, P E; Maza, M

    2016-02-01

    Human papillomavirus (HPV) is the necessary cause of cervical cancer, the fourth most common cancer and cause of cancer-related death in females worldwide. HPV also causes anal, vaginal, vulvar, penile, and oropharyngeal cancer. Prophylactic HPV vaccines based on recombinantly expressed virus-like particles have been developed. Two first-generation, U.S. Food and Drug Administration (FDA)-approved vaccines prevent infections and disease caused by HPV16 and HPV18, the two HPV genotypes that cause approximately 70% of cervical cancer, and one of these vaccines also prevents HPV6 and HPV11, the two HPV genotypes that cause 90% of genital warts. A next-generation vaccine, recently approved by the U.S. FDA, targets HPV16, HPV18, and five additional HPV genotypes that together causes approximately 90% of cervical cancer as well as HPV6 and HPV11. In clinical trials, these vaccines have shown high levels of efficacy against disease and infections caused by the targeted HPV genotypes in adolescent females and males and older females. Data indicate population effectiveness, and therefore cost effectiveness, is highest in HPV-naive young females prior to becoming sexually active. Countries that implemented HPV vaccination before 2010 have already experienced decreases in population prevalence of targeted HPV genotypes and related anogenital diseases in women and via herd protection in heterosexual men. Importantly, after more than 100 million doses given worldwide, HPV vaccination has demonstrated an excellent safety profile. With demonstrated efficacy, cost-effectiveness, and safety, universal HPV vaccination of all young, adolescent women, and with available resources at least high-risk groups of men, should be a global health priority. Failure to do so will result in millions of women dying from avertable cervical cancers, especially in low- and middle-income countries, and many thousands of women and men dying from other HPV-related cancers. PMID:26429676

  10. Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study

    PubMed Central

    Smith, Leah M.; Kaufman, Jay S.; Strumpf, Erin C.; Lévesque, Linda E.

    2015-01-01

    Background: Suboptimal human papillomavirus (HPV) vaccine coverage in some jurisdictions is partly attributed to fears that vaccination may increase risky sexual behaviour. We assessed the effect of HPV vaccination on clinical indicators of sexual behaviour among adolescent girls in Ontario. Methods: Using Ontario’s administrative health databases, we identified a population-based cohort of girls in grade 8 in the 2 years before (2005/06 and 2006/07) and after (2007/08 and 2008/09) implementation of Ontario’s grade 8 HPV vaccination program. For each girl, we then obtained data on vaccine receipt in grades 8 and 9 and data on indicators of sexual behaviour (pregnancy and non–HPV-related sexually transmitted infections) in grades 10–12. Using a quasi-experimental method known as regression discontinuity, we estimated, for each outcome, the risk difference (RD) and relative risk (RR) attributable to vaccination and to program eligibility. Results: The cohort comprised 260 493 girls, of whom 131 781 were ineligible for the program and 128 712 were eligible. We identified 15 441 (5.9%) cases of pregnancy and sexually transmitted infection and found no evidence that vaccination increased the risk of this composite outcome: RD per 1000 girls −0.61 (95% confidence interval [CI] −10.71 to 9.49) and RR 0.96 (95% CI 0.81 to 1.14). Similarly, we found no discernible effect of program eligibility: RD per 1000 girls −0.25 (95% CI −4.35 to 3.85) and RR 0.99 (95% CI 0.93 to 1.06). The findings were similar when outcomes were assessed separately. Interpretation: We present strong evidence that HPV vaccination does not have any significant effect on clinical indicators of sexual behaviour among adolescent girls. These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age. PMID:25487660

  11. Ohio Appalachia public health department personnel: human papillomavirus (HPV) vaccine availability, and acceptance and concerns among parents of male and female adolescents.

    PubMed

    Oldach, Benjamin R; Katz, Mira L

    2012-12-01

    Public health departments (n = 48) serving the 32 counties of Ohio Appalachia were contacted to determine human papillomavirus (HPV) vaccine availability and to assess patient and parental attitudes, perceived barriers, and decisional differences about vaccination for male and female adolescents. Nurses or nursing supervisors in 46 of 48 health departments agreed to participate with 45 (97.8 %) reporting that HPV vaccines were available for males and females. HPV vaccination barriers reported most frequently were lack of knowledge about the vaccines, concerns about potential side effects, the newness of the HPV vaccines, and parents believing their children were not sexually active or were too young to receive an HPV vaccine. Provider reports of the primary differences in the acceptability of an HPV vaccine among parents of males compared to the parents of females were lack of awareness that an HPV vaccine was available for males, not understanding why the vaccine should be given to males, and fear of vaccination increasing sexual promiscuity among female adolescents. Half of the health departments (n = 24) reported that parents of females were more receptive toward HPV vaccination, 16 health departments reported no difference in acceptability based on gender of the child, and 5 health departments reported that parents of males were more receptive. This study suggests that there are different informational needs of males and females and parents of male and female children when making an informed decision about HPV vaccination. Findings highlight content to include in strategies to increase HPV vaccination rates among Appalachia Ohio residents. PMID:22968822

  12. An exploratory study of adolescent female reactions to direct-to-consumer advertising: the case of the Human Papillomavirus (HPV) Vaccine.

    PubMed

    Leader, Amy E; Cashman, Rebecca; Voytek, Chelsea D; Baker, Jillian L; Brawner, Bridgette M; Frank, Ian

    2011-10-01

    When the human papillomavirus (HPV) vaccine was approved in 2006, an extensive direct-to-consumer (DTC) advertising campaign raised awareness and promoted vaccination. This study explores adolescents' exposure to and understanding of the messages in these advertisements. Sixty-seven African American females participated in a focus group about DTC advertising for the HPV vaccine. Virtually all adolescents had seen an HPV vaccine DTC advertisement, but most did not understand the health information contained in it. If DTC advertising is to be an effective source of health information for adolescents in the future, it must take into account the unique features of an adolescent audience. PMID:22054031

  13. The HPV Vaccination Crisis

    Cancer.gov

    Following the release of a consensus statement from the NCI-Designated Cancer Centers urging HPV vaccination in the United States, Dr. Noel Brewer discusses the country’s low vaccination rates and how clinicians can help to improve them.

  14. Parent Perceptions Important for HPV Vaccine Initiation among Low Income Adolescent Girls

    PubMed Central

    Staras, Stephanie A.S.; Vadaparampil, Susan T.; Patel, Roshni P.; Shenkman, Elizabeth A.

    2014-01-01

    Objective The study aims were to assess the influence of provider recommendations on parental vaccine perceptions and identify the most potent parent vaccine perceptions for HPV vaccine series initiation considering provider recommendation strength. Methods We administered a questionnaire and assessed HPV vaccine claims among a stratified-random sample of parents of 9-17 year old girls enrolled in Florida's Medicaid and the Children's Health Insurance Program. Using multivariate analyses, we evaluated the associations between: (1) parent vaccine perceptions and provider recommendation strength, and (2) parent vaccine perceptions and HPV vaccine series initiation (≥ 1 vaccine claim or positive parental report) controlling for provider recommendation strength. Results The majority of the 2,422 participating parents agreed that the HPV vaccine was safe (61%), would not make girls more likely to have sex (69%), and prevented cervical cancer (71%). About half (44%) reported receiving a strong provider recommendation. Compared to parents without recommendations, parents with strong recommendations had 2 to 7 times higher odds of agreeing that: vaccines are safe, the HPV vaccine is safe, not concerned about side effects, and the vaccine prevents cervical cancer. Even when considering provider recommendation strength, HPV vaccine series initiation was more likely among girls of parents who agreed rather than disagreed that the HPV vaccine was safe [Odds Ratio (OR) =5.8, 95% Confidence Interval (CI) = 3.1, 11.1), does not cause sex (OR=2.0, 95% CI = 1.2, 3.4), prevents cervical cancer (OR=2.0, 95% CI = 1.0, 3.4), and prevents HPV infections (OR=1.8, 95% CI = 1.0, 3.0). Conclusions Parent concerns about HPV vaccine are similar to their concerns about other vaccines. Providers should focus HPV vaccine discussions with parents on vaccine safety and illness prevention. PMID:25180815

  15. Human Papillomavirus (HPV) Vaccine (Gardasil)

    MedlinePlus

    ... changes or ringing in the ears.Like all vaccines, HPV vaccines will continue to be monitored for unusual ... visit CDC's website at http://www.cdc.gov/vaccines. HPV Vaccine (Gardasil) Information Statement. U.S. Department of Health ...

  16. Knowledge and Perceptions of HPV and the HPV Vaccine among Pre-adolescent Girls and Their Guardians in Georgetown, Guyana

    PubMed Central

    Tyrell, E; Ramsammy-Boyce, K

    2015-01-01

    ABSTRACT Objectives: To examine the knowledge and perceptions of 11-year old girls and their guardians toward the human papillomavirus (HPV), HPV (mandatory) vaccination and cervical cancer and to determine their main sources of health information. Methods: A cross-sectional study was done by interviewing two separate study populations ie 11-year old girls from five primary schools in Georgetown and their guardians. Questions were designed to assess level of knowledge as well as perceptions about mandatory vaccination and sources of health information. Results: A total of 87 girls participated, of whom 10 (11%) had already received the HPV vaccine. Overall, when asked whether they knew of HPV, the HPV vaccine, cervical cancer or the Pap smear, more than half of the girls, in every instance, did not know. Seventy-four guardians took part and most (> 80%) of them claimed that they knew about these parameters except for HPV transmission (40%) and the cause of cervical cancer (30%). Both girls and guardians responded poorly to questions about the detection of cervical cancer. Furthermore, only two of the 14 girls who stated that they knew how HPV was transmitted, actually answered correctly that it was sexual transmission. Girls were almost twice as likely to be in favour of mandatory vaccination as guardians (OR 1.8, 95% CI: 0.9, 3.6) but the difference was not significant (p > 0.05). The girls indicated health centres/clinics (58%), whilst TV/radio (66%) was the preference for the guardians as their most popular health information sources. Conclusions: These findings point to a necessity for educational programmes and activities in which children and their guardians can meaningfully participate and be informed about the different aspects of HPV vaccination. PMID:26035815

  17. [HPV prophylactic vaccines].

    PubMed

    Konopnicki, D

    2014-09-01

    Since 2007, two prophylactic vaccines against Human Papillomavirus (HPV) infection and HPV. induced lesions (both precancerous dysplasia and cancer) have been registered in Belgium. In multicentre randomized trials including more than 64,000 patients, these vaccines were shown to be highly efficient against the occurrence of condyloma and of dysplastic lesion in the cervix, vagina and vulva in females and in the anus in males. These vaccines display an excellent tolerance and safety profile, the most common adverse event being minor and transient side effects at the injection site. The protection given by these vaccines is more important in subjects that have not been in contact with HPV previously ; moreover the title of neutralizing antibodies against HPV are significantly higher in children vaccinated before 15 years-old age compared to young person vaccinated after this age. For these two reasons, it is recommended to vaccinate before the first sexual relationships. Recently, several studies have demonstrated that vaccination by two doses given at 0 and 6 months in children before 15 years-old was equivalent to the three doses scheme that should be given at 0, 1 or 2 and 6 months in subjects aged 15 years or more. In the countries that have achieved a high vaccine coverage among their young female population, the prevalence of HPV infection and the incidence of high grade cervical dysplasia have significantly decreased while condyloma has almost disappeared four years after the implementation of HPV vaccination. In HIV-positive subjects who are particularly susceptible to infection and lesions induced by HPV, vaccination brings levels of antibody comparable to what is found in the general population with similar safety. PMID:25675641

  18. The Uptake of Human Papillomavirus (HPV) Vaccine among Adolescent Females in the United States: A Review of the Literature

    ERIC Educational Resources Information Center

    Bartlett, Jacqueline A.; Peterson, Jane Anthony

    2011-01-01

    A comprehensive review of literature was conducted to identify the barriers and facilitators, from the parents'/guardians' and primary care providers' (PCPs) perspective, that are associated with the uptake of Human Papillomavirus (HPV) vaccine among adolescent females. Findings from 14 peer-reviewed articles indicate that 37% of adolescent…

  19. Socioeconomic and Racial-ethnic Disparities in Prosocial Health Attitudes: The Case of Human Papillomavirus (HPV) Vaccination for Adolescent Males.

    PubMed

    Polonijo, Andrea N; Carpiano, Richard M; Reiter, Paul L; Brewer, Noel T

    2016-09-01

    Research on prosocial attitudes, social networks, social capital, and social stratification suggest that lower-socioeconomic status (SES), Hispanic, and nonwhite individuals will be more likely than their higher-SES and non-Hispanic white counterparts to engage in health behaviors that serve a social good. Analyzing data from the University of North Carolina Human Papillomavirus (HPV) Immunization in Sons Study, we test whether SES and race-ethnicity are associated with willingness to vaccinate via prosocial attitudes toward HPV vaccination among adolescent males (n = 401) and parents (n = 518). Analyses revealed that (a) parents with lower education and (b) black and Hispanic parents and adolescent males reported higher prosocial vaccination attitudes, but only some attitudes were associated with higher willingness to vaccinate. We discuss these findings in terms of how prosocial attitudes may motivate certain health behaviors and serve as countervailing mechanisms in the (re)production of health disparities and promising targets of future public health interventions. PMID:27601412

  20. Human Papillomavirus (HPV) Vaccine (Cervarix)

    MedlinePlus

    ... std/hpv and http://www.cdc.gov/vaccines HPV Vaccine (Cervarix) Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 5/3/2011.

  1. Human Papillomavirus (HPV) Vaccine (Gardasil)

    MedlinePlus

    ... prevent HPV. It may be given to both males and females.This vaccine can prevent most cases of cervical ... and genital warts and anal cancer in both males and females.Protection from HPV vaccine is expected to be ...

  2. Different models of HPV vaccine decision making among adolescent girls, parents, and health care clinicians in New Mexico

    PubMed Central

    Getrich, Christina M.; Broidy, Lisa M.; Kleymann, Erin; Helitzer, Deborah L.; Kong, Alberta S.; Sussman, Andrew L.

    2015-01-01

    Objective HPV vaccination rates in the United States have been lower than anticipated since the vaccine became widely available globally in 2006. Of particular concern are data that suggest disparities in vaccine receipt among U.S. ethnic minority and health disparity populations such as Hispanics, who are disproportionately affected by cervical cancer. Given these trends, it is important to examine actual vaccination decision making processes among clinicians, parents, and adolescents to identify strategies to enhance uptake. Design We conducted a mixed-method study examining HPV vaccine decision making, utilizing both structured questionnaires of mothers and daughters and semi-structured interviews with mothers, daughters, and healthcare clinicians to more deeply investigate decision-making dynamics. Quantitative analysis was used for descriptive purposes, while qualitative analysis featured an iterative process to examine factors related to decision-making surrounding the HPV vaccine. The study was conducted in two primary care clinics serving predominantly Hispanic patients in an urban New Mexico setting through RIOS Net, a primary care practice-based research network. Results We conducted 22 questionnaires and 30 interviews. We identified three aspects of vaccine delivery that were similar across clinics: availability/supply of the vaccine, favorable clinician attitudes towards the vaccine, and clinicians’ competing demands. We also identified three decision-making stages (pre-encounter, encounter, and post-encounter), though we found distinct differences in decision-making processes at the two sites. We describe the differences between an encounter-based and a process-based model of decision making, and the ways in which explanatory factors might influence the decision-making process. Conclusion Our findings suggest that factors other than race and ethnicity, such as education, socio-economic status, and health care access, play an important role in HPV

  3. HPV vaccines: a controversial issue?

    PubMed Central

    Nicol, A.F.; Andrade, C.V.; Russomano, F.B.; Rodrigues, L.L.S.; Oliveira, N.S.; Provance, D.W.

    2016-01-01

    Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits. PMID:27074168

  4. HPV and HPV Vaccine Education Intervention: Effects on Parents, Healthcare Staff, and School Staff

    PubMed Central

    Reiter, Paul L.; Stubbs, Brenda; Panozzo, Catherine A.; Whitesell, Dianne; Brewer, Noel T.

    2011-01-01

    Background Increasing knowledge about HPV and HPV vaccine is a potentially important way to increase vaccination rates, yet few education interventions have addressed these topics. We report the results of an education intervention targeting three key groups who have contact with adolescent females. Methods We conducted HPV education intervention sessions during 2008 and 2009 in Guilford County, North Carolina. Parents (n=376), healthcare staff (n=118), and school staff (n=456) attended the one-time sessions and completed self-administered surveys. Analyses used mixed regression models to examine the intervention’s effects on participants’ self-rated HPV knowledge, objectively assessed HPV and HPV vaccine knowledge, and beliefs about HPV vaccine. Results Participants had relatively low levels of objectively assessed HPV and HPV vaccine knowledge prior to the intervention. The education intervention increased self-rated HPV knowledge among all three key groups (all p<0.001), as well as objectively assessed knowledge about many aspects of HPV and HPV vaccine among healthcare and school staff members (all p<0.05). Following the intervention, over 90% of school staff members believed HPV and HPV vaccine education is worthwhile for school personnel and that middle schools are an appropriate venue for this education. Most parents (97%) and school staff members (85%) indicated they would be supportive of school-based vaccination clinics. Conclusions Our education intervention greatly increased HPV and HPV vaccine knowledge among groups influential to the HPV vaccination behaviors of adolescent females. Impact Education interventions represent a simple yet potentially effective strategy for increasing HPV vaccination and garnering stronger support for school-based vaccination clinics. PMID:21949110

  5. Attitudes, Knowledge and Factors Associated with Human Papillomavirus (HPV) Vaccine Uptake in Adolescent Girls and Young Women in Victoria, Australia

    PubMed Central

    Tung, Iris L. Y.; Machalek, Dorothy A.; Garland, Suzanne M.

    2016-01-01

    Background Human papillomavirus (HPV) vaccination targets high-risk HPV16/18 that cause 70% of all cancers of the cervix. In Australia there is a fully-funded, school-based National HPV Vaccination Program which has achieved vaccine initiation rate of 82% among age-eligible females. Improving HPV vaccination rates is important in the prevention of morbidity and mortality associated with HPV-related disease. This study aimed to identify factors and barriers associated with uptake of the HPV vaccine in the Australian Program. Methods Between 2011 and 2014, females aged 18–25 years, living in Victoria, Australia who were offered HPV vaccination between 2007 and 2009 as part of the National HPV Vaccination Program, living in Victoria, Australia were recruited into a a young women’s study examining effectiveness of the Australian National HPV Vaccination Program. Overall, 668 participants completed the recruitment survey, which collected data of participants’ demographics and HPV knowledge. In 2015 these participants were invited to complete an additional supplementary survey on parental demographics and attitudes towards vaccinations. Results In 2015, 417 participants completed the supplementary survey (62% response rate). Overall, 19% of participants were unvaccinated. In multivariate analyses, HPV vaccination was significantly associated with their being born in Australia (p<0.001), having completed childhood vaccinations (p<0.001) and their parents being main decision-makers for participants’ HPV vaccination (p<0.001). The main reason reported for HPV non-vaccination was parental concern about vaccine safety (43%). Compared with HPV-vaccinated participants, those unvaccinated were significantly more likely to be opposed to all vaccines, including HPV vaccines (p<0.001) and were less likely to consider vaccinating their own children with all vaccines (p = 0.033), including HPV vaccines (p<0.001). Overall, 61% of unvaccinated participants reported that a

  6. Effect of School-based Human Papillomavirus (HPV) Vaccination on Adolescent Girls’ Knowledge and Acceptability of the HPV Vaccine in Ibanda District in Uganda

    PubMed Central

    Turiho, Andrew Kampikaho; Okello, Elialilia S.; Muhwezi, Wilson W.; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R.

    2015-01-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls’ knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19–8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56–2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16–5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  7. Effect of school-based human papillomavirus (hpv) vaccination on adolescent girls' knowledge and acceptability of the HPV vaccine in Ibanda District in Uganda.

    PubMed

    Turiho, Andrew Kampikaho; Okello, Elialilia S; Muhwezi, Wilson W; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R

    2014-12-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls' knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19-8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56-2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16-5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  8. Human papillomavirus (HPV) vaccination of adolescents in the South African private health sector: Lessons from the HPV demonstration project in KwaZulu-Natal.

    PubMed

    Tathiah, N; Naidoo, M; Moodley, I

    2015-11-01

    In South Africa (SA), >4,000 women die annually of cervical cancer, a disease caused by the human papillomavirus (HPV). Infections caused by certain genotypes of HPV increase the risk of cervical cancer. HIV-infected women in particular are more likely to have persistent HPV infection, with higher-risk genotypes. In SA, two vaccines (HPV quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant (Gardasil) and HPV bivalent (types 16 and 18) vaccine, recombinant (Cervarix)) are currently registered for the prevention of HPV-related disease. In the past, there have been significant challenges to achieving high coverage and uptake of vaccination–contributory factors include cost and lack of awareness. An HPV demonstration project among schoolgirls in rural KwaZulu-Natal showed that high vaccine uptake is achievable. In 2014, the National Department of Health launched the national HPV vaccination programme among female learners attending public schools. Awareness of HPV vaccination among healthcare providers, education of parents, teachers and learners, and avoidance of missed opportunities for vaccination are vital to the success of the programme. Primary healthcare practitioners may play an important role in cervical cancer prevention by identifying and offering vaccination to girls who miss the opportunity to be vaccinated at school. HPV vaccination should be considered as one arm of a comprehensive programme of cervical cancer prevention and control. PMID:26937512

  9. HPV Vaccine - Questions and Answers

    MedlinePlus

    ... and Media Resources News Newsletters Events Redirect for HPV Vaccine FAQ Recommend on Facebook Tweet Share Compartir ... to the address below. http://www.cdc.gov/hpv/parents/questions-answers.html File Formats Help: How ...

  10. Mothers' support for voluntary provision of HPV vaccine in schools.

    PubMed

    Kadis, Jessica A; McRee, Annie-Laurie; Gottlieb, Sami L; Lee, Morgan R; Reiter, Paul L; Dittus, Patricia J; Brewer, Noel T

    2011-03-21

    HPV vaccination rates among adolescents in the United States lag behind some other developed countries, many of which routinely offer the vaccine in schools. We sought to assess mothers' willingness to have their adolescent daughters receive HPV vaccine at school. A national sample of mothers of adolescent females ages 11-14 completed our internet survey (response rate=66%). The final sample (n=496) excluded mothers who did not intend to have their daughters receive HPV vaccine in the next year. Overall, 67% of mothers who intended to vaccinate their daughters or had vaccinated their daughters reported being willing to have their daughters receive HPV vaccine at school. Mothers were more willing to allow their daughters to receive HPV vaccine in schools if they had not yet initiated the vaccine series for their daughters or resided in the Midwest or West (all p<.05). The two concerns about voluntary school-based provision of HPV vaccine that mothers most frequently cited were that their daughters' doctors should keep track of her shots (64%) and that they wished to be present when their daughters were vaccinated (40%). Our study suggests that most mothers who support adolescent vaccination for HPV find school-based HPV vaccination an acceptable option. Ensuring communication of immunization records with doctors and allowing parents to be present during immunization may increase parental support. PMID:21300097

  11. Preventing Cervical Cancer with HPV Vaccines

    Cancer.gov

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  12. Detection of systemic and mucosal HPV-specific IgG and IgA antibodies in adolescent girls one and two years after HPV vaccination

    PubMed Central

    Scherpenisse, Mirte; Mollers, Madelief; Schepp, Rutger M.; Meijer, Chris J.L.M.; de Melker, Hester E.; Berbers, Guy A.M.; van der Klis, Fiona R.M.

    2013-01-01

    The bivalent HPV16/18 vaccine induces high antibody concentrations in serum while data about antibody responses in the cervix are limited. In this study, we investigated pre- and post-vaccination antibody responses against seven high-risk HPV types by detection of IgG and IgA HPV-specific antibodies in cervical secretion samples (CVS) and serum. From an HPV vaccine monitoring study CVS and serum samples were available (pre-vaccination (n = 297), one year (n = 211) and two years (n = 141) post-dose-one vaccination) from girls aged 14–16 y. The girls were vaccinated with the bivalent HPV vaccine at months 0, 1 and 6. CVS was self-sampled using a tampon. Samples were tested for HPV-specific antibodies (HPV16/18/31/33/45/52/58) by a VLP-based multiplex immunoassay. Post-vaccination, IgG and IgA antibody levels for HPV16/18 were detectable in CVS and amounted to 2% and 1% of the IgG and IgA antibody levels observed in serum, respectively. The antibody levels remained constant between one and two years after vaccination. The correlation between CVS and serum was similar for IgG and IgA vaccine-derived antibody levels for HPV16 (rs = 0.58, rs = 0.54) and HPV18 (rs = 0.50, rs = 0.55). Vaccine-derived IgG antibody levels against cross-reactive HPV types in CVS and in serum were highest for HPV45. No IgA cross-reactive antibody responses could be detected in CVS. Post-vaccination, HPV16/18 IgG and IgA antibodies are not only detectable in serum but also in CVS. The correlation of HPV16/18 IgG antibody levels between serum and CVS suggests that vaccine induced HPV antibodies transudate and/or exudate from the systemic circulation to the cervical mucosa to provide protection against HPV infections. PMID:23149693

  13. Racial Differences in HPV Knowledge, HPV Vaccine Acceptability, and Related Beliefs among Rural, Southern Women

    ERIC Educational Resources Information Center

    Cates, Joan R.; Brewer, Noel T.; Fazekas, Karah I.; Mitchell, Cicely E.; Smith, Jennifer S.

    2009-01-01

    Context: Because cervical cancer mortality in the United States is twice as high among black women as white women and higher in rural areas, providing human papillomavirus (HPV) vaccine to rural black adolescents is a high priority. Purpose: To identify racial differences in knowledge and attitudes about HPV, cervical cancer, and the HPV vaccine…

  14. Paediatricians’ attitudes and practices towards HPV vaccination

    PubMed Central

    Ishibashi, Kimiko L.; Koopmans, Joy; Curlin, Farr A.; Alexander, Kenneth A.; Ross, Lainie Friedman

    2008-01-01

    Aim In June 2006, the human papillomavirus (HPV) vaccine, Gardasil, was licensed for use in the United States. We examined whether paediatricians would recommend the vaccine, obstacles they encountered and characteristics associated with not recommending the HPV vaccine to all eligible patients. Methods Four hundred fifty general paediatricians, 200 members of the section of infectious diseases and 200 members of the section of adolescent medicine of the American Academy of Pediatrics web-based directory were surveyed. Results Of 752 eligible paediatricians, 373 (50%) responded. Eighty-eight percent (292 of 332) of respondents stated that they would give the vaccine to all, 36 (11%) would give it to some and 4 (1%) would give it to none of their eligible patients. The main obstacles were cost and safety; a minority expressed concern about the vaccine’s potential impact on adolescent sexual activity. Physicians who would not recommend HPV vaccination to all eligible patients were more likely to be generalists, have higher intrinsic religiosity, self-describe as conservative, report later adoption of new drugs/vaccines, and would not encourage vaccinating their own daughter or the daughter of a close friend. Conclusion Although paediatricians are highly supportive of the HPV vaccine, certain characteristics may predict reluctance to immunize. PMID:18671696

  15. Long-term persistence of systemic and mucosal immune response to HPV-16/18 AS04-adjuvanted vaccine in preteen/adolescent girls and young women.

    PubMed

    Petäjä, Tiina; Pedersen, Court; Poder, Airi; Strauss, Gitte; Catteau, Gregory; Thomas, Florence; Lehtinen, Matti; Descamps, Dominique

    2011-11-01

    Vaccination against oncogenic human papillomavirus (HPV) types is one key intervention for cervical cancer prevention. This follow-up study assessed the persistence of the systemic and mucosal immune responses together with the safety profile of the HPV-16/18 AS04-adjuvanted vaccine administered to young women aged 10-25 years. Serum and cervicovaginal secretion (CVS) samples were collected at prespecified time-points during the 48-month follow-up period. Anti-HPV-16/18 antibody levels in serum and CVS were measured by enzyme-linked immunosorbent assay (ELISA). At Month 48, all subjects remained seropositive for serum anti-HPV-16 and -18 antibodies. As previously observed, anti-HPV-16 and -18 antibodies levels (ELISA Units/mL) were higher in subjects vaccinated at the age of 10-14 years (2862.2 and 940.8) compared to subjects vaccinated at the age of 15-25 years (1186.2 and 469.8). Moreover, anti-HPV-16 and -18 antibodies in CVS were still detectable for subjects aged 15-25 years (84.1% and 69.7%, respectively). There was a strong correlation between serum and CVS anti-HPV-16 and -18 antibodies levels (correlation coefficients = 0.84 and 0.90 at Month 48, respectively) supporting the hypothesis of transudation or exudation of serum immunoglobulin G antibodies through the cervical epithelium. The HPV-16/18 AS04-adjuvanted vaccine had a clinically acceptable safety profile. In conclusion, this follow-up study shows that the HPV-16/18 AS04-adjuvanted vaccine administered to preteen/adolescents girls and young women induces long-term systemic and mucosal immune response and has a clinically acceptable safety profile up to 4 years after the first vaccine dose. PMID:21190190

  16. Asking mom: formative research for an HPV vaccine campaign targeting mothers of adolescent girls.

    PubMed

    Shafer, Autumn; Cates, Joan R; Diehl, Sandra J; Hartmann, Miriam

    2011-10-01

    Vaccination against the types of human papillomavirus (HPV) that cause about 70% of cervical cancers is approved for use in girls and women between 9 and 26 years of age and recommended routinely in 11-12-year-old girls. This article reports on the systematic theory-based formative research conducted to develop HPV vaccine messages for a campaign targeting racially diverse mothers of nonvaccinated 11-12-year-old girls in rural Southeastern United States. A consortium of 13 county health departments concerned about high rates of cervical cancer in their region relative to state and national averages initiated the campaign. The research examined behavioral determinants for vaccination decisions as well as mothers' reactions to message frames and emotional appeals. On the basis of focus groups and intercept interviews (n = 79), the authors demonstrated how preproduction message research and production message testing were used to develop messages that would motivate mothers of preteen girls. Core emotional truths that emerged were a mother's instinct to protect her daughter from harm and to embrace aspirations for her daughter's future. Mothers also reacted more positively to text about preventing cervical cancer than about preventing HPV, a sexually transmitted disease. Mothers preferred message concepts with photos of minorities and Caucasian mothers and daughters. PMID:21728780

  17. Evaluation of an Intervention Providing HPV Vaccine in Schools

    PubMed Central

    Stubbs, Brenda W.; Panozzo, Catherine A.; Moss, Jennifer L.; Reiter, Paul L.; Whitesell, Dianne H.; Brewer, Noel T.

    2014-01-01

    Objectives To conduct outcome and process evaluations of school-located HPV vaccination clinics in partnership with a local health department. Methods Temporary clinics provided the HPV vaccine to middle school girls in Guilford County, North Carolina, in 2009–2010. Results HPV vaccine initiation was higher among girls attending host schools than satellite schools (6% vs. 1%, OR = 6.56, CI = 3.99–10.78). Of the girls who initiated HPV vaccine, 80% received all 3 doses. Private insurance or federal programs paid for most vaccine doses. Conclusions Lessons learned for creating more effective school-health department partnerships include focusing on host schools and delivering several vaccines to adolescents, not just HPV vaccine alone. PMID:24034684

  18. Increasing HPV vaccination series completion rates via text message reminders.

    PubMed

    Matheson, Elaine C; Derouin, Anne; Gagliano, Martha; Thompson, Julie A; Blood-Siegfried, Jane

    2014-01-01

    Human papillomavirus (HPV) is the most frequently diagnosed sexually transmitted infection in the United States. It is associated with the development of cervical, anal-genital, and oral-pharyngeal cancers. The rate of HPV infection among adolescents and young adults in the United States remains high, and completion rates of an HPV vaccine series remain low. At an urban pediatric clinic, adolescent and young adult participants aged 11 to 22 years (n = 37) received text message reminders for their second and third dose of HPV vaccine over an 8-month study period. Of the participants receiving text message reminders, 14% completed the vaccine series at the optimal time, whereas 0% of an interested group (n = 43) and only 3% of a standard care group (n = 232) completed the vaccine series at the optimal time. Findings support the use of text message reminders to improve HPV vaccine series completion rates in a pediatric practice. PMID:24200295

  19. Formative Research on HPV Vaccine Acceptability Among Latina Farmworkers

    PubMed Central

    Luque, John S.; Castañeda, Heide; Tyson, Dinorah Martinez; Vargas, Natalia; Meade, Cathy D.

    2011-01-01

    The purpose of this study was to identify the barriers and benefits to human papillomavirus (HPV) vaccination in a low-income, Latina farmworker population in central Florida. This study reports on formative qualitative research conducted on perceptions of benefits, barriers, costs, place, and promotion related to the HPV vaccine from surveys and interviews with a sample of 46 low-income, Latina farm workers and 19 health care workers serving this population. It was found that Latina farmworkers hold many misperceptions about the HPV vaccine and the potential links between HPV infection and cervical cancer. In addition, it was observed that HPV vaccination intention was inversely related to concerns about adolescent sexual behavior and low perceived risk of infection but might be positively influenced by belief in illness prevention and physician recommendation. These findings add to the growing research on HPV vaccine acceptability among Latina subgroups to inform intervention development, marketing materials, education, and policy. PMID:21881079

  20. Adolescent Male Human Papillomavirus Vaccination

    PubMed Central

    Nanagas, Vivian C.; Stolfi, Adrienne; Nanagas, Maria T.; Eberhart, Gregory M.; Alter, Sherman J.

    2016-01-01

    Objective. To determine male vaccination rates with quadrivalent human papillomavirus vaccine (HPV4) before and after the October 2011 national recommendation to routinely immunize adolescent males. Methods. We reviewed HPV4 dose 1 (HPV4-1) uptake in 292 adolescent males in our urban clinic prior to national recommendations and followed-up for HPV4 series completion rates. After national recommendation, 248 urban clinic and 247 suburban clinic males were reviewed for HPV4-1 uptake. Factors associated with HPV4-1 refusal were determined with multiple logistic regression. Results. Of the initial 292 males, 78% received HPV4-1 and 38% received the 3-dose series. After recommendation, HPV4-1 uptake was 59% and 7% in urban and suburban clinics, respectively. Variables associated with HPV4-1 uptake/refusal included time period, race, type of insurance, and receipt of concurrent vaccines. Conclusions. HPV4-1 vaccination rates in our urban clinic were high before and after routine HPV vaccine recommendations for adolescent males. Our vaccination rates were much higher than in a suburban practice. PMID:27336012

  1. Alternative dosage schedules with HPV VLP vaccines

    PubMed Central

    Stanley, Margaret A.; Sudenga, Staci L.; Giuliano, Anna R.

    2014-01-01

    Summary Human papillomavirus (HPV) vaccines can prevent multiple cancers in women and men. Difficulties in the cost and completion of the three-dose vaccine series have led to considerations of alternative dose schedules. In clinical trials, three doses given within a 12-month period versus the standard six-month period yielded comparable results, and immunogenicity appears comparable with two doses in adolescent females compared to the three-dose series in adult females. While the data are generally supportive of moving to a two-dose vaccine schedule among young female adolescents, the adoption of a two-dose vaccine schedule still poses a potential risk to the strength and longevity of the immune response. Public health authorities implementing a two-dose vaccine schedule should devise risk management strategies to minimize the potential impact on cancer prevention. PMID:25001893

  2. HPV vaccines and cancer prevention, science versus activism.

    PubMed

    Tomljenovic, Lucija; Wilyman, Judy; Vanamee, Eva; Bark, Toni; Shaw, Christopher A

    2013-01-01

    The rationale behind current worldwide human papilloma virus (HPV) vaccination programs starts from two basic premises, 1) that HPV vaccines will prevent cervical cancers and save lives and, 2) have no risk of serious side effects. Therefore, efforts should be made to get as many pre-adolescent girls vaccinated in order to decrease the burden of cervical cancer. Careful analysis of HPV vaccine pre- and post-licensure data shows however that both of these premises are at odds with factual evidence and are largely derived from significant misinterpretation of available data. PMID:23369430

  3. Physician support of HPV vaccination school-entry requirements.

    PubMed

    Califano, Sophia; Calo, William A; Weinberger, Morris; Gilkey, Melissa B; Brewer, Noel T

    2016-06-01

    School-entry requirements in the US have led to high coverage for several vaccines, but few states and jurisdictions have adopted these policies for human papillomavirus (HPV) vaccination. Because physicians play a key role in advocating for vaccination policies, we assessed physician support of requiring HPV vaccine for school entry and correlates of this support. Participants were a national sample of 775 physicians who provide primary care, including vaccines, to adolescents. Physicians completed an online survey in 2014 that assessed their support for school-entry requirements for HPV vaccination of 11 and 12 y olds. We used multivariable logistic regression to assess correlates of support for these requirements. The majority of physicians (74%) supported some form of school-entry requirements, with or without opt-out provisions. When opt-out provisions were not specified, 47% agreed that laws requiring HPV vaccination for school attendance were a "good idea." Physicians more often agreed with requirements, without opt-out provisions, if they: had more years in practice (OR=1.49; 95% CI: 1.09-2.04), gave higher quality HPV vaccine recommendations (OR=2.06; 95% CI: 1.45-2.93), believed that having requirements for Tdap, but not HPV, vaccination undermined its importance (OR=3.33; 95% CI: 2.26-4.9), and believed HPV vaccination was as or more important than other adolescent vaccinations (OR=2.30; 95% CI: 1.65-3.18). In conclusion, we found that many physicians supported school-entry requirements for HPV vaccination. More research is needed to investigate the extent to which opt-out provisions might weaken or strengthen physician support of HPV vaccination school-entry requirements. PMID:26900726

  4. HPV Vaccine Information for Young Women

    MedlinePlus

    ... STD on Facebook Sexually Transmitted Diseases (STDs) HPV Vaccine Information For Young Women Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Three vaccines are available to prevent the human papillomavirus (HPV) ...

  5. Cancer Experts Endorse CDC's HPV Vaccine Guidelines

    MedlinePlus

    ... news/fullstory_159950.html Cancer Experts Endorse CDC's HPV Vaccine Guidelines Boys and girls should start the ... American Cancer Society has endorsed the U.S. government's HPV vaccination recommendations, which include immunizing all preteens against ...

  6. Effective Strategies for HPV Vaccine Delivery: The Views of Pediatricians

    PubMed Central

    Tissot, Abbigail M.; Zimet, Gregory D.; Rosenthal, Susan L.; Bernstein, David I.; Wetzel, Caitlin; Kahn, Jessica A.

    2007-01-01

    Purpose Pediatricians will play a critical role in human papillomavirus (HPV) vaccine delivery. The objectives of this research were to examine pediatricians' views about key issues related to HPV vaccine delivery and identify their strategies for effective vaccine delivery. Methods A diverse sample of practicing pediatricians was recruited from a three-state region using a purposeful sampling strategy. Participants completed in-depth, semi-structured interviews. Qualitative data were analyzed using framework analysis. Results The mean age of the 31 participants was 47 (range 30-78) years, 17 (55%) were female, 9 (29%) black, and 4 (13%) Latino. Participants noted that cultural issues, including a family's religious and ethnic background, were important considerations when recommending an HPV vaccine. Almost all participants believed that vaccination should be universal rather than targeted, but opinions regarding legislative mandates for vaccination varied. Those in favor of mandates cited their potential to maximize the public health impact of immunization, while those opposed noted that HPV is not transmitted casually and were concerned about limited data on the long-term safety and efficacy of HPV vaccines. Pediatricians noted that specific strategies for effective vaccine delivery would be needed for an STI vaccine targeted toward adolescents, especially considering the poor public understanding of HPV. These included provision of HPV vaccines in alternative settings, guidance for pediatricians as to how to address parental concerns, and specific educational initiatives. Conclusions The views of pediatricians, who have extensive experience administering vaccines to children and adolescents, will be valuable as HPV vaccine delivery strategies are designed. PMID:17659214

  7. [HPV vaccine for cervical cancer prevention].

    PubMed

    Kawana, Kei

    2010-06-01

    High-risk HPV is the causative virus(requirement) for genital cancers with cervical cancer being most prevalent. Thus, theoretically, if HPV infection could be completely eradicated, most of genital cancers could be prevented. Viewed this way, HPV vaccines began to be studied about 10 years ago. Merck in the U.S. and Glaxo Smith Kline (GSK) in Europe launched full-scale development of prophylactic vaccines against HPV, and their vaccines were approved and commercially available in the worldwide. In this paper, efficacy and issues for the HPV vaccine and cancer screening in Japan are discussed. PMID:20535972

  8. HPV vaccines: Translating immunogenicity into efficacy.

    PubMed

    Turner, Taylor B; Huh, Warner K

    2016-06-01

    Currently available human papillomavirus (HPV) vaccines are very successful at preventing persistent HPV infection and premalignant cervical lesions. In part due to the unique aspects of HPV immunogenicity and high levels of efficacy no immune correlate has been identified for HPV vaccination. Serum neutralizing antibodies are used to measure vaccine response, but their role as a correlate has not been verified, and this theory fails to explain the prevention of HPV related non-mucosal lesions. Identifying a true correlate would aid in future work in this area but will be difficult in the setting of a highly efficacious vaccine. PMID:26512762

  9. HPV Knowledge and Vaccine Acceptability Among Hispanic Fathers

    PubMed Central

    Byrne, Margaret M.; Vanderpool, Robin; Shin, Sarah; Kobetz, Erin

    2013-01-01

    The purpose of this study was to examine human papillomavirus (HPV) knowledge and vaccine acceptability in a convenience sample of immigrant Hispanic men, many of whom are parents of adolescents. Data on 189 male callers were collected from the National Cancer Institute’s Cancer Information Service Spanish-language call center. Most participants were willing to vaccinate their adolescent son (87.5 %) or daughter (78.8 %) against HPV. However, among this sample, awareness of HPV was low and knowledge of key risk factors varied. These findings can help guide the development of culturally informed educational efforts aimed at increasing informed decision-making about HPV vaccination among Hispanic fathers. PMID:23377881

  10. Human Papillomavirus (HPV) Infections and the Importance of HPV Vaccination

    PubMed Central

    Wang, Chia-ching J.

    2016-01-01

    HPV persistence is necessary for the development of anogenital cancer. Studies show that cervical and anal HPV infections in women and in men who have sex with men are common. Clearance of HPV infection is similarly common; few individuals show persistence unless they are HIV-infected. HIV strongly influences the development of cervical and anal cancer, as well as their pre-malignant counterparts. Women with cervical and vulvar HPV-associated lesions have higher rates of anal cancer than the general population. HPV also plays an important role in pathogenesis of head and neck cancers, particularly oropharyngeal cancer. Two commercially available HPV vaccines have been proven to be safe and efficacious against cervical HPV16/18 infections and associated precancerous lesions; one of these has also been shown to prevent HPV16/18-associated anal lesions. The FDA has also just approved a new nonavalent HPV vaccine. HPV vaccines will play an important role in prevention of HPV-associated cancers.

  11. Human papillomavirus vaccination among adolescents in Georgia.

    PubMed

    Underwood, Natasha L; Weiss, Paul; Gargano, Lisa M; Seib, Katherine; Rask, Kimberly J; Morfaw, Christopher; Murray, Dennis; DiClemente, Ralph J; Hughes, James M; Sales, Jessica M

    2015-01-01

    Human papillomavirus (HPV) vaccination coverage for adolescent females and males remains low in the United States. We conducted a 3-arm randomized controlled trial (RCT) conducted in middle and high schools in eastern Georgia from 2011-2013 to determine the effect of 2 educational interventions used to increase adolescent vaccination coverage for the 4 recommended adolescent vaccines: Tdap, MCV4, HPV and influenza. As part of this RCT, this article focuses on: 1) describing initiation and completion of HPV vaccine series among a diverse population of male and female adolescents; 2) assessing parental attitudes toward HPV vaccine; and 3) examining correlates of HPV vaccine series initiation and completion. Parental attitude score was the strongest predictor of HPV vaccine initiation among adolescents (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.80, 2.39). Other correlates that significantly predicted HPV series initiation were gender, study year, and intervention arm. Parental attitudes remained a significant predictor of receipt of 3 doses of HPV vaccine along with gender, race, school type and insurance type. This study demonstrates that positive parental attitudes are important predictors of HPV vaccination and critical to increasing coverage rates. Our findings suggest that more research is needed to understand how parental attitudes are developed and evolve over time. PMID:25912372

  12. Human papillomavirus vaccination among adolescents in Georgia

    PubMed Central

    Underwood, Natasha L; Weiss, Paul; Gargano, Lisa M; Seib, Katherine; Rask, Kimberly J; Morfaw, Christopher; Murray, Dennis; DiClemente, Ralph J; Hughes, James M; Sales, Jessica M

    2015-01-01

    Human papillomavirus (HPV) vaccination coverage for adolescent females and males remains low in the United States. We conducted a 3-arm randomized controlled trial (RCT) conducted in middle and high schools in eastern Georgia from 2011–2013 to determine the effect of 2 educational interventions used to increase adolescent vaccination coverage for the 4 recommended adolescent vaccines: Tdap, MCV4, HPV and influenza. As part of this RCT, this article focuses on: 1) describing initiation and completion of HPV vaccine series among a diverse population of male and female adolescents; 2) assessing parental attitudes toward HPV vaccine; and 3) examining correlates of HPV vaccine series initiation and completion. Parental attitude score was the strongest predictor of HPV vaccine initiation among adolescents (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.80, 2.39). Other correlates that significantly predicted HPV series initiation were gender, study year, and intervention arm. Parental attitudes remained a significant predictor of receipt of 3 doses of HPV vaccine along with gender, race, school type and insurance type. This study demonstrates that positive parental attitudes are important predictors of HPV vaccination and critical to increasing coverage rates. Our findings suggest that more research is needed to understand how parental attitudes are developed and evolve over time. PMID:25912372

  13. HPV (Human Papillomavirus) Gardasil Vaccine - What You Need to Know

    MedlinePlus

    ... is taken in its entirety from the CDC HPV (Human Papillomavirus) Vaccine - Gardasil® Vaccine Information Statement (VIS): www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil.html . CDC review information for HPV Gardasil® ...

  14. HPV Vaccine and Pregnancy

    MedlinePlus

    ... 16/18 vaccine: a combined analysis of five randomized controlled trials. Obstet Gynecol 114(6):1179-1188. ... types 16 and 18: pooled analysis of two randomized clinical trials. BMJ 340:C712. Winckworth LC and ...

  15. Partnering with middle school students to design text messages about HPV vaccination.

    PubMed

    Cates, Joan R; Ortiz, Rebecca R; North, Steve; Martin, Amanda; Smith, Richalle; Coyne-Beasley, Tamera

    2015-03-01

    Human papillomavirus (HPV) vaccination is routinely recommended for U.S. adolescents ages 11 to 12 years, yet vaccine coverage remains low. Text message HPV immunization reminders to parents have been effective with increasing uptake, but text messages directly to adolescents in order to increase HPV vaccination uptake are unknown. The purpose of this study was to examine the acceptability of text messages about HPV vaccination and message preferences among adolescents. Middle school students (n = 43) assisted in designing text messages to promote HPV vaccine among their peers. Through seven focus groups and two in-class surveys, we assessed students' knowledge of HPV vaccine, use of texting, and preferences for text messages and sources. The average age of participants was 13 years, and all were White (17 males, 26 females) in this rural setting. More than 70% used text messaging with a cell phone. The text message with the best composite score (M = 2.33, SD = 0.72) for likeability, trustworthiness, and motivation to seek more information was a gain frame emphasizing reduction in HPV infection if vaccinated against HPV. Text messages with lower scores emphasized threats of disease if not vaccinated. Participants (68%) preferred doctors as their information source. Text messaging to adolescents may be a strategy to improve HPV knowledge and vaccination. PMID:25258431

  16. HPV vaccine: Current status and future directions

    PubMed Central

    Kumar, Sushil; Biswas, Manash; Jose, Tony

    2015-01-01

    HPV Vaccine was introduced to prevent cervical cancer known to be caused by infection with one or more of the high risk subtypes of the Human papilloma virus (HPV). Since introduction, trials have proven its efficacy in preventing Cervical intraepithelial neoplasia (CIN) beyond doubt and its effectiveness in preventing cervical cancer though presumptive is reasonably certain as per mathematical modelling. It also prevents other HPV related anogenital and oropharyngeal malignancies in both sexes. HPV vaccines have courted many controversies related to its efficacy, safety, ideal age of vaccination, use in HPV infected individuals and use in males. The currently available vaccines are based on L1 Viral like particles (VLP) and hence highly species specific, thermolabile, costly and are purely prophylactic. The quest for a cheaper, thermostable and broad spectrum vaccine has led to many newer prophylactic vaccines. Therapeutic vaccines were born out of the inescapable necessity considering high HPV related morbidity projected in the non HPV naïve population. Therapeutic vaccines would immediately reduce this burden and also help in the management of HPV related cancers alone or as part of combination strategies. Ongoing research is aimed at a total control over HPV related malignancies in the near future. PMID:25859081

  17. HPV Vaccine Effective at Multiple Anatomic Sites

    Cancer.gov

    A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l

  18. Preventing cervical cancer and genital warts - How much protection is enough for HPV vaccines?

    PubMed

    Stanley, Margaret

    2016-07-01

    HPV associated disease is a global health problem: 5.2% of all cancers are HPV associated with HPV 16 and 18 accounting for 70% of cases of cervical cancer. Genital warts caused by HPV 6 and 11 have a lifetime risk of acquisition of 10%. HPV vaccines are subunit vaccines consisting of virus like particles comprised of the L1 major capsid protein. Two vaccines have been licenced since 2006/2007 and are in the National Immunisation programmes in 62 countries. Both vaccines include HPV 16 and 18 VLPs and one also includes HPV 6 and 11. The vaccines are highly immunogenic and well tolerated. Genital HPV is a sexually transmitted infection with peak incidence occurring just after the onset of sexual activity and the routine cohort for immunisation in almost all countries are adolescent girls 9-15 years of age with or without catch up for older adolescents and young women. Population effectiveness is now being demonstrated for these vaccines in countries with high vaccine coverage. HPV vaccines are highly immunogenic and effective and the original 3 dose schedules have already been reduced, for those 14 years and under, to 2 for both licenced vaccines. There is preliminary evidence that 1 dose of vaccine is as effective as 2 or 3 in preventing persistent HPV infection in the cervix in young women and further reductions in dosage may be possible if supported by appropriate virological, immunological and modelling studies. PMID:27211079

  19. [The importance of HPV vaccination in men].

    PubMed

    Sehnal, Borek; Chlíbek, Roman; Sláma, Jiří

    2016-01-01

    The important goal of immunization programs in many countries is the reduction of the incidence of cervical cancer using either the quadrivalent (Silgard/Gardasil) or the bivalent (Cervarix) HPV (human papillomavirus) vaccine. Nevertheless, HPV infection is associated with the development of cancers of anus, vagina, vulva and penis, and cancers of the head and neck and genital warts, too. Large trials for both vaccines find efficacy against HPV-related infection and different HPV associated diseases.Infection with HPV and diseases caused by HPV are common in boys and men, too. Approximately 5.2 % of all cancers are HPV associated and the burden of HPV associated disease in men is now comparable to that in women in economically developed countries. Randomized control trials demonstrate robust antibody responses and high efficacy also in men. Several countries recommend gender-neutral vaccination.Detailed cost effective modeling has preceded these decisions showing that when the burden of disease in men is included in the models then, depending upon vaccine price, coverage of a vaccinated population, and other factors male vaccination can become cost effective. Vaccine price had a decisive impact on results. However, increasing coverage in girls is substantially more effective and cost-effective than expanding vaccination coverage to boys and should be considered a priority. Since 2012, vaccination of girls at the age of 13-14 years has been covered from the health insurance in the Czech Republic. PMID:27481200

  20. Acceptability of HPV vaccine for males and preferences for future education programs among Appalachian residents.

    PubMed

    Reiter, Paul L; Oldach, Benjamin R; Randle, Katherine E; Katz, Mira L

    2014-03-01

    Appalachia is a geographic region with several disparities related to human papillomavirus (HPV) infection, yet little is known about acceptability of HPV vaccine for males among Appalachian residents. HPV vaccine acceptability and preferences for future HPV vaccine education programs were examined among residents of Appalachian Ohio. Focus groups and in-depth interviews were conducted with Appalachian Ohio residents between July and October 2011. Participants (n = 102 from 24 focus groups and 5 in-depth interviews) included four key stakeholder groups: health care providers, community leaders, parents with adolescent sons, and young adult men ages 18 to 26 years. Support for vaccinating males against HPV was high among participants, despite low awareness and knowledge about HPV vaccine for males. Participants reported three categories of potential barriers to vaccinating males against HPV: concerns about vaccine safety and side effects, access to care and vaccination logistics, and gender and cultural issues. Participants reported that HPV vaccine was viewed as being only for females in their communities and that receiving the vaccine may be emasculating or embarrassing to males. Participants suggested that future HPV vaccine education programs mainly target parents, include basic information about HPV-related diseases and HPV vaccine (e.g., number of doses, cost), and present the vaccine as having the potential to prevent cancer (as opposed to preventing genital warts). Acceptability of HPV vaccine for males was high among residents of Appalachian Ohio. Future HPV vaccine education programs in Appalachia should address common potential barriers to vaccination and help destigmatize vaccination among males. PMID:24085197

  1. Recombinant Human Papillomavirus (HPV) Nonavalent Vaccine

    Cancer.gov

    This page contains brief information about recombinant human papillomavirus (HPV) nonavalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.

  2. Recombinant Human Papillomavirus (HPV) Bivalent Vaccine

    Cancer.gov

    This page contains brief information about recombinant human papillomavirus (HPV) bivalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.

  3. Recombinant Human Papillomavirus (HPV) Quadrivalent Vaccine

    Cancer.gov

    This page contains brief information about recombinant human papillomavirus (HPV) quadrivalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.

  4. Vaccine Reduces HPV Infections in Young Men

    Cancer.gov

    An international randomized clinical trial has shown that the vaccine Gardasil can reduce the incidence of anogenital human papillomavirus (HPV) infections in young men 16 to 26 years of age at the time of vaccination.

  5. How will HPV vaccines affect cervical cancer?

    PubMed Central

    Roden, Richard; Wu, T.-C.

    2011-01-01

    Cancer of the uterine cervix is the second largest cause of cancer deaths in women, and its toll is greatest in populations that lack screening programmes to detect precursor lesions. Persistent infection with ‘high risk’ genotypes of human papillomavirus (HPV) is necessary, although not sufficient, to cause cervical carcinoma. Therefore, HPV vaccination provides an opportunity to profoundly affect cervical cancer incidence worldwide. A recently licensed HPV subunit vaccine protects women from a high proportion of precursor lesions of cervical carcinoma and most genital warts. Here we examine the ramifications and remaining questions that surround preventive HPV vaccines. PMID:16990853

  6. HPV vaccine (human papillomavirus) Cervarix - what you need to know

    MedlinePlus

    ... is taken in its entirety from the CDC HPV (Human Papillomavirus) Cervarix® Vaccine Information Statement: www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-cervarix.html . CDC review information for HPV Cervarix® ...

  7. HPV Knowledge and Vaccine Acceptability among Hispanic Fathers

    ERIC Educational Resources Information Center

    Kornfeld, Julie; Byrne, Margaret M.; Vanderpool, Robin; Shin, Sarah; Kobetz, Erin

    2013-01-01

    The purpose of this study was to examine human papillomavirus (HPV) knowledge and vaccine acceptability in a convenience sample of immigrant Hispanic men, many of whom are parents of adolescents. Data on 189 male callers were collected from the National Cancer Institute's Cancer Information Service Spanish-language call center. Most participants…

  8. The Effect of Guidance regarding Home Exercise and ADL on Adolescent Females Suffering from Adverse Effects after HPV Vaccination in Japanese Multidisciplinary Pain Centers

    PubMed Central

    Ushida, Takahiro; Shibata, Masahiko; Kitahara, Masaki; Yabuki, Shoji; Sumitani, Masahiko; Murakami, Takanori; Iseki, Masako; Hosoi, Masako; Shiokawa, Hiroaki; Tetsunaga, Tomoko; Nishie, Hiroyuki; Fukui, Sei; Kawasaki, Motohiro; Inoue, Sinsuke; Nishihara, Makoto; Aono, Shuichi; Ikemoto, Tatunori; Kawai, Takashi; Arai, Young-Chang

    2016-01-01

    Background. Two prophylactic papillomavirus (HPV) vaccines have been available for primary prevention of cervical cancer. Although serious adverse effects (AE) were rare, more than 230 women have been suffering from severe AEs such as persistent pain and headache in Japan. Our research group started to treat adolescent females suffering from the AEs. Objective. To survey the characteristics of and the effects of cognitive behavioral therapy on adolescent female suffering from the AEs in Japanese multidisciplinary pain centers. Methods. One hundred and forty-five patients suffering from the AEs were reviewed retrospectively and 105 patients of them were provided guidance on home exercise and activities of daily living based partially on a cognitive-behavioral approach. The intensity of pain was rated by the patients using a numerical rating scale (NRS). Furthermore, the Hospital Anxiety and Depression Scale (HADS) and the Pain Catastrophizing Scale (PCS) were used. Results. Eighty out of the 105 patients who received the guidance were followed up, 10 displayed a marked improvement, and 43 showed some improvement. Conclusions. Guidance on home exercise and activities of daily living based on a cognitive-behavioral approach alleviated the AEs that women suffered from after HPV vaccination in Japan.

  9. No evidence that HPV vaccination leads to sexual risk compensation.

    PubMed

    Hansen, Bo T

    2016-06-01

    Uptake of the HPV vaccine has been lower than the uptake of most other childhood vaccines offered in public programs. Since the HPV vaccine protects against a sexually transmitted virus, one barrier to uptake specific to the HPV vaccine may be the concern that vaccination may encourage risky sexual behaviour. Unanimous findings from recent studies show that HPV vaccination does not lead to sexual risk compensation, which is an important message to parents, clinicians and other decision-makers regarding HPV vaccination. Some issues remain to be investigated, like HPV vaccination and sexual risk compensation among boys. PMID:27003447

  10. Prophylactic HPV vaccination and anal cancer.

    PubMed

    Stier, Elizabeth A; Chigurupati, Nagasudha L; Fung, Leslie

    2016-06-01

    The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. A retrospective analysis also suggests that qHPV vaccination of older MSM treated for AIN2+ may significantly decrease the risk of recurrence of the AIN2+. The HPV types detected in anal cancer are included in the 9-valent vaccine. Thus, the 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer. PMID:26933898

  11. Developing a Tablet-Based Self-Persuasion Intervention Promoting Adolescent HPV Vaccination: Protocol for a Three-Stage Mixed-Methods Study

    PubMed Central

    Lee, Simon Craddock; Marks, Emily G; Persaud, Donna; Skinner, Celette Sugg; Street, Richard L; Wiebe, Deborah J; Farrell, David; Bishop, Wendy Pechero; Fuller, Sobha; Baldwin, Austin S

    2016-01-01

    Background Human papillomavirus (HPV)-related cancers are a significant burden on the US health care system that can be prevented through adolescent HPV vaccination. Despite guidelines recommending vaccination, coverage among US adolescents is suboptimal particularly among underserved patients (uninsured, low income, racial, and ethnic minorities) seen in safety-net health care settings. Many parents are ambivalent about the vaccine and delay making a decision or talking with a provider about it. Self-persuasion—generating one’s own arguments for a health behavior—may be particularly effective for parents who are undecided or not motivated to make a vaccine decision. Objective Through a 3-stage mixed-methods protocol, we will identify an optimal and feasible self-persuasion intervention strategy to promote adolescent HPV vaccination in safety-net clinics. Methods In Stage 1, we will define content for a tablet-based self-persuasion app by characterizing (1) parents’ self-generated arguments through cognitive interviews conducted with parents (n=50) of patients and (2) parent-provider HPV vaccine discussions through audio recordings of clinic visits (n=50). In Stage 2, we will compare the effects of the four self-persuasion intervention conditions that vary by cognitive processing level (parents verbalize vs listen to arguments) and choice of argument topics (parents choose vs are assigned topics) on parental vaccine intentions in a 2 × 2 factorial design randomized controlled trial (n=160). This proof-of-concept trial design will identify which intervention condition is optimal by quantitatively examining basic self-persuasion mechanisms (cognitive processing and choice) and qualitatively exploring parent experiences with intervention tasks. In Stage 3, we will conduct a pilot trial (n=90) in the safety-net clinics to assess feasibility of the optimal intervention condition identified in Stage 2. We will also assess its impact on parent

  12. Intervention effects from a social marketing campaign to promote HPV vaccination in preteen boys

    PubMed Central

    Cates, Joan R.; Diehl, Sandra J.; Crandell, Jamie L.; Coyne-Beasley, Tamera

    2014-01-01

    Objectives Adoption of human papillomavirus (HPV) vaccination in the US has been slow. In 2011, HPV vaccination of boys was recommended by CDC for routine use at ages 11–12. We conducted and evaluated a social marketing intervention with parents and providers to stimulate HPV vaccination among preteen boys. Methods We targeted parents and providers of 9–13 year old boys in a 13 county NC region. The 3-month intervention included distribution of HPV vaccination posters and brochures to all county health departments plus 194 enrolled providers; two radio PSAs; and an online CME training. A Cox proportional hazards model was fit using NC immunization registry data to examine whether vaccination rates in 9–13 year old boys increased during the intervention period in targeted counties compared to control counties (n=15) with similar demographics. To compare with other adolescent vaccines, similar models were fit for HPV vaccination in girls and meningococcal and Tdap vaccination of boys in the same age range. Moderating effects of age, race, and Vaccines for Children (VFC) eligibility on the intervention were considered. Results The Cox model showed an intervention effect (β=0.29, HR=1.34, p=.0024), indicating that during the intervention the probability of vaccination increased by 34% in the intervention counties relative to the control counties. Comparisons with HPV vaccination in girls and Tdap and meningococcal vaccination in boys suggest a unique boost for HPV vaccination in boys during the intervention. Model covariates of age, race and VFC eligibility were all significantly associated with vaccination rates (p<.0001 for all). HPV vaccination rates were highest in the 11–12 year old boys. Overall, three of every four clinic visits for Tdap and meningococcal vaccines for preteen boys were missed opportunities to administer HPV vaccination simultaneously. Conclusions Social marketing techniques can encourage parents and health care providers to vaccinate

  13. Study Hints At HPV Vaccine's Cancer Prevention Promise

    MedlinePlus

    ... gov/news/fullstory_159696.html Study Hints at HPV Vaccine's Cancer Prevention Promise Fewer vaccinated young women ... July 4, 2016 (HealthDay News) -- The human papillomavirus (HPV) vaccine appears to prevent abnormalities that can lead ...

  14. Study Hints At HPV Vaccine's Cancer Prevention Promise

    MedlinePlus

    ... news/fullstory_159696.html Study Hints at HPV Vaccine's Cancer Prevention Promise Fewer vaccinated young women had ... 4, 2016 (HealthDay News) -- The human papillomavirus (HPV) vaccine appears to prevent abnormalities that can lead to ...

  15. Human Papillomavirus (HPV) Vaccine (Gardasil-9)

    MedlinePlus

    ... vaccinated?Gardasil-9 prevents many cancers caused by human papillomavirus (HPV) infections, including:cervical cancer in females ... 9) Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National ...

  16. HPV vaccine for teen boys: Dyadic analysis of parents' and sons' beliefs and willingness

    PubMed Central

    Moss, Jennifer L.; Reiter, Paul L.; Brewer, Noel T.

    2015-01-01

    Objective Parents and adolescents often decide together whether the child should receive human papillomavirus (HPV) vaccine. However, few studies have investigated the dyadic nature of beliefs that affect this process. Method Data came from the 2010 HPV Immunization in Sons (HIS) Study, a national sample of 412 parents and their adolescent sons. We conducted dyadic multivariate logistic regression to test the relationships between parents' and sons' HPV vaccine beliefs and their willingness to have the son receive the vaccine. Results Fewer than half of parents and sons were willing to have the sons receive HPV vaccine (43% and 29%, respectively). Willing parents and sons anticipated greater regret if the son did not receive HPV vaccine but later contracted an HPV infection (parent odds ratio [OR]=1.72, 95% confidence interval [CI]=1.24-2.40; son OR=1.51, 95% CI=1.04-2.19) (both p<.05). Lower concerns about side effects, such as pain and fainting, were also associated with willingness. Conclusion Parents and sons were more willing to have the son receive HPV vaccine if they had higher anticipated regret about potential HPV infection and lower concerns about side effects. Communication campaigns should target these beliefs to increase parents' and sons' willingness to seek HPV vaccination. PMID:26190364

  17. Shift in prevalence of HPV types in cervical cytology specimens in the era of HPV vaccination

    PubMed Central

    FISCHER, SONJA; BETTSTETTER, MARCUS; BECHER, ANDREA; LESSEL, MARLENE; BANK, CYRIL; KRAMS, MATTHIAS; BECKER, INGRID; HARTMANN, ARNDT; JAGLA, WOLFGANG; GAUMANN, ANDREAS

    2016-01-01

    The aim of the present population-based cohort study was to analyze the association between the prevalence of 32 types of human papilloma virus (HPV) in 615 female patients with abnormal cervical cytopathology findings. In total, 32 HPV types were screened by DNA array technology. HPV infection was detected in 470 women (76.42%), 419 of whom (89.15%) were infected with ≥1 high-risk (HR)-HPV type. HPV16, which is recognized as the main HR-HPV type responsible for the development of cervical cancer, was observed in 32.98% of HPV+ participants, followed by HPV42 (18.09%), HPV31 (17.66%), HPV51 (13.83%), HPV56 (10.00%), HPV53 (8.72%) and HPV66 (8.72%). The prevalence of HR-HPV types, which may be suppressed directly (in the case of HPV16 and 18), or possibly via cross-protection (in the case of HPV31) following vaccination, was considerably lower in participants ≤22 years of age (HPV16, 28.57%; HPV18, 2.04%; HPV31, 6.12%), compared with participants 23–29 years of age (HPV16, 45.71%; HPV18, 7.86%; HPV31, 22.86%), who were less likely to be vaccinated. Consequently, the present study hypothesizes that there may be a continuous shift in the prevalence of HPV types as a result of vaccination. Furthermore, the percentage of non-vaccine HR-HPV types was higher than expected, considering that eight HPV types formerly classified as ‘low-risk’ or ‘probably high-risk’ are in fact HR-HPV types. Therefore, it may be important to monitor non-vaccine HPV types in future studies, and an investigation concerning several HR-HPV types as risk factors for the development of cervical cancer is required. PMID:27347187

  18. Correlates of human papillomavirus (HPV) vaccine coverage: A state-level analysis

    PubMed Central

    Moss, Jennifer L.; Reiter, Paul L.; Brewer, Noel T.

    2014-01-01

    Background We tested the hypothesis that states with higher rates of cancers associated with human papillomavirus (HPV) would have lower HPV vaccine coverage. Methods We gathered state-level data on HPV-related cancer rates and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered state-level data on demographic composition and contact with the healthcare system. We calculated Pearson correlations for these ecological relationships. Results HPV vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r=−.29 and −.46, respectively). In addition, vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r=−.30). Other cancer rates were associated with HPV vaccine initiation and follow-through among girls, but not among boys. HPV vaccine initiation among girls was lower in states with higher proportions of non-Hispanic black residents and lower proportions of higher income residents. HPV vaccine follow-through was higher in states with greater levels of adolescents' contact with the healthcare system. Conclusions HPV vaccine coverage for girls was lower in states with higher HPV-related cancer rates. Public health efforts should concentrate on geographic areas with higher cancer rates. Strengthening adolescent preventive healthcare use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage. PMID:25585064

  19. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices.

    PubMed

    Petrosky, Emiko; Bocchini, Joseph A; Hariri, Susan; Chesson, Harrell; Curtis, C Robinette; Saraiya, Mona; Unger, Elizabeth R; Markowitz, Lauri E

    2015-03-27

    During its February 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent human papillomavirus (HPV) vaccine (9vHPV) (Gardasil 9, Merck and Co., Inc.) as one of three HPV vaccines that can be used for routine vaccination. HPV vaccine is recommended for routine vaccination at age 11 or 12 years. ACIP also recommends vaccination for females aged 13 through 26 years and males aged 13 through 21 years not vaccinated previously. Vaccination is also recommended through age 26 years for men who have sex with men and for immunocompromised persons (including those with HIV infection) if not vaccinated previously. 9vHPV is a noninfectious, virus-like particle (VLP) vaccine. Similar to quadrivalent HPV vaccine (4vHPV), 9vHPV contains HPV 6, 11, 16, and 18 VLPs. In addition, 9vHPV contains HPV 31, 33, 45, 52, and 58 VLPs. 9vHPV was approved by the Food and Drug Administration (FDA) on December 10, 2014, for use in females aged 9 through 26 years and males aged 9 through 15 years. For these recommendations, ACIP reviewed additional data on 9vHPV in males aged 16 through 26 years. 9vHPV and 4vHPV are licensed for use in females and males. Bivalent HPV vaccine (2vHPV), which contains HPV 16, 18 VLPs, is licensed for use in females. This report summarizes evidence considered by ACIP in recommending 9vHPV as one of three HPV vaccines that can be used for vaccination and provides recommendations for vaccine use. PMID:25811679

  20. Biopower, Normalization, and HPV: A Foucauldian Analysis of the HPV Vaccine Controversy.

    PubMed

    Engels, Kimberly S

    2016-09-01

    This article utilizes the Foucauldian concepts of biopower and normalization to give an analysis of the debate surrounding the controversial administration of the HPV vaccine to adolescents. My intention is not to solve the problem, rather to utilize a Foucauldian framework to bring various facets of the issue to light, specifically the way the vaccine contributes to strategies of power in reference to how young adults develop within relationships of power. To begin, the article provides an overview of the Foucauldian concepts of biopower and normalization, including how these two strategies of power were present in the administration of the smallpox vaccine in the 19th century. Next, information about HPV and the history of the current controversy in the United States is presented. Lastly, the article presents an analysis of the strategies of biopower and normalization present in the debate on HPV, including an emphasis on how the vaccination is similar to, and different from, 19th century smallpox vaccination. It also explores the way that mechanisms of disease control affect and are affected by individual subjects, in this case, adolescents. PMID:26438668

  1. Understanding HPV vaccine uptake among Cambodian American girls.

    PubMed

    Taylor, Victoria M; Burke, Nancy J; Ko, Linda K; Sos, Channdara; Liu, Qi; Do, H Hoai; Talbot, Jocelyn; Yasui, Yutaka; Bastani, Roshan

    2014-10-01

    Cervical cancer incidence rates vary substantially among racial/ethnic groups in the United States (US) with women of Southeast Asian descent having the highest rates. Up to 70 % of cervical cancers could be prevented by widespread use of the human papillomavirus (HPV) vaccine. However, there is a lack of information about HPV vaccine uptake among Southeast Asian girls in the US. We conducted a telephone survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators and uptake. Our study group included 86 Cambodian mothers who lived in the Seattle metropolitan area. The proportions of survey participants who reported their daughter had initiated and completed the HPV vaccine series were only 29 and 14 %, respectively. Higher levels of vaccine uptake were significantly associated with mothers having heard about the HPV vaccine from a health professional and having received a recent Pap test. Commonly cited barriers to HPV vaccination included lack of knowledge about the HPV vaccine, not having received a physician recommendation for HPV vaccination and thinking the HPV vaccine is unnecessary in the absence of health problems. Linguistically and culturally appropriate HPV educational programs should be developed and implemented in Cambodian American communities. These programs should aim to enhance understanding of disease prevention measures, increase knowledge about the HPV vaccine and empower women to ask their daughter's doctors for HPV vaccination. PMID:24532309

  2. Understanding HPV Vaccine Uptake Among Cambodian American Girls

    PubMed Central

    Taylor, Victoria M.; Burke, Nancy J.; Ko, Linda K.; Sos, Channdara; Liu, Qi; Do, H. Hoai; Talbot, Jocelyn; Yasui, Yutaka; Bastani, Roshan

    2014-01-01

    Cervical cancer incidence rates vary substantially among racial/ethnic groups in the United States (US) with women of Southeast Asian descent having the highest rates. Up to 70% of cervical cancers could be prevented by widespread use of the human papillomavirus (HPV) vaccine. However, there is a lack of information about HPV vaccine uptake among Southeast Asian girls in the US. We conducted a telephone survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators, and uptake. Our study group included 86 Cambodian mothers who lived in the Seattle metropolitan area. The proportions of survey participants who reported their daughter had initiated and completed the HPV vaccine series were only 29% and 14%, respectively. Higher levels of vaccine uptake were significantly associated with mothers having heard about the HPV vaccine from a health professional and having received a recent Pap test. Commonly cited barriers to HPV vaccination included lack of knowledge about the HPV vaccine, not having received a physician recommendation for HPV vaccination, and thinking the HPV vaccine is unnecessary in the absence of health problems. Linguistically and culturally appropriate HPV educational programs should be developed and implemented in Cambodian American communities. These programs should aim to enhance understanding of disease prevention measures, increase knowledge about the HPV vaccine, and empower women to ask their daughters’ doctors for HPV vaccination. PMID:24532309

  3. Acceptability of HPV vaccine implementation among parents in India.

    PubMed

    Paul, Proma; Tanner, Amanda E; Gravitt, Patti E; Vijayaraghavan, K; Shah, Keerti V; Zimet, Gregory D; Study Group, Catch

    2014-01-01

    Due to high cervical cancer rates and limited research on human papillomavirus (HPV) vaccine acceptability in India, the research team examined parental attitudes toward HPV vaccines. Thirty-six interviews with parents were conducted to assess sexually transmitted infection (STI)-related knowledge and HPV-specific vaccine awareness and acceptability. Despite limited knowledge, parents had positive views toward HPV vaccines. Common barriers included concerns about side effects, vaccine cost, and missing work to receive the vaccine. Parents were strongly influenced by health care providers' recommendations. Our findings suggest that addressing parental concerns, health worker training and polices, and efforts to minimize cost will be central to successful HPV vaccine implementation. PMID:23611111

  4. Effects of a Presidential Candidate’s Comments on HPV Vaccine

    PubMed Central

    Zucker, Rachel A.; Reiter, Paul L.; Mayer, Melissa K.; Brewer, Noel T.

    2015-01-01

    Background During and after the 2011 Republican presidential debate, a candidate questioned the safety of HPV vaccine. We sought to determine what effect these comments had on parents. Methods A national sample of 327 parents with adolescent sons ages 11–17 completed online surveys in fall 2010 (baseline, about a year before the debate) and 2011 (follow-up, about a month after the debate). We used regression models to examine the association of parents’ awareness of the candidate’s comments with HPV vaccine initiation among their sons, their willingness to get sons free HPV vaccine, and their beliefs about potential harms of HPV vaccine. Results Overall, 17% of parents reported hearing about the Republican presidential candidate’s comments about HPV vaccine. Parents who were aware of the comments had a larger increase between baseline and follow-up in the belief that HPV vaccine might cause short-term health problems (mean change=0.47) compared to parents who were not aware (mean change=0.07, p<0.001). Awareness was not associated with HPV vaccine initiation among parents’ adolescent sons, changes in parents’ willingness to get their sons free HPV vaccine, or other outcomes (all p>0.05). Conclusions Although the candidate’s comments may have increased some parents’ beliefs about the short-term harms of HPV vaccine, the comments had no impact on other beliefs, willingness to vaccinate, or behavior. Having accurate information about HPV vaccine that is readily available to the public during such controversies may diminish their impact. PMID:25950109

  5. HPV testing and vaccination in Europe.

    PubMed

    Leeson, Simon C; Alibegashvili, Tamar; Arbyn, Marc; Bergeron, Christine; Carriero, Carmine; Mergui, Jean-Luc; Nieminen, Pekka; Prendiville, Walter; Redman, Charles W E; Rieck, Gudrun C; Quaas, Jens; Petry, K Ulrich

    2014-01-01

    Current cytology-based screening has a moderate sensitivity to detect cervical intraepithelial neoplasia grade 3 (CIN 3) and cervical cancer even in those states providing rigorous quality control of their cervical screening programs. The impact of vaccination against human papillomavirus (HPV) types 16 and 18 as well as the incorporation of HPV testing on the detection of CIN 3 and cancer is discussed. HPV testing used as a triage for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions, test of cure after treatment, and HPV-based primary screening may improve current cervical screening programs.HPV testing as a triage test for ASCUS seems to offer an improved sensitivity, with a similar specificity as compared to repeat cytology for diagnosing high-grade CIN and has been recommended throughout most EU states. HPV testing as a triage test for low-grade squamous intraepithelial lesions has a low specificity and is not recommended in most member states. HPV test of cure offers an improved sensitivity compared to cytology for women with persistent cervical precancer after treatment. HPV-based cervical cancer screening is more effective than screening with cytology. The effects of HPV-based screening depend on the organization of the program and on adherence to algorithms for screening triage. Otherwise, it is likely that HPV-based screening will increase the referral rate to colposcopy including more women with no detectable cervical lesion. HPV vaccination will require many years to evaluate any beneficial effects on cervical cancer incidence and mortality. PMID:23774078

  6. Cross-protective vaccine efficacy of the bivalent HPV vaccine against HPV31 is associated with humoral immune responses

    PubMed Central

    Safaeian, Mahboobeh; Kemp, Troy J.; Pan, David Yuanji; Porras, Carolina; Rodriguez, Ana Cecilia; Schiffman, Mark; Cortes, Bernal; Katki, Hormuzd; Wacholder, Sholom; Schiller, John T.; Gonzalez, Paula; Penrose, Kerri; Lowy, Douglas R.; Quint, Wim; van Doorn, Leen-Jan; Herrero, Rolando; Hildesheim, Allan; Pinto, Ligia A.

    2013-01-01

    Background: We investigated the role of antibody responses as potential mechanism for the cross-protective vaccine-efficacies (VE) observed from randomized clinical trials of the HPV16/18 bivalent vaccine. Results: HPV31 cases had lower HPV16 antibody levels than controls (OR4th quartile compared with 1st quartile = 0.63; 95%CI: 0.36–1.08; p-trend = 0.03). HPV31 cases were also less likely to have detectable HPV31 neutralization, and HPV16 avidity than controls. No statistically significant differences by HPV18 antibody or HPV45 neutralization were observed among HPV45 cases and controls. Protection against HPV58 was not associated with any of the markers, confirming the specificity of our findings. Methods: Samples are from three-dose HPV vaccine recipients from the Costa Rica HPV16/18 vaccine trial. Women with a new HPV31, HPV45, or HPV58 infections over four years of follow-up were compared with randomly selected control women—with no new infection with HPV31/45/58—with respect to HPV16 and HPV18 antibody, HPV31, HPV45, and HPV58 neutralization, and HPV16 avidity. Conclusions: High HPV16 levels and avidity, and the ability to neutralize HPV31 were associated with protection against newly detected HPV31 infections, suggesting that the partial VE demonstrated for HPV31 is likely to be mediated at least in part through antibodies induced by HPV16/18 vaccination. PMID:23571174

  7. HPV Vaccine - Gardasil: What You Need to Know

    MedlinePlus

    ... prevent HPV. It may be given to both males and females. This vaccine can prevent most cases of cervical ... and genital warts and anal cancer in both males and females. Protection from HPV vaccine is expected to be ...

  8. Women Have a Preference for Their Male Partner to Be HPV Vaccinated

    PubMed Central

    Harper, Diane Medved; Alexander, Natalie Marya; Ahern, Debra Ann; Comes, Johanna Claire; Smith, Melissa Smith; Heutinck, Melinda Ann; Handley, Sandra Martin

    2014-01-01

    Background Peer influence and social networking can change female adolescent and young adult behavior. Peer influence on preferences for male human papillomavirus (HPV) vaccination has not been documented. The primary aim of this study was to determine if women had preferences about male sexual partner HPV vaccination receipt. Methods and Findings A prospective survey of women 18–26 years of age was conducted at an urban university student health clinic. Education about the two HPV vaccines, cervical cancer and genital warts was provided. Women self-reported their demographic and medical history data, as well as their own preferences for HPV vaccine and their preferences for their male partner HPV vaccine using a 5 point Likert scale. 601 women, mean age of 21.5 years (SD 2.4), participated between 2011 and 2012. Nearly 95% of respondents were heterosexual; condoms and contraceptives were used in over half of the population. Regardless of the woman's vaccination status, women had significantly higher (strongly agree/agree) preferences for the male partner being vaccinated with HPV4 than not caring if he was vaccinated (63.6% vs. 13.1%, p<0.001). This preference was repeated for sexual risk factors and past reproductive medical history. Women who received HPV4 compared to those choosing HPV2 had a significantly lower proportion of preferences for not caring if the male partner was vaccinated (13% vs. 22%, p = 0.015). Conclusions Women preferred a HPV vaccinated male partner. Peer messaging might change the male HPV vaccination uptake. PMID:24828237

  9. HPV Vaccine Use among African American Girls: Qualitative Formative Research using a Participatory Social Marketing Approach

    PubMed Central

    Hull, Pamela C.; Williams, Elizabeth A.; Khabele, Dineo; Dean, Candace; Bond, Brea; Sanderson, Maureen

    2014-01-01

    OBJECTIVE To generate recommendations for framing messages to promote HPV vaccination, specifically for African American adolescents and their parents who have not yet made a decision about the vaccine (the “Undecided” market segment). METHODS Focus groups and interviews were conducted with African American girls ages 11–18 (N=34) and their mothers (N=31), broken into market segments based on daughter’s vaccination status and mother’s intent to vaccinate. RESULTS Findings suggested that the HPV vaccine should be presented to “Undecided” mothers and adolescents as a routine vaccine (just like other vaccines) that helps prevent cancer. Within the “Undecided” segment, we identified two sub-segments based on barriers to HPV vaccination and degree of reluctance. The “Undecided/Ready If Offered” segment would easily accept HPV vaccine if given the opportunity, with basic information and a healthcare provider recommendation. The “Undecided/Skeptical” segment would need more in-depth information to allay concerns about vaccine safety, mistrust of drug companies, and recommended age. Some mothers and girls had the erroneous perception that girls do not need the vaccine until they become sexually active. African American adolescents and their mothers overwhelmingly thought campaigns should target both girls and boys for HPV vaccination. In addition, campaigns and messages may need to be tailored for pre-teens (ages 9–12) versus teens (ages 13–18) and their parents. CONCLUSIONS Findings pointed to the need to “normalize” the perception of HPV vaccine as just another routine vaccine (e.g., part of pre-teen vaccine package). Findings can inform social marketing campaigns targeting Undecided or ethnically diverse families. PMID:24491412

  10. Current state in the development of candidate therapeutic HPV vaccines.

    PubMed

    Yang, Andrew; Jeang, Jessica; Cheng, Kevin; Cheng, Ting; Yang, Benjamin; Wu, T-C; Hung, Chien-Fu

    2016-08-01

    The identification of human papillomavirus (HPV) as an etiological factor for HPV-associated malignancies creates the opportunity to control these cancers through vaccination. Currently, available preventive HPV vaccines have not yet demonstrated strong evidences for therapeutic effects against established HPV infections and lesions. Furthermore, HPV infections remain extremely common. Thus, there is urgent need for therapeutic vaccines to treat existing HPV infections and HPV-associated diseases. Therapeutic vaccines differ from preventive vaccines in that they are aimed at generating cell-mediated immunity rather than neutralizing antibodies. The HPV-encoded early proteins, especially oncoproteins E6 and E7, form ideal targets for therapeutic HPV vaccines since they are consistently expressed in HPV-associated malignancies and precancerous lesions, playing crucial roles in the generation and maintenance of HPV-associated disease. Our review will cover various therapeutic vaccines in development for the treatment of HPV-associated lesions and cancers. Furthermore, we review strategies to enhance vaccine efficacy and the latest clinical trials on therapeutic HPV vaccines. PMID:26901118

  11. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 vaccine and HPV-6/11/16/18 vaccine

    PubMed Central

    Baron, Mira; Levin, Myron J; Chatterjee, Archana; Fox, Bradley; Scholar, Sofia; Rosen, Jeffrey; Chakhtoura, Nahida; Meric, Dorothée; Dessy, Francis J; Datta, Sanjoy K; Descamps, Dominique; Dubin, Gary

    2011-01-01

    In this observer-blind study (NCT00423046), women (N = 1,106), stratified by age (18–26, 27–35, 36–45 y), were randomized (1:1) to receive the HPV-16/18 vaccine (Cervarix®, GlaxoSmithKline Biologicals, Months 0, 1, 6) or the HPV-6/11/16/18 vaccine (Gardasil® Merck and Co., Inc., Months 0, 2, 6). Month 7 results were previously reported; we now report Month 24 results. In the according-to-protocol cohort for immunogenicity (seronegative and DNA-negative at baseline for HPV type analyzed), seropositivity rates of neutralizing antibodies (nAbs) [pseudovirion-based neutralization assay] were, across all age strata, 100% (HPV-16/18 vaccine) and 97.5–100% (HPV-6/11/16/18 vaccine) for HPV-16, and 99.0–100% (HPV-16/18 vaccine) and 72.3–84.4% (HPV-6/11/16/18 vaccine) for HPV-18. Corresponding geometric mean titers (GMTs) were 2.4–5.8-fold higher for HPV-16 and 7.7–9.4-fold higher for HPV-18 with the HPV-16/18 vaccine vs. the HPV-6/11/16/18 vaccine; HPV-16 and HPV-18 GMTs were significantly higher with the HPV-16/18 vaccine than the HPV-6/11/16/18 vaccine (p < 0.0001) in the total vaccinated cohort (received ≥1 vaccine dose, irrespective of baseline sero/DNA-status). Similar results were obtained using enzyme-linked immunosorbent assay (ELISA ). Positivity rates and GMTs of antigen-specific IgG antibodies in cervicovaginal secretions (ELISA) were not significantly different between vaccines. At Month 24, CD4+ T-cell responses for HPV-16 and HPV-18 were higher with the HPV-16/18 vaccine; memory B-cell response was higher for HPV-18 with the HPV-16/18 vaccine and similar between vaccines for HPV-16. Both vaccines were generally well tolerated. Although an immunological correlate of protection has not been defined, differences in the magnitude of immune response between vaccines may represent determinants of duration of protection. PMID:22048173

  12. Deconstructing Human Papillomavirus (HPV) Knowledge: Objective and Perceived Knowledge in Males' Intentions to Receive the HPV Vaccine

    ERIC Educational Resources Information Center

    Krawczyk, Andrea; Stephenson, Ellen; Perez, Samara; Lau, Elsa; Rosberger, Zeev

    2013-01-01

    Background: The human papillomavirus (HPV) vaccine was recently approved for men. To effectively tailor HPV education efforts toward men, it is important to understand what men know about HPV and how this knowledge relates to their decision to receive the vaccine. This study examines how objective HPV knowledge, objective HPV vaccine knowledge,…

  13. Increasing HPV vaccination through policy for public health benefit.

    PubMed

    Brandt, Heather M; Pierce, Jennifer Young; Crary, Ashley

    2016-06-01

    Vaccines against specific types of human papillomavirus (HPV) linked to cancer and other diseases have been met with mixed acceptance globally and in the United States. Policy-level interventions have been shown to be effective in increasing public health benefit. Government policies and mandates may result in improved HPV vaccination coverage and reduced disease burden, and alternative policies that improve unhindered access to HPV vaccination may allow success as well. The purpose of this commentary is to summarize policy efforts to maximize the public health benefit of HPV vaccination. We examine selected examples of HPV vaccination policy in global contexts and in the United States. PMID:26669416

  14. Pros, cons, and ethics of HPV vaccine in teens—Why such controversy?

    PubMed Central

    2014-01-01

    Introduction Human papillomavirus (HPV) infection remains one of the most commonly sexually transmitted infections in both females and males. HPV viruses are associated with several manifestations including genital warts, but more importantly for urology practitioners, cervical and penile carcinomas and recurrent genital condylomata in both sexes. The incidence of HPV-related carcinomas has increased in cervical, oropharyngeal, vulvar, penile, and anal cancers. Effective vaccines have been available for almost a decade, but widespread adoption of vaccine administration has been problematic for multiple reasons. Many countries (over 100) have adopted vaccine programs for females and an increasing number of countries are extending the indications to include males between the ages of 9-26. There still seems to be controversy surrounding these universal vaccination programs as well as some ethical and practical concerns regarding the administration of a vaccine for diseases that are associated with sexual contact in both sexes, especially during the early adolescent years. Objective The objective was to provide a review of the available literature so pediatric and adult urologists may be more aware of the issues related to HPV vaccination in order to more effectively counsel patients and parents regarding the risks, benefits, and public health issues regarding HPV vaccination. This topic is especially relevant to pediatric urologists who see patients in the target age group for the HPV vaccine. There has been an explosion of literature regarding HPV vaccination programs and the relative difficulty in adopting the vaccine series with a completion rate of under 50% of patients in the recommended age ranges for vaccination. Methods Articles were obtained from an extensive Medline literature search (1998-present) to evaluate the current HPV vaccination regimens for teenagers with special emphasis on the urologically focused disease burden. Results The adoption of universal

  15. Acceptability of HPV Vaccines and Associations with Perceptions Related to HPV and HPV Vaccines Among Men Who Have Sex with Men in Hong Kong

    PubMed Central

    Lau, Joseph T. F.; Wang, Zixin; Kim, Jean H.; Lau, Mason; Lai, Coco H. Y.; Mo, Phoenix K. H.

    2013-01-01

    HPV vaccines are available to men but there are few studies investigating the acceptability of HPV vaccines among men who have sex with men (MSM), a high risk group. We assessed the intention to take up HPV vaccines among MSM in Hong Kong and the associated factors related to cognitions on HPV and HPV vaccines, basing on the Health Belief Model (n = 542). The acceptability of HPV vaccines was 20% (unconditional on efficacies and price), 29.2% (conditional on efficacies and market price), 51.7% (conditional on efficacies and discounted price) and 79.1% (conditional on efficacies and free price). Adjusting for background variables, composite scores of perceived susceptibility, perceived severity, perceived barriers and cue to actions were significantly associated with acceptability of HPV vaccines conditional on specific efficacies and the market price. Acceptability of HPV vaccines was highly price sensitive. Future studies need to use conditional measures. Implementation and translational researches are warranted. PMID:23451188

  16. Characteristics of Memory B Cells Elicited by a Highly Efficacious HPV Vaccine in Subjects with No Pre-existing Immunity

    PubMed Central

    Scherer, Erin M.; Smith, Robin A.; Simonich, Cassandra A.; Niyonzima, Nixon; Carter, Joseph J.; Galloway, Denise A.

    2014-01-01

    Licensed human papillomavirus (HPV) vaccines provide near complete protection against the types of HPV that most commonly cause anogenital and oropharyngeal cancers (HPV 16 and 18) when administered to individuals naive to these types. These vaccines, like most other prophylactic vaccines, appear to protect by generating antibodies. However, almost nothing is known about the immunological memory that forms following HPV vaccination, which is required for long-term immunity. Here, we have identified and isolated HPV 16-specific memory B cells from female adolescents and young women who received the quadrivalent HPV vaccine in the absence of pre-existing immunity, using fluorescently conjugated HPV 16 pseudoviruses to label antigen receptors on the surface of memory B cells. Antibodies cloned and expressed from these singly sorted HPV 16-pseudovirus labeled memory B cells were predominantly IgG (>IgA>IgM), utilized diverse variable genes, and potently neutralized HPV 16 pseudoviruses in vitro despite possessing only average levels of somatic mutation. These findings suggest that the quadrivalent HPV vaccine provides an excellent model for studying the development of B cell memory; and, in the context of what is known about memory B cells elicited by influenza vaccination/infection, HIV-1 infection, or tetanus toxoid vaccination, indicates that extensive somatic hypermutation is not required to achieve potent vaccine-specific neutralizing antibody responses. PMID:25330199

  17. HPV (Human Papillomavirus) Gardasil Vaccine - What You Need to Know

    MedlinePlus

    ... taken in its entirety from the CDC HPV (Human Papillomavirus) Vaccine - Gardasil® Vaccine Information Statement (VIS): www. ... WHAT IS HPV? Genital human papillomavirus (HPV) is the most common ... in the United States. More than half of sexually active men ...

  18. Parents’ Internet use for information about HPV vaccine

    PubMed Central

    McRee, Annie-Laurie; Reiter, Paul L.; Brewer, Noel T.

    2012-01-01

    Purpose The Internet is an increasingly common source of health-related information. We sought to examine associations between parents’ Internet information-seeking and their knowledge, attitudes and beliefs about human papillomavirus (HPV) vaccine. Methods We interviewed parents within a year after approval of HPV vaccine for females and males. Participants were North Carolina parents with daughters ages 10–18 surveyed by telephone in Fall 2007 (n=773); and a national sample of parents with sons ages 11–17 surveyed online in Fall 2010 (n=115). We used multivariate regression to examine associations of past and intended Internet seeking for HPV vaccine information with knowledge and health belief model-related constructs. Results Among parents of daughters, having heard of HPV vaccine through the Internet (8%) was associated with higher HPV knowledge, perceived likelihood of HPV, and vaccination willingness, and with receiving a doctor’s recommendation. It was also associated with lower perceived vaccine harms, uncertainty, and anticipated regret. Parents of sons who heard of HPV vaccine through the Internet (10%) perceived greater barriers to vaccination than parents who learned about HPV vaccine for males through other sources. Intended future Internet information-seeking among parents of daughters (69%) was more likely if they perceived a lower likelihood that their daughters would get HPV if they were vaccinated (all p<.05). Conclusions Our findings suggest a positive influence of accessing information on the Internet about HPV vaccine. It was associated with higher knowledge and mostly positive parental attitudes and beliefs. PMID:22172505

  19. 9-Valent HPV vaccine for cancers, pre-cancers and genital warts related to HPV.

    PubMed

    Pitisuttithum, Punnee; Velicer, Christine; Luxembourg, Alain

    2015-11-01

    Human papillomavirus (HPV) is the causative agent of nearly all cervical cancer cases as well as a substantial proportion of anal, vulvar, vaginal, penile and oropharyngeal cancers, making it responsible for approximately 5% of the global cancer burden. The first-generation HPV vaccines that is, quadrivalent HPV type 6/11/16/18 vaccine and bivalent HPV type 16/18 vaccine were licensed in 2006 and 2007, respectively. A second-generation 9-valent HPV type 6/11/16/18/31/33/45/52/58 vaccine with broader cancer coverage was initiated even before the first vaccines were approved. By preventing HPV infection and disease due to HPV31/33/45/52/58, the 9vHPV vaccine has the potential to increase prevention of cervical cancer from 70 to 90%. In addition, the 9vHPV vaccine has the potential to prevent 85-95% of HPV-related vulvar, vaginal and anal cancers. Overall, the 9vHPV vaccine addresses a significant unmet medical need, although further health economics and implementation research is needed. PMID:26366475

  20. Parents' perceptions of provider communication regarding adolescent vaccines.

    PubMed

    Dempsey, Amanda F; Pyrzanowski, Jennifer; Lockhart, Steven; Campagna, Elizabeth; Barnard, Juliana; O'Leary, Sean T

    2016-06-01

    Strong provider recommendations for adolescent vaccines are critical for achieving high vaccination levels.  However, little is known about parents' preferred provider communication strategies for adolescent vaccines in general, and for human papillomavirus (HPV) vaccines specifically. We performed a cross-sectional survey of 800 parents of 9-14 year olds in April 2014 to assess current adolescent vaccine communication practices by providers, parents' preferred HPV vaccine-specific communication strategies, and the association of these two outcomes with experiential, attitudinal and demographic characteristics.  Among the 356 parents in the study (response rate 48%), HPV vaccines were reported as less likely to have been "very strongly" recommended by their adolescent's provider (39%) than other adolescent-targeted vaccines (45%-59%, <0.05 for all comparisons).  Receiving a very strong recommendation for HPV vaccines was associated with a higher likelihood of vaccine receipt (71% versus 39%, p<0.001), or among those not yet vaccinated, increased likelihood of positive vaccination intentions (82% vs. 60%, p = 0.015).  Nearly all parents (87%) reported that, if available, they would use a website providing personalized HPV vaccine-related materials before their adolescent's next check-up, and other technology-based communications were also endorsed by the majority of parents.   From these data we conclude that parents received weaker recommendations for HPV vaccines than other adolescent vaccines, and that most parents want additional HPV vaccine-related materials, preferably delivered using a variety of technology-based modalities which is not their providers' current practice. PMID:27078515

  1. Universal routine HPV vaccination for young girls in Uganda: a review of opportunities and potential obstacles

    PubMed Central

    2012-01-01

    This article reviews the existing realities in Uganda to identify opportunities and potential obstacles of providing universal routine HPV vaccination to young adolescent girls. Cervical cancer is a public health priority in Uganda where it contributes to about 50–60% of all female malignancies. It is associated with a dismal 5-year relative survival of approximately 20%. With adequate financial resources, primary prevention through vaccination is feasible using existing education and health infrastructure. Cost-effectiveness studies show that at a cost of US$2 per dose, the current vaccines would be cost effective. With optimal (≥70%) coverage of the target population, the lifetime risk of cervical cancer could be reduced by >50%. Uganda fulfils 4 out of the 5 criteria set by the WHO for the introduction of routine HPV vaccination to young adolescent girls. The existing political commitment, community support for immunization and the favorable laws and policy environment all provide an opportunity that should not be missed to introduce this much needed vaccine to the young adolescent girls. However, sustainable financing by the government without external assistances remains a major obstacle. Also, the existing health delivery systems would require strengthening to cope with the delivery of HPV vaccine to a population that is normally not targeted for routine vaccination. Given the high incidence of cervical cancer and in the absence of a national screening program, universal HPV vaccination of Ugandan adolescent girls is critical for cervical cancer prevention. PMID:22950658

  2. HPV Vaccination in India: Critical Appraisal

    PubMed Central

    Saxena, Pikee; Acharya, Anita S.; Mishra, Archana; Batra, Swaraj

    2014-01-01

    Cervical cancer is the third most common cancer in women worldwide. The role of human papilloma virus (HPV) in the genesis of cervical carcinoma is well documented. The HPV 16 and 18 are found to be most commonly associated with invasive cervical carcinoma. The advent of cervical carcinoma vaccine has advanced the hopes that eradication of cervical carcinoma might be possible in future. The scenario of prevention of cervical carcinoma is completely different in developed and developing countries. The implementation of the vaccination as a routine in India is still controversial. Here we have tried to critically analyse these issues in Indian context. However it is clear that cervical cancer vaccine is not an immediate panacea and cannot replace the cervical cancer screening which is mandatory in Indian context. PMID:25006481

  3. HPV Vaccine - Cervarix: What You Need to Know

    MedlinePlus

    VACCINE INFORMATION STATEMENT HPV Vaccine Cervarix ® (Human Papillomavirus) What You Need to Know Many Vaccine Information Statements are available in Spanish and other languages. See www. immunize. org/ ...

  4. Human Papillomavirus Vaccination Coverage Among Female Adolescents in Managed Care Plans - United States, 2013.

    PubMed

    Ng, Judy; Ye, Faye; Roth, Lindsey; Sobel, Katherine; Byron, Sepheen; Barton, Mary; Lindley, Megan; Stokley, Shannon

    2015-10-30

    Human papillomavirus (HPV) is the most common sexually transmitted infection, with a reported 79 million persons aged 15–59 years in the United States currently infected with HPV, and approximately 14 million new cases diagnosed each year. Although most HPV infections are asymptomatic, transient, and do not cause disease, persistent HPV infection can lead to cervical, vulvar, vaginal, anal, penile, and oropharyngeal cancer. In the United States, approximately 27,000 HPV-attributable cancers occur each year. HPV vaccination is an effective primary prevention strategy that can reduce many of the HPV infections that lead to cancer, and is routinely recommended for adolescents aged 11–12 years. To determine whether the recommended HPV vaccination series is currently being administered to adolescents with health insurance, CDC and the National Committee for Quality Assurance (NCQA) assessed 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS). The HEDIS HPV Vaccine for Female Adolescents performance measure evaluates the proportion of female adolescent members in commercial and Medicaid health plans who receive the recommended 3-dose HPV vaccination series by age 13 years. In 2013, in the United States, the median HPV vaccination coverage levels for female adolescents among commercial and Medicaid plans were 12% and 19%, respectively (ranges = 0%–34% for commercial plans; 5%–52% for Medicaid plans). Improving HPV vaccination coverage and understanding of what health plans might do to support HPV vaccination are needed, including understanding the barriers to, and facilitators for, vaccination coverage. PMID:26513219

  5. Beta-test Results for an HPV Information Web site: GoHealthyGirls.org – Increasing HPV Vaccine Uptake in the United States

    PubMed Central

    Nodulman, Jessica A.; Kong, Alberta S.; Wheeler, Cosette M.; Buller, David B.; Woodall, W. Gill

    2014-01-01

    A web site, GoHealthyGirls, was developed to educate and inform parents and their adolescent daughters about human papillomavirus (HPV) and HPV vaccines. This article provides an overview of web site development and content followed by the results of a beta-test of the web site. 63 New Mexican parents of adolescent girls tested the site. Results indicated that GoHealthyGirls was a functioning and appealing web site. During this brief educational intervention, findings suggest that the web site has the potential to increase HPV vaccine uptake. This research supports the Internet as a valuable channel to disseminate health education and information to diverse populations. PMID:25221442

  6. HPV Vaccination's Second Act: Promotion, Competition, and Compulsion

    PubMed Central

    2010-01-01

    Developments regarding human papillomavirus (HPV) vaccines will transform HPV vaccination in the United States while simultaneously raising several new policy and ethical concerns. Policymakers, vaccine manufacturers, and the public health community must now respond to the presence of competing vaccines that are similar but distinct, particularly with respect to genital wart prevention and the benefits of vaccinating males. This work arises in the shadow of the contentious introduction of the HPV vaccine Gardasil (Merck & Co, Inc, Whitehouse Station, NJ) in 2006, particularly the opposition to efforts in many states to require the vaccine for school attendance. I review the current status of HPV vaccine policy in the United States and examine issues of public health ethics and policy central to ongoing and future HPV vaccination programs. PMID:20724671

  7. The development of a culturally relevant, theoretically driven HPV prevention intervention for urban adolescent females and their parents/guardians.

    PubMed

    Brawner, Bridgette M; Baker, Jillian L; Voytek, Chelsea D; Leader, Amy; Cashman, Rebecca R; Silverman, Randee; Peter, Nadja; Buchner, Bradley J; Barnes, Christopher A; Jemmott, Loretta S; Frank, Ian

    2013-07-01

    Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, accounting for the large majority of cervical cancer and anogenital warts cases. Two HPV vaccines are currently licensed and recommended for women and girls. However, vaccination rates have been suboptimal, with evidence of disparities influencing both uptake and series completion among African American and Hispanic adolescents. There has been a dearth of theory-based, behavioral interventions targeted to prevent HPV infection and increase HPV vaccine uptake among urban adolescents. This article describes the development of two skills-based intervention curricula aimed to increase HPV prevention and vaccination among low-income urban adolescent females 9 to 18 years old. Guided by the theory of planned behavior, elicitation research was conducted to elucidate the social psychological factors that underlie HPV vaccination intentions (N = 141). The findings were subsequently used to identify theoretical mediators of behavioral change to drive the intervention. Culturally relevant strategies to promote HPV vaccination were translated into the curricula content. Both curricula were designed to motivate and empower participants to reduce risk of being infected with HPV. Targeting theoretical mediators of behavioral change, derived from the voices of the community, may prove to be successful in increasing HPV vaccination and preventing HPV. PMID:23099659

  8. Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison.

    PubMed

    Marlow, Laura A V; Zimet, Gregory D; McCaffery, Kirsten J; Ostini, Remo; Waller, Jo

    2013-01-21

    Since vaccination against human papillomavirus (HPV) became available, awareness of HPV has dramatically increased. Implementation of a vaccine program varies internationally yet no studies have explored the influence this has on the public's knowledge of HPV. The present study aimed to explore differences in awareness of HPV and HPV knowledge across three countries: The US, UK and Australia. Participants (n=2409) completed a validated measure of HPV knowledge as part of an online survey. There were higher levels of HPV awareness among men and women in the US than the UK and Australia. Being male and having a lower educational level was associated with lower HPV awareness in all three countries. Awareness of HPV vaccine was higher in women from the US than the UK and Australia. Women in the US scored significantly higher on general HPV knowledge (on a 15-item scale) than women in the UK and Australia, but there were no between country differences in HPV vaccine knowledge (on a 6-item scale). When asked about country-specific vaccine availability, participants in the US were less able to identify the correct answers than participants in the UK and Australia. More than half of participants did not know: HPV can cause genital warts; most sexually active people will get HPV at some point in their life; or HPV doesn't usually need treatment. Pharmaceutical advertising campaigns could explain why awareness of HPV and HPV vaccine is higher in the US and this has helped to get some important messages across. Significant gaps in HPV knowledge remain across all three countries. PMID:23246310

  9. Attitudes and perceptions towards HPV vaccination among young women in Saudi Arabia

    PubMed Central

    Hussain, Aneela N.; Alkhenizan, Abdullah; McWalter, Patricia; Qazi, Nusrat; Alshmassi, Amal; Farooqi, Samina; Abdulkarim, Ahmed

    2016-01-01

    Background: Rising incidence of human papillomavirus (HPV) infection and cervical cancer can be reduced by effective vaccination. Saudi Food and Drug Administration approved prophylactic HPV vaccine in 2010 for females of 11–26 years. Objectives: To determine the awareness of HPV infection, its health sequel and the attitude and barriers to the acceptance of HPV vaccine by young women in Saudi Arabia. Dynamics influencing the decision of patients and parents regarding vaccination were assessed to foster effective and strategically focused interventions. Materials and Methods: All patients of Family Medicine department, King Faisal Specialist Hospital and Research Center, Riyadh were invited to participate in this study from January 2012 to June 2014. A culturally sensitive and specially designed questionnaire was administered using an interview-based model to assess the knowledge, perception, and associated sociodemographic factors of HPV. Results: A total of 325 patients participated as per the inclusion criteria: 87.4% were Saudis, 53.5% had university or higher education and 65.2% were adolescents (age 11-19 years). The questionnaire was answered by participants (50.8%) or guardians (49.2%). About 34.5% of the population was aware of HPV infection, and 27.4% were aware of its relation with cervical cancer. However, awareness of the HPV vaccine, perception of its prevention of cervical cancer and other HPV-related disease was relatively low (32.3%), Saudis (29.9%) versus non-Saudis (48.8%) (P = 0.016). More guardians (41.2%) were aware of the HPV vaccine and its impact than participants (27.9%) (P = 0.01). Higher educational background (43.1%) increased the knowledge of HPV compared to less than high school education (24.5%) (odds ratio: 2.33; 95% confidence interval: 1.44–3.76). Nearly 64.3% of participants agreed, and 35.7% refused to receive the HPV vaccine. Conclusion: Knowledge and perception of HPV infection as an sexually transmitted infections and its

  10. HPV Vaccine Awareness and Knowledge Among Women Living with HIV.

    PubMed

    Wigfall, L T; Bynum, S A; Brandt, H M; Hébert, J R

    2016-03-01

    Cervical cancer risk is increased among women living with HIV (WLH). Human papillomavirus (HPV) vaccination has been shown to be safe and immunogenic among WLH. We examined HPV vaccine awareness and HPV knowledge among WLH. This cross-sectional study collected data from 145 WLH between March 2011 and April 2012. An interviewer-administered survey assessed HPV vaccine awareness and knowledge. Stata/IC 13 was used to perform chi-square tests and multivariate logistic regression analyses. Our sample was 90 % non-Hispanic black and 64 % earned <$10,000/year. Few (38 %) had heard of the HPV vaccine. Half (50 %) knew that HPV caused cervical cancer. HPV vaccine awareness was ten times higher among WLH who knew HPV caused cervical cancer (OR = 10.17; 95 % CI 3.82-27.06). HPV vaccine awareness is low among WLH. Cancer prevention efforts aimed at raising awareness about the HPV vaccine and increasing knowledge about HPV are necessary first steps in reducing cervical cancer disparities among WLH. PMID:26561426

  11. Preventing Cervical Cancer in the United States: Barriers and Resolutions for HPV Vaccination

    PubMed Central

    Beavis, Anna Louise; Levinson, Kimberly L.

    2016-01-01

    Human papillomavirus (HPV) vaccination rates for preadolescent and adolescent girls in the United States are far behind those of other developed nations. These rates differ substantially by region and state, socioeconomic status, and insurance status. In parents and young women, a lack of awareness and a misperception of the risk of this vaccine drive low vaccination rates. In physicians, lack of comfort with discussion of sexuality and the perception that the vaccine should be delayed to a later age contribute to low vaccination rates. Patient- and physician-targeted educational campaigns, systems-based interventions, and school-based vaccine clinics offer a variety of ways to address the barriers to HPV vaccination. A diverse and culturally appropriate approach to promoting vaccine uptake has the potential to significantly improve vaccination rates in order to reach the Healthy People 2020 goal of over 80% vaccination in adolescent girls. This article reviews the disparities in HPV vaccination rates in girls in the United States, the influences of patients’, physicians’, and parents’ attitudes on vaccine uptake, and the proposed interventions that may help the United States reach its goal for vaccine coverage. PMID:26870696

  12. Preventing Cervical Cancer in the United States: Barriers and Resolutions for HPV Vaccination.

    PubMed

    Beavis, Anna Louise; Levinson, Kimberly L

    2016-01-01

    Human papillomavirus (HPV) vaccination rates for preadolescent and adolescent girls in the United States are far behind those of other developed nations. These rates differ substantially by region and state, socioeconomic status, and insurance status. In parents and young women, a lack of awareness and a misperception of the risk of this vaccine drive low vaccination rates. In physicians, lack of comfort with discussion of sexuality and the perception that the vaccine should be delayed to a later age contribute to low vaccination rates. Patient- and physician-targeted educational campaigns, systems-based interventions, and school-based vaccine clinics offer a variety of ways to address the barriers to HPV vaccination. A diverse and culturally appropriate approach to promoting vaccine uptake has the potential to significantly improve vaccination rates in order to reach the Healthy People 2020 goal of over 80% vaccination in adolescent girls. This article reviews the disparities in HPV vaccination rates in girls in the United States, the influences of patients', physicians', and parents' attitudes on vaccine uptake, and the proposed interventions that may help the United States reach its goal for vaccine coverage. PMID:26870696

  13. Quadrivalent HPV vaccine safety review and safety monitoring plans for nine-valent HPV vaccine in the United States.

    PubMed

    Gee, Julianne; Weinbaum, Cindy; Sukumaran, Lakshmi; Markowitz, Lauri E

    2016-06-01

    Quadrivalent human papillomavirus (4vHPV) vaccine was licensed for use in the United States in 2006 and through 2015 was the predominate HPV vaccine used. With the exception of syncope, a known preventable adverse event after any injected vaccination, both pre-licensure and post-licensure 4vHPV safety data have been reassuring with no confirmed safety signals identified. Nine-valent HPV vaccine (9vHPV) was licensed in 2014. This review includes post-licensure 4vHPV safety findings published to date that have informed the US vaccination program; these data will inform US safety monitoring and evaluation for 9vHPV. PMID:27029786

  14. Brief Client-Centered Motivational and Behavioral Intervention to Promote HPV Vaccination in a Hard-to-Reach Population: A Pilot Randomized Controlled Trial.

    PubMed

    Joseph, Natalie Pierre; Bernstein, Judith; Pelton, Steve; Belizaire, Myrdell; Goff, Ginette; Horanieh, Nour; Freund, Karen M

    2016-08-01

    Objective To evaluate the impact of a client-centered behavioral intervention (Brief Negotiated Interviewing) on mothers' human papillomavirus (HPV) vaccine knowledge and vaccination initiation for their adolescent daughters. Methods We randomized mothers to intervention (n = 100) and control (n = 100) groups, and followed them over 12 months. Electronic medical records were reviewed to determine vaccination status. The primary outcome was receipt of the first vaccine. The secondary outcome was HPV vaccine knowledge among mothers. Results Brief Negotiated Interviewing intervention mothers demonstrated increased knowledge about HPV (pre/post mean score of 5 to 10 out of a possible 11; P < .001) and significantly higher mean knowledge scores (10 vs 6, P < .001) than control mothers. However, initiation and completion rates of the vaccine were not significantly different between groups. Conclusions Increasing HPV vaccine knowledge did not translate into increased vaccine uptake or completion of vaccination series. Future intervention must explore vaccine reminders to increase HPV vaccination rates. PMID:26968631

  15. HPV

    MedlinePlus

    ... of HPV. Most are harmless, but about 30 types put you at risk for cancer. These types affect the genitals and you get them through ... to cancer. Both Pap and HPV tests are types of cervical cancer ... not eliminate, the risk of catching or spreading HPV. Vaccines can protect ...

  16. HPV vaccination to prevent cervical cancer and other HPV-associated disease: from basic science to effective interventions.

    PubMed

    Lowy, Douglas R

    2016-01-01

    Identification of HPV infection as the etiologic agent of virtually all cases of cervical cancer, as well as a proportion of other epithelial cancers, has led to development of three FDA-approved multivalent prophylactic HPV vaccines composed of virus-like particles (VLPs). This essay describes the research and development that led to the VLP vaccines; discusses their safety, efficacy, and short-term effect on HPV-associated disease; and speculates that even a single dose of these vaccines, when given to adolescents, might be able to confer long-term protection. The HPV field exemplifies how long-term funding for basic research has lead to clinical interventions with the long-term potential to eradicate most cancers attributable to HPV infection. Although this essay is the result of my receiving the 2015 Harrington Prize for Innovation in Medicine from the Harrington Discovery Institute and the American Society for Clinical Investigation, this clinical advance has depended on the research of many investigators, development of commercial vaccines by the pharmaceutical companies, and participation of many patient volunteers in the clinical trials. PMID:26727228

  17. HPV vaccination for prevention of skin cancer

    PubMed Central

    Vinzón, Sabrina E; Rösl, Frank

    2015-01-01

    Cutaneous papillomaviruses are associated with specific skin diseases, such as extensive wart formation and the development of non-melanoma skin cancer (NMSC), especially in immunosuppressed patients. Hence, clinical approaches are required that prevent such lesions. Licensed human papillomavirus (HPV) vaccines confer type-restricted protection against HPV types 6, 11, 16 and 18, responsible of 90% of genital warts and 70% of cervical cancers, respectively. However, they do not protect against less prevalent high-risk types or cutaneous HPVs. Over the past few years, several studies explored the potential of developing vaccines targeting cutaneous papillomaviruses. These vaccines showed to be immunogenic and prevent skin tumor formation in certain animal models. Furthermore, under conditions mimicking the ones found in the intended target population (i.e., immunosuppression and in the presence of an already established infection before vaccination), recent preclinical data shows that immunization can still be effective. Strategies are currently focused on finding vaccine formulations that can confer protection against a broad range of papillomavirus-associated diseases. The state-of-the-art of these approaches and the future directions in the field will be presented. PMID:25692212

  18. HPV vaccination: The most pragmatic cervical cancer primary prevention strategy.

    PubMed

    Sankaranarayanan, Rengaswamy

    2015-10-01

    The evidence that high-risk HPV infections cause cervical cancers has led to two new approaches for cervical cancer control: vaccination to prevent HPV infections, and HPV screening to detect and treat cervical precancerous lesions. Two vaccines are currently available: quadrivalent vaccine targeting oncogenic HPV types 16, 18, 6, and 11, and bivalent vaccine targeting HPV 16 and 18. Both vaccines have demonstrated remarkable immunogenicity and substantial protection against persistent infection and high-grade cervical cancer precursors caused by HPV 16 and 18 in HPV-naïve women, and have the potential to prevent 70% of cervical cancers in adequately vaccinated populations. HPV vaccination is now implemented in national programs in 62 countries, including some low- and middle-income countries. The early findings from routine national programs in high-income countries are instructive to encourage low- and middle-income countries with a high risk of cervical cancer to roll out HPV vaccination programs and to introduce resource-appropriate cervical screening programs. PMID:26433502

  19. HPV vaccine (human papillomavirus) Cervarix - what you need to know

    MedlinePlus

    ... taken in its entirety from the CDC HPV (Human Papillomavirus) Cervarix® Vaccine Information Statement: www.cdc.gov/ ... What is HPV? Genital human papillomavirus (HPV) is the most common ... in the United States. More than half of sexually active men ...

  20. Cervical cancer screening of HPV vaccinated populations: Cytology, molecular testing, both or none.

    PubMed

    El-Zein, Mariam; Richardson, Lyndsay; Franco, Eduardo L

    2016-03-01

    Cervical cancer control includes primary prevention through vaccination to prevent human papillomavirus (HPV) infection and secondary prevention through screening to detect and treat cervical precancerous lesions. This review summarizes the evidence for the population impact of vaccines against oncogenic HPV types in reducing the prevalence of cervical precancerous lesions. We examine the gradual shift in screening technology from cervical cytology alone to cytology and HPV cotesting, and finally to the recognition that HPV testing can serve alone as the new screening paradigm, particularly in the initial post-vaccination era. We should expect an impact on screening performance and practices, as cohorts of HPV-vaccinated girls and adolescents reach cervical cancer screening age. In preparation for changes in the screening paradigm for the vaccination era, we propose that policymaking on cervical cancer screening should mirror current practices with other cancers as benchmarks. Cervical precancerous lesions will become a very rare condition following the widespread implementation of HPV vaccines with broader coverage in the number of preventable oncogenic types. Irrespective of screening technology, the false positive results will far outnumber the true positive ones, a tipping point that will herald a new period when the harms from cervical cancer screening will outweigh its benefits. We present a conceptual framework to guide decision making when we reach this point within 25-30 years. PMID:26631958

  1. The Implementation and Acceptability of an HPV Vaccination Decision Support System Directed at Both Clinicians and Families

    PubMed Central

    Mayne, Stephanie; Karavite, Dean; Grundmeier, Robert W.; Localio, Russell; Feemster, Kristen; DeBartolo, Elena; Hughes, Cayce C.; Fiks, Alexander G.

    2012-01-01

    We developed an electronic medical record (EMR)-based HPV vaccine decision support intervention targeting clinicians, (immunization alerts, education, and feedback) and families (phone reminders and referral to an educational website). Through telephone surveys completed by 162 parents of adolescent girls, we assessed the acceptability of the family-focused intervention and its effect on information-seeking behavior, communication, and HPV vaccine decision-making. The intervention was acceptable to parents and 46% remembered receiving the reminder call. Parents reported that the call prompted them to seek out information regarding the HPV vaccine, discuss the vaccine with friends and family, and reach a decision. Parents whose adolescent girls attended practices receiving the clinician-focused intervention were more likely to report that their clinician discussed the HPV vaccine at preventive visits. The results of this study demonstrate the acceptability and potential impact on clinical care of a comprehensive decision support system directed at both clinicians and families. PMID:23304334

  2. Ten years of HPV vaccines: State of art and controversies.

    PubMed

    Angioli, Roberto; Lopez, Salvatore; Aloisi, Alessia; Terranova, Corrado; De Cicco, Carlo; Scaletta, Giuseppe; Capriglione, Stella; Miranda, Andrea; Luvero, Daniela; Ricciardi, Roberto; Montera, Roberto; Plotti, Francesco

    2016-06-01

    The human papillomavirus (HPV) represents one of the most common sexually transmitted infections and it has been related to cervical cancer. The HPV vaccines prevent infection with certain species of HPV associated with the development of cervical cancer or genital warts. We carried out a PubMed search up to 2015 evaluating all randomized studies published in literature. This review discusses the current status of HPVs vaccines on the global market, efficacy, safety profiles, controversies and future vaccine developments. Three HPVs vaccines are currently on the global market: bivalent, quadrivalent and ninevalent. Bivalent and quadrivalent vaccines can protect against almost 70% of cervical HPV-related cancerous and precancerous conditions and the ninevalent vaccine, instead, provides a protection against almost 90%. The use of vaccinations raised several controversies in the last years and, currently, is not possible to establish which type of vaccine is most effective, however all of them are safe. PMID:27066937

  3. Development of a Cost-Effective Educational Tool to Promote Acceptance of the HPV Vaccination by Hispanic Mothers.

    PubMed

    Brueggmann, Doerthe; Opper, Neisha; Felix, Juan; Groneberg, David A; Mishell, Daniel R; Jaque, Jenny M

    2016-06-01

    Although vaccination against the Human Papilloma Virus (HPV) reduces the risk of related morbidities, the vaccine uptake remains low in adolescents. This has been attributed to limited parental knowledge and misconceptions. In this cross sectional study, we assessed the (1) clarity of educational material informing Hispanic mothers about HPV, cervical cancer and the HPV vaccine, (2) determined vaccination acceptability and (3) identified predictors of vaccine acceptance in an underserved health setting. 418 Hispanic mothers received the educational material and completed an anonymous survey. 91 % of participants understood most or all of the information provided. 77 % of participants reported vaccine acceptance for their children; this increased to 84 % when only those with children eligible to receive vaccination were included. Significant positive predictors of maternal acceptance of the HPV vaccine for their children were understanding most or all of the provided information, older age and acceptance of the HPV vaccine for themselves. Concerns about safety and general dislike of vaccines were negatively associated with HPV vaccine acceptance. Prior knowledge, level of education, previous relevant gynecologic history, general willingness to vaccinate and other general beliefs about vaccines were not significantly associated with HPV vaccine acceptance. The majority of participants reported understanding of the provided educational material. Vaccine acceptability was fairly high, but was even higher among those who understood the information. This study documents a cost-effective way to provide Hispanic mothers with easy-to-understand HPV-related information that could increase parental vaccine acceptability and future vaccine uptake among their children. PMID:26516016

  4. Vietnamese Health Care Providers' Preferences Regarding Recommendation of HPV Vaccines.

    PubMed

    Asiedu, Gladys B; Breitkopf, Carmen Radecki; Kremers, Walter K; Ngo, Quang V; Nguyen, Nguyen V; Barenberg, Benjamin J; Tran, Vinh D; Dinh, Tri A

    2015-01-01

    Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of 34±11.9 years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention. PMID:26163611

  5. Human papilloma virus (HPV) vaccination in childhood: challenges and perspectives

    PubMed Central

    Mammas, I; Maher, F; Theodoridou, M; Spandidos, D

    2011-01-01

    Vaccination against human papilloma virus (HPV) in childhood is a significant step forward in the reduction of HPV associated morbidity and mortality and a considerable scientific achievement. However, many challenges remain to be overcome if an effective HPV vaccine programme is to be successfully introduced worldwide. The aim of this review is to identify and summarize the new issues concerning HPV vaccination that have emerged since its introduction into clinical practice in school-aged girls. According to the literature, the overall impact of HPV vaccination on cervical cancer is unlikely to be apparent for the next decade. Cost-effectiveness is of particular importance, particularly in developing countries. Determining the age at which the vaccine should be administered, whether to include boys in addition to girls, the costs and the implications for cervical screening are issues that need to be addressed by conducting further research. PMID:24391408

  6. HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women.

    PubMed

    Lechuga, Julia; Vera-Cala, Lina; Martinez-Donate, Ana

    2016-02-01

    Latina women are at heightened risk of cervical cancer incidence and mortality. The human papillomavirus (HPV) is the principal cause of the majority of cervical cancer cases. A vaccine that protects against HPV was licensed in 2006. Eight years post-licensure, mixed research findings exist regarding the factors that predict vaccine uptake in Latinas. We conducted a population-based phone survey with a random sample of 296 Latinas living in a Midwestern U.S. City. Intention to vaccinate was significantly associated with health care provider recommendations, worry about side effects, knowing other parents have vaccinated, perceived severity of HPV, and worry that daughter may become sexually active following vaccination. Worry that daughter may become sexually active was the only factor related to vaccine uptake. Findings suggest that training providers to discuss the low risk of severe side effects, consequences of persistent HPV, and sexuality related concerns with Latino women may encourage vaccination. PMID:25432149

  7. Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women over Age 30 in the United States

    PubMed Central

    Kim, Jane J.; Ortendahl, Jesse; Goldie, Sue J.

    2009-01-01

    Background Women over the age of 30 are the main beneficiaries of improved cervical cancer screening with human papillomavirus (HPV) DNA testing. The role of vaccination against HPV types 16 and 18, recommended routinely in pre-adolescent girls, is unclear in this age group. Objective To assess the health and economic outcomes of HPV vaccination in older women participating in the U.S. screening program. Design Cost-effectiveness analysis with an empirically-calibrated model. Data Sources Published literature. Target Population U.S. women, ages 35–45. Time Horizon Lifetime. Perspective Societal. Interventions HPV vaccination added to screening strategies that differ by test (cytology, HPV DNA testing), frequency, and start age, versus screening alone. Outcome Measures Incremental cost-effectiveness ratios (2006 U.S. dollars per quality-adjusted life year (QALY) gained). Results of Base-Case Analysis In the context of annual or biennial screening, HPV vaccination of women ages 35–45 ranged from $116,950 to $272,350 per QALY using cytology with HPV DNA testing for triage of equivocal results, and from $193,690 to $381,590 per QALY using combination cytology and HPV DNA testing, depending on age and screening frequency. Results of Sensitivity Analysis Probabilistic sensitivity analysis revealed that the probability of HPV vaccination being cost-effective for women ages 35–45 was 0% when screening occurred annually or biennially, and <5% when screening occurred triennially, at thresholds considered good value for money. Limitations Uncertainty in the natural history of disease and vaccine efficacy in older women. Conclusions Given currently available information, the effectiveness of HPV vaccination of screened women over age 30 appears, on average, to be small. Compared with current screening that uses sensitive HPV DNA testing, HPV vaccination in this older population is associated with cost-effectiveness ratios that are less attractive than well

  8. HPV (Human Papillomavirus) vaccine - what you need to know [Gardasil®-9

    MedlinePlus

    ... is taken in its entirety from the CDC HPV (Human Papillomavirus) Gardasil-9 Vaccine Information Statement (VIS): www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil-9.html . CDC review information for HPV ...

  9. Mothers' acceptance of human papillomavirus (HPV) vaccination for daughters in a country with a high prevalence of HPV.

    PubMed

    Alder, Susanna; Gustafsson, Sofia; Perinetti, Claudia; Mints, Miriam; Sundström, Karin; Andersson, Sonia

    2015-05-01

    Cervical cancer is the second most common cancer among women in Argentina and the mortality rate is not declining despite opportunistic screening. Free-of-charge human papillomavirus (HPV) vaccination of 11-year-old girls was introduced in 2011. Parental acceptance of HPV vaccination is considered to be of great importance for HPV vaccine uptake. However, little is known regarding this factor in Argentina. The aim of the present study was to explore maternal HPV vaccination acceptance, willingness to pay for HPV vaccination and correlates of this willingness, awareness of HPV and HPV-associated disease and behaviors and attitudes associated with HPV vaccination acceptance. A total of 180 mothers of girls aged 9-15 years comprised this quantitative, cross-sectional, survey-based study, conducted at two hospitals in the Mendoza Province. Correlates of willingness to pay for HPV vaccination were obtained using multivariable logistic regression models. Maternal HPV vaccination acceptance was 90%, and 60% of mothers were willing to pay for HPV vaccination. Mothers who were gainfully employed and had a higher disposable household income were significantly more willing to pay for HPV vaccination [odds ratio (OR)=2.54, 95% confidence interval (CI) 1.01-6.38; OR=3.28, 95% CI 1.36-7.94, respectively], as were mothers who were aware of cervical cancer prior to the study (OR=3.22, 95% CI 1.02-10.14). Only one in 10 mothers were informed that HPV vaccination does not offer complete protection against cervical cancer. In conclusion, the present study showed high maternal HPV vaccination acceptance, although acceptance decreased when vaccination was not free-of-charge. Continuous public education campaigns are needed to improve knowledge of HPV, HPV vaccines and HPV-associated disease. PMID:25738832

  10. Intent to Receive an HPV Vaccine among University Men and Women and Implications for Vaccine Administration

    ERIC Educational Resources Information Center

    Jones, Melissa; Cook, Robert

    2008-01-01

    Objective and Participants: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. Methods: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer…

  11. Racial and ethnic differences in HPV knowledge, attitudes, and vaccination rates among low-income African-American, Haitian, Latina and Caucasian young adult women

    PubMed Central

    Clark, Jack A.; Mercilus, Glory; Wilbur, MaryAnn B.; Figaro, Jean; Perkins, Rebecca

    2013-01-01

    Objective To examine facilitators and barriers to HPV vaccine uptake in African-American, Haitian, Latina, and White women ages 18–22 and to determine vaccination completion rates among participants over 5 years. Design Using semi-structured interviews and medical record review, we assessed HPV knowledge and attitudes towards HPV vaccination among young women. We then determined their subsequent HPV vaccination initiation and completion rates. We used constructs from the Health Belief Model and methods based in grounded theory and content analysis to identify attitudes towards HPV vaccination cues to initiate vaccination, perception of HPV, and how communication about issues of sexuality may impact vaccine uptake. Participants We enrolled 132 African-American, Haitian, Latina, and White women aged 18–22 years who visited an urban academic medical center and two affiliated community health centers between the years 2007 and 2012. Main Outcome Measures Intent to vaccinate and actual vaccination rates Results Of 132 participants, 116 (90%) stated that they were somewhat or very likely to accept HPV vaccination if offered by their physician, but only 51% initiated the vaccination over the next 5 years. Seventy-eight percent of those who initiated vaccination completed the 3 doses of the HPV vaccine series. Forty-five percent (45%, n=50) of the adolescents who started the series completed three doses over a five year period: forty-two percent African-American (n=16), thirty-three percent Haitian (n=13), sixty-three percent Latina (n=10), and sixty-five White young women (n=11) completed the three-dose series. Despite low knowledge, they reported high levels of trust in physicians and were willing to vaccinate if recommended by their physicians. Conclusion Desire for HPV vaccination is high among older adolescents, physician recommendation and use of every clinic visit opportunity may improve vaccine uptake in young women. More White young women completed the HPV

  12. HPV Awareness and Vaccine Willingness among Dominican Immigrant Parents Attending a Federal Qualified Health Clinic in Puerto Rico

    PubMed Central

    Colón-López, Vivian; Quiñones, Valerie; Del Toro-Mejías, Lizbeth M.; Conde-Toro, Alexandra; Serra-Rivera, Michelle J.; Martínez, Tania M.; Rodríguez, Verónica; Berdiel, Luis; Villanueva, Héctor

    2014-01-01

    The purpose of this study was to describe the socio-demographic characteristics, awareness of human papillomavirus (HPV), and willingness to vaccinate among a convenience sample of 60 immigrant Dominican parents of adolescent sons in a Federal Qualified Health Clinic (FQHC) in Puerto Rico (PR). Participation involved completing a self-administered survey. Even though more than half of the parents had not received proper HPV vaccine orientation from healthcare provider (58.3%) nor asked provider for vaccination recommendation for their adolescent sons (56.7%), most parents were aware of HPV (91.7%) and HPV vaccination among males (55.0%). Among those with unvaccinated sons, willingness to vaccinate the son within the next year was high (83.8%). The low vaccination percentage (31.7%) and information exchange between the parents and the son’s healthcare provider indicates an opportunity for future culturally tailored interventions to target HPV vaccination among healthcare providers and parents of foreign descent in order to increase HPV vaccine uptake among males. PMID:25023490

  13. A Survey of Physicians' Attitudes and Practices about the Human Papillomavirus (HPV) Vaccine in Hawai‘i

    PubMed Central

    Dela Cruz, May Rose I; Tsark, JoAnn U; Chen, John J; Braun, Kathryn L

    2015-01-01

    The human papillomavirus (HPV) vaccine has the potential to decrease the incidence of several cancers that affect women and men. Despite recommendations by the medical and public health community, and the incorporation of the vaccine into the adolescent immunization schedule, uptake of the vaccine remains well below target goals. To understand potential physician barriers to recommendation and provision of the vaccine, a cross-sectional survey was administered to Hawai‘i pediatricians and family physicians from July 2012 to September 2012 on their attitudes, practices, and perceived barriers regarding HPV vaccination. Surveys were mailed to 465 members of the local pediatrics and family medicine professional chapters, and 87 responses were received for a response rate of 19%. After excluding 14 responses, 73 surveys were included in the analysis. Although almost all of the respondents reported stocking and administering the HPV vaccine in their offices, only 71% reported strongly recommending the HPV vaccine to girls 11–12 years, and only 57% strongly recommend the vaccine to boys 11–12 years old. Lack of insurance coverage and other financial considerations were barriers to provision of the vaccine by physicians. Physicians who felt it is necessary to discuss sexuality with patients prior to recommending the vaccine were significantly less likely to strongly recommend the vaccine to boys 11–12 years old. Public health efforts should focus on addressing the financial barriers and encouraging physicians to recommend the HPV vaccine according to the guidelines. PMID:26225269

  14. Usability Testing of an HPV Information Website for Parents and Adolescents

    PubMed Central

    Starling, Randall; Nodulman, Jessica A.; Kong, Alberta S.; Wheeler, Cosette M.; Buller, David B.; Woodall, W. Gill

    2015-01-01

    Objective Parents make the decisions regarding their children’s health care. Unfortunately, many parents are misinformed about HPV and HPV vaccines. In order to help parents make an informed decision regarding HPV vaccination for their daughter, the GoHealthyGirls website was created for parents and their adolescent daughters. Usability testing was conducted with members of the target population to refine the website prior to conducting an efficacy trial. Methods Parents with girls (n=9) between the ages of 11-13 and 11-13 year old adolescents (n=10) were recruited for usability testing. The testing consisted of completing twelve scenarios where participants were asked to find specific information on the GoHealthyGirls site. This was followed by a self-administered system usability scale—to determine ease of use and functionality of the website—and a user satisfaction survey. Results Both adult and adolescent participants were able to easily find the requested information and reported an increased positive opinion of HPV vaccines after visiting the website. Both groups of participants reported favorable evaluations of using the website. Conclusion The GoHealthyGirls website has the potential to help parents of adolescent daughters make an informed decision about HPV vaccination. A large scale efficacy trial will determine its usefulness. PMID:26594313

  15. Social work student attitudes toward contraception and the HPV vaccine.

    PubMed

    Flaherty, Chris; Ely, Gretchen E; Akers, L Shevawn; Dignan, Mark; Bonistall Noland, Tara

    2012-01-01

    The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National Association of Social Workers (NASW) stance on reproductive health outlined in the NASW policy statement on family planning and reproductive health. The relationship between levels of religious activity and attitudes toward these aspects of reproductive health was also examined. Results suggest that almost all of the respondents support public funding for family planning. Furthermore, almost all students indicate willingness to refer clients for general contraception. However, results related to emergency contraception indicate that 72% of students disagree that it should be available for adolescents over the counter, even with parental consent, which is inconsistent with the NASW perspective. Sixty-four percent of students report believing that the HPV vaccine is unsafe. Further, as levels of religious activity increased, acceptance of some of these aspects of reproductive health decreased. Implications for social work practice, education, and directions for future research are discussed. PMID:22489559

  16. Literature review of HPV vaccine delivery strategies: considerations for school- and non-school based immunization program.

    PubMed

    Paul, Proma; Fabio, Anthony

    2014-01-01

    School-based vaccination is becoming a more widely considered method of delivering HPV immunizations to an adolescent population; however, many countries do not have experience with delivering adolescent vaccines or school-based programs. This literature review will summarize the experiences from countries implementing non-health facility-based and health facility-based vaccination programs and assess HPV vaccine coverage. In October 2012, a systematic search in PubMed for studies related to the evaluation of national/regional, pilot, or demonstration HPV immunization programs that worked within existing health system yielded nine articles, representing seventeen countries. School-based programs achieved high HPV vaccination coverage rates in 9 to 13-year-old girls across the different studies and geographic locations, suggesting non-health facility-based programs are possible for HPV vaccine introduction. Grade-based, compared to age-based, eligibility criteria may be easier to implement in school settings. More studies are needed to explore the methods to standardize estimates for HPV vaccine coverage so that programs can be appropriately evaluated. PMID:24295804

  17. Knowledge of HPV, Perception of Risk, and Intent to Obtain HPV Vaccination among Male University Students

    ERIC Educational Resources Information Center

    Larsen, Dawn

    2014-01-01

    Human papillomavirus (HPV), the most common sexually transmitted virus in the world, is associated with almost all cases of cervical cancer. It is also related to vulvar, vaginal, penile, anal, and oropharyngeal cancer. HPV vaccination is recommended by the Centers for Disease Control and Prevention (CDC) for both boys and girls. Unfortunately,…

  18. Vaccination against Human Papilloma Virus infection in male adolescents: Knowledge, attitudes, and acceptability among parents in Italy

    PubMed Central

    Bianco, Aida; Pileggi, Claudia; Iozzo, Francesca; Nobile, Carmelo Giuseppe A; Pavia, Maria

    2014-01-01

    Objectives: To elicit information about parents’ knowledge, attitudes, and acceptability toward HPV infection and vaccination of male adolescents in Italy; to identify subgroups of this population who exhibit poor knowledge about prevention of HPV infection and reveal negative attitudes toward HPV vaccination in relation to their male sons. Study design: Data were collected via self-administered anonymous questionnaire from 1021 parents of males aged 10 to 14 y who were recruited from a random sample of public secondary schools in the South of Italy. Results: Three-quarters (72.6%) reported that the vaccine is a preventive measure for HPV infection and 55.8% that condom use reduces the risk of HPV infection. A high education level, abundant sources of information about HPV infection received from physicians, and knowledge about HPV infection were factors significantly associated with high level of knowledge about preventive measures for HPV infection. 71% revealed their intentions to vaccinate their sons, and this intention was significantly associated with perceived benefits both for HPV vaccination for girls and for childhood recommended vaccinations as well as a need for additional information about HPV vaccination. 53.7% of the eligible parents reported that their daughters had been vaccinated against HPV. Conclusion: Results of the study suggest that the risk of acquiring HPV infection and HPV-related diseases is sorely underestimated. Knowledge on the benefits of adolescents’ HPV vaccination in cancer prevention in both sexes should be improved to maximize uptake of HPV vaccination. PMID:25483471

  19. Tumor prevention in HPV8 transgenic mice by HPV8-E6 DNA vaccination.

    PubMed

    Marcuzzi, Gian Paolo; Awerkiew, Sabine; Hufbauer, Martin; Schädlich, Lysann; Gissmann, Lutz; Eming, Sabine; Pfister, Herbert

    2014-06-01

    The genus beta human papillomavirus 8 (HPV8) is involved in the development of cutaneous squamous cell carcinomas (SCCs) in individuals with epidermodysplasia verruciformis. Immunosuppressed transplant recipients are prone to harbor particularly high betapapillomavirus DNA loads, which may contribute to their highly increased risk of SCC. Tumor induction in HPV8 transgenic mice correlates with increased expression of viral oncogenes E6 and E2. In an attempt to prevent skin tumor development, we evaluated an HPV8-E6-DNA vaccine, which was able to stimulate a detectable HPV8-E6-specific cell-mediated immune response in 8/15 immunized mice. When skin of HPV8 transgenic mice was grafted onto non-transgenic littermates, the grafted HPV8 transgenic tissue was not rejected and papillomas started to grow within 14 days all over the transplant of 9/9 non-vaccinated and 7/15 not successfully vaccinated mice. In contrast, no papillomas developed in 6/8 successfully vaccinated mice. In the other two of these eight mice, a large ulcerative lesion developed within the initial papilloma growth or papilloma development was highly delayed. As the vaccine completely or partially prevented papilloma development without rejecting the transplanted HPV8 positive skin, the immune system appears to attack only keratinocytes with increased levels of E6 protein, which would give rise to papillomas. PMID:24446083

  20. Health care professionals and adolescent vaccination

    PubMed Central

    Zimet, Gregory D

    2014-01-01

    In their recently published research study, Gargano et al. found that a physician's recommendation and parental health beliefs had significant effects on adolescent vaccination rates and on parental intentions to vaccinate. This research replicates the findings of a number of human papillomavirus (HPV) vaccine-focused research studies, but explores new territory by focusing on all recommended adolescent vaccines: meningococcal-conjugate (MCV4), HPV, influenza, and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. Although Gargano et al.'s study is relatively small in scale and focuses on only one county in Georgia, their results are consistent with many other research reports, suggesting that their findings are robust and replicable. Most published intervention studies have targeted parents and young adults, with little focus on health care professionals. However, given the centrality of physician recommendation in adolescent vaccination, as shown by Gargano et al., it is clear that the time has come to develop and evaluate interventions that help physicians and other health care professionals to more effectively implement strong and routine recommendations for all adolescent platform vaccines. PMID:25483506

  1. Perceptions of HPV Vaccine amongst UK University Students

    ERIC Educational Resources Information Center

    Martin, Ellen; Senior, Naomi; Abdullah, Ammar; Brown, Janine; Collings, Suzanne; Racktoo, Sophie; Walpole, Sarah; Zeiton, Moez; Heffernan, Catherine

    2011-01-01

    Purpose: The aim of this small-scale focus group study is to explore the impact the Human Papilloma Virus (HPV) vaccine has on attitudes towards HPV, cervical cancer and sexual risk taking amongst university students in the UK. Design/methodology/approach: Participants were recruited through advertisements placed on notice boards throughout the…

  2. Interventions to increase HPV vaccination coverage: A systematic review.

    PubMed

    Smulian, Elizabeth A; Mitchell, Krista R; Stokley, Shannon

    2016-06-01

    We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies. PMID:26838959

  3. Interventions to increase HPV vaccination coverage: A systematic review

    PubMed Central

    Smulian, Elizabeth A.; Mitchell, Krista R.; Stokley, Shannon

    2016-01-01

    ABSTRACT We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies. PMID:26838959

  4. Urine testing to monitor the impact of HPV vaccination in Bhutan and Rwanda.

    PubMed

    Franceschi, Silvia; Chantal Umulisa, M; Tshomo, Ugyen; Gheit, Tarik; Baussano, Iacopo; Tenet, Vanessa; Tshokey, Tshokey; Gatera, Maurice; Ngabo, Fidele; Van Damme, Pierre; Snijders, Peter J F; Tommasino, Massimo; Vorsters, Alex; Clifford, Gary M

    2016-08-01

    Bhutan (2010) and Rwanda (2011) were the first countries in Asia and Africa to introduce national, primarily school-based, human papillomavirus (HPV) vaccination programmes. These target 12 year-old girls and initially included catch-up campaigns (13-18 year-olds in Bhutan and ninth school grade in Rwanda). In 2013, to obtain the earliest indicators of vaccine effectiveness, we performed two school-based HPV urine surveys; 973 female students (median age: 19 years, 5th-95th percentile: 18-22) were recruited in Bhutan and 912 (19 years, 17-20) in Rwanda. Participants self-collected a first-void urine sample using a validated protocol. HPV prevalence was obtained using two PCR assays that differ in sensitivity and type spectrum, namely GP5+/GP6+ and E7-MPG. 92% students in Bhutan and 43% in Rwanda reported to have been vaccinated (median vaccination age = 16, 5th-95th: 14-18). HPV positivity in urine was significantly associated with sexual activity measures. In Rwanda, HPV6/11/16/18 prevalence was lower in vaccinated than in unvaccinated students (prevalence ratio, PR = 0.12, 95% confidence interval, CI: 0.03-0.51 by GP5+/GP6+, and 0.45, CI: 0.23-0.90 by E7-MPG). For E7-MPG, cross-protection against 10 high-risk types phylogenetically related to HPV16 or 18 was of borderline significance (PR = 0.68; 95% CI: 0.45-1.01). In Bhutan, HPV6/11/16/18 prevalence by GP5+/GP6+ was lower in vaccinated than in unvaccinated students but CIs were broad. In conclusion, our study supports the feasibility of urine surveys to monitor HPV vaccination and quantifies the effectiveness of the quadrivalent vaccine in women vaccinated after pre-adolescence. Future similar surveys should detect increases in vaccine effectiveness if vaccination of 12 year-olds continues. PMID:26991686

  5. Adolescent Vaccination Strategies: Interventions to Increase Coverage.

    PubMed

    Lehmann, Corinne E; Brady, Rebecca C; Battley, Reuben O; Huggins, Jennifer L

    2016-08-01

    While vaccines have decreased the burden of disease, many adolescents still remain under-immunized, particularly for human papillomavirus (HPV) and influenza. We review the most current data regarding adolescent immunizations in the United States and discuss proven strategies that work for increasing vaccination rates. Strategies that have been shown to improve rates include provider feedback, immunization information systems (or registries), and enhanced access outside of provider offices, such as school-based immunization programs. Overall, practices may want to consider multimodal quality improvement approaches to enhance practice vaccination rates. The public health and cost benefits of immunizing adolescents are well known, yet recent measles outbreaks in the United States have highlighted issues with state immunization laws and vaccine refusals. Providers should be clear in their advice regarding vaccines and use effective reminder strategies as parents commonly cite not having enough information or knowledge that a vaccine was needed for their adolescent. Additional research is needed regarding adolescent consent for vaccines, as well as adolescent and parental refusal, in order to design systems that will help inform families and allow for widespread vaccine availability. PMID:27146296

  6. The Effectiveness of a Facebook-Assisted Teaching Method on Knowledge and Attitudes about Cervical Cancer Prevention and HPV Vaccination Intention among Female Adolescent Students in Taiwan

    ERIC Educational Resources Information Center

    Lai, Ching-Yi; Wu, Wei-Wen; Tsai, Shao-Yu; Cheng, Su-Fen; Lin, Kuan-Chia; Liang, Shu-Yuan

    2015-01-01

    Background: Lack of education is a known barrier to vaccination, but data on the design and effectiveness of interventions remain limited. Objective: This study aims to identify the effectiveness of a Facebook-assisted teaching method on female adolescents' knowledge and attitudes about cervical cancer prevention and on their human papillomavirus…

  7. The internet’s role in HPV vaccine education

    PubMed Central

    Patel, Pooja R; Berenson, Abbey B

    2014-01-01

    The internet is the second most popular source, after healthcare providers, of information regarding human papillomavirus (HPV). These online searches usually begin with the user entering generic terms in the search engine, and then reading the first few results that the engine returns. Unfortunately, research shows that much of this information obtained about the HPV vaccine is inaccurate and incomplete. In this review, we summarize the literature pertaining to online information concerning the HPV vaccine and review concerns related to obtaining online medical information. Finally, we propose possible solutions medical providers can employ in their everyday practice to help their patients obtain accurate information through their online searches. PMID:24553151

  8. Human papilloma virus vaccine: determinants of acceptability by mothers for adolescents in Nigeria.

    PubMed

    Ezeanochie, Michael C; Olagbuji, Biodun N

    2014-09-01

    Vaccination of adolescent females against Human Papilloma Virus (HPV), the causative agent for cervical cancer has recently become available. As minors, parental acceptance of the vaccines for adolescent daughters requires exploration. This was a cross-sectional survey of 201 mothers attending the gynaecology clinic in a University Teaching Hospital in Nigeria on acceptability of the HPV vaccines and its determinants. Although 70% accepted vaccination of their daughters, 30% were unwilling and the commonest reason for unwillingness was that it may encourage sexual promiscuity (62.3%). Mothers with poor knowledge of STI were significantly more unwilling to accept HPV vaccines compared to those with average or good knowledge (p = 0.002). Furthermore, perception of susceptibility to HPV infection by daughters was significantly associated with acceptance of the vaccines (p = 0.0001). Increased advocacy and public enlightenment on cervical cancer control and the role of HPV vaccines in its prevention is still necessary especially in developing countries. PMID:25508051

  9. Human papilloma virus vaccine: determinants of acceptability by mothers for adolescents in Nigeria.

    PubMed

    Ezeanochie, Michael C; Olagbuji, Biodun N

    2014-09-01

    Vaccination of adolescent females against Human Papilloma Virus (HPV), the causative agent for cervical cancer has recently become available. As minors, parental acceptance of the vaccines for adolescent daughters requires exploration. This was a cross-sectional survey of 201 mothers attending the gynaecology clinic in a University Teaching Hospital in Nigeria on acceptability of the HPV vaccines and its determinants. Although 70% accepted vaccination of their daughters, 30% were unwilling and the commonest reason for unwillingness was that it may encourage sexual promiscuity (62.3%). Mothers with poor knowledge of STI were significantly more unwilling to accept HPV vaccines compared to those with average or good knowledge (p = 0.002). Furthermore, perception of susceptibility to HPV infection by daughters was significantly associated with acceptance of the vaccines (p = 0.0001). Increased advocacy and public enlightenment on cervical cancer control and the role of HPV vaccines in its prevention is still necessary especially in developing countries. PMID:25438520

  10. Towards a HPV Vaccine Knowledgebase for Patient Education Content.

    PubMed

    Wang, Dennis; Cunningham, Rachel; Boom, Julie; Amith, Muhammad; Tao, Cui

    2016-01-01

    Human papillomavirus is a widespread sexually transmitted infection that can be prevented with vaccination. However, HPV vaccination rates in the United States are disappointingly low. This paper will introduce a patient oriented web ontology intended to provide an interactive way to educate patients about HPV and the HPV vaccine that will to empower patients to make the right vaccination decision. The information gathered for this initial draft of the ontology was primarily taken from the Centers for Disease Control and Prevention's Vaccine Information Statements. The ontology currently consists of 160 triples, 141 classes, 52 properties and 55 individuals. For future iterations, we aim to incorporate more information as well as obtain subject matter expert feedback to improve the overall quality of the ontology. PMID:27332237

  11. The effect of a booster dose of quadrivalent or bivalent HPV vaccine when administered to girls previously vaccinated with two doses of quadrivalent HPV vaccine.

    PubMed

    Gilca, Vladimir; Sauvageau, Chantal; Boulianne, Nicole; De Serres, Gatson; Crajden, Mel; Ouakki, Manale; Trevisan, Andrea; Dionne, Marc

    2015-01-01

    This randomized, blinded study evaluated the immunogenicity and safety of a booster dose of Gardasil (qHPV) or Cervarix (bHPV) when administered to 12-13 year-old girls who were vaccinated at the age of 9-10 with 2 doses of qHPV (0-6 months). 366 out of 416 eligible girls participated in this follow-up study. Antibody titers were measured just before and one month post-booster. A Luminex Total IgG assay was used for antibody assessment and results are presented in Liminex Units (LU). Three years post-primary vaccination, 99-100% of subjects had detectable antibodies to 4HPV genotypes included in the qHPV with GMTs varying from 50 to 322 LU depending on genotype. After a booster dose of qHPV, a ≥4 fold increase of antibody titers to genotypes included in the vaccine was observed in 88-98% of subjects. Post-booster GMTs varied from 1666 to 4536 LU depending on genotype. These GMTs were 1.1 to 1.8-fold higher when compared to those observed one month post-second dose. After a booster of bHPV, a ≥4 fold increase of antibody titers to HPV16 and HPV18 was observed in 93-99% of subjects. The anti-HPV16 and HPV18 GMTs were 5458 and 2665 LU, respectively. These GMTs were 1.2 and 1.8 higher than those observed in the qHPV group (both P < 0.01). In bHPV group a 1.4-1.6-fold increase of antibody GMTs to HPV6 and HPV11was also observed (P < 0.001). The safety profile was acceptable for both vaccines. Both qHPV and bHPV increase antibody titers when given as a booster to girls previously vaccinated with 2 doses of qHPV. The magnitude of the immune response after booster is vaccine-dependent and has the same pattern as that reported after primary vaccination with qHPV or bHPV. When given as a booster, both vaccines have an acceptable safety profile. Longer follow-up studies are warranted to assess the need of booster doses. PMID:25714044

  12. The effect of a booster dose of quadrivalent or bivalent HPV vaccine when administered to girls previously vaccinated with two doses of quadrivalent HPV vaccine

    PubMed Central

    Gilca, Vladimir; Sauvageau, Chantal; Boulianne, Nicole; De Serres, Gatson; Crajden, Mel; Ouakki, Manale; Trevisan, Andrea; Dionne, Marc

    2015-01-01

    This randomized, blinded study evaluated the immunogenicity and safety of a booster dose of Gardasil (qHPV) or Cervarix (bHPV) when administered to 12–13 year-old girls who were vaccinated at the age of 9–10 with 2 doses of qHPV (0–6 months). 366 out of 416 eligible girls participated in this follow-up study. Antibody titers were measured just before and one month post-booster. A Luminex Total IgG assay was used for antibody assessment and results are presented in Liminex Units (LU). Three years post-primary vaccination, 99–100% of subjects had detectable antibodies to 4HPV genotypes included in the qHPV with GMTs varying from 50 to 322 LU depending on genotype. After a booster dose of qHPV, a ≥4 fold increase of antibody titers to genotypes included in the vaccine was observed in 88–98% of subjects. Post-booster GMTs varied from 1666 to 4536 LU depending on genotype. These GMTs were 1.1 to 1.8-fold higher when compared to those observed one month post-second dose. After a booster of bHPV, a ≥4 fold increase of antibody titers to HPV16 and HPV18 was observed in 93–99% of subjects. The anti-HPV16 and HPV18 GMTs were 5458 and 2665 LU, respectively. These GMTs were 1.2 and 1.8 higher than those observed in the qHPV group (both P < 0.01). In bHPV group a 1.4–1.6-fold increase of antibody GMTs to HPV6 and HPV11was also observed (P < 0.001). The safety profile was acceptable for both vaccines. Both qHPV and bHPV increase antibody titers when given as a booster to girls previously vaccinated with 2 doses of qHPV. The magnitude of the immune response after booster is vaccine-dependent and has the same pattern as that reported after primary vaccination with qHPV or bHPV. When given as a booster, both vaccines have an acceptable safety profile. Longer follow-up studies are warranted to assess the need of booster doses. PMID:25714044

  13. Human Papillomavirus (HPV) Vaccine (Gardasil-9)

    MedlinePlus

    ... 9 prevents many cancers caused by human papillomavirus (HPV) infections, including:cervical cancer in females vaginal and ... Gardasil-9 can prevent most of these cancers. HPV infection usually comes from sexual contact, and most ...

  14. Immunogenicity of next-generation HPV vaccines in non-human primates: Measles-vectored HPV vaccine versus Pichia pastoris recombinant protein vaccine.

    PubMed

    Gupta, Gaurav; Giannino, Viviana; Rishi, Narayan; Glueck, Reinhard

    2016-09-01

    Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide. HPVs are oncogenic small double-stranded DNA viruses that are the primary causal agent of cervical cancer and other types of cancers, including in the anus, oropharynx, vagina, vulva, and penis. Prophylactic vaccination against HPV is an attractive strategy for preventing cervical cancer and some other types of cancers. However, there are few safe and effective vaccines against HPV infections. Current first-generation commercial HPV vaccines are expensive to produce and deliver. The goal of this study was to develop an alternate potent HPV recombinant L1-based vaccines by producing HPV virus-like particles into a vaccine that is currently used worldwide. Live attenuated measles virus (MV) vaccines have a well-established safety and efficacy record, and recombinant MV (rMV) produced by reverse genetics may be useful for generating candidate HPV vaccines to meet the needs of the developing world. We studied in non-human primate rMV-vectored HPV vaccine in parallel with a classical alum adjuvant recombinant HPV16L1 and 18L1 protein vaccine produced in Pichia pastoris. A combined prime-boost approach using both vaccines was evaluated, as well as immune interference due to pre-existing immunity against the MV. The humoral immune response induced by the MV, Pichia-expressed vaccine, and their combination as priming and boosting approaches was found to elicit HPV16L1 and 18L1 specific total IgG and neutralizing antibody titres. Pre-existing antibodies against measles did not prevent the immune response against HPV16L1 and 18L1. PMID:27523740

  15. Overcoming barriers to HPV vaccination: A randomized clinical trial of a culturally-tailored, media intervention among African American girls.

    PubMed

    DiClemente, Ralph J; Murray, Colleen Crittenden; Graham, Tracie; Still, Julia

    2015-01-01

    Although genital HPV is the most prevalent STI in the US, rates of vaccination uptake among high-risk subgroups remain low. Investigations of vaccine compliance have mainly targeted mother-daughter dyads, which in some settings may prove difficult. This study examines an innovative culturally tailored, computer-delivered media-based strategy to promote HPV vaccine uptake. Data, inclusive of sociodemographics, sexual behaviors, knowledge, attitudes, and beliefs about HPV and vaccination were collected via ACASI from 216 African American adolescent females (ages 14-18 years) seeking services in family planning and STI public health clinics in metropolitan Atlanta. Data were obtained prior to randomization and participation in an interactive media-based intervention designed to increase HPV vaccination uptake. Medical record abstraction was conducted 7 month post-randomization to assess initial vaccine uptake and compliance. Participants in the intervention were more compliant to vaccination relative to a placebo comparison condition (26 doses vs. Seventeen doses; p=0.12). However, vaccination series initiation and completion were lower than the national average. Thorough evaluation is needed to better understand factors facilitating HPV vaccine uptake and compliance, particularly perceived susceptibility and the influence of the patient-provider encounter in a clinical setting. PMID:26378650

  16. Use of the nonavalent HPV vaccine in individuals previously fully or partially vaccinated with bivalent or quadrivalent HPV vaccines.

    PubMed

    Van Damme, Pierre; Bonanni, Paolo; Bosch, F Xavier; Joura, Elmar; Kjaer, Susanne Krüger; Meijer, Chris J L M; Petry, Karl-Ulrich; Soubeyrand, Benoit; Verstraeten, Thomas; Stanley, Margaret

    2016-02-01

    With the availability of the nonavalent human papillomavirus (HPV) vaccine, vaccinees, parents and healthcare providers need guidance on how to complete an immunization course started with the bi- or quadrivalent vaccine and whether to revaccinate individuals who have completed a full immunization course with the bi- or quadrivalent vaccine. To answer these questions three parameters should be considered: age at the start of vaccination (9 to 14 years of age versus 15 years and older, the cut-off for 2 or 3 doses schedule), the number of doses already received and the time interval between doses. Based on a number of scenarios, we propose that the 9-valent vaccine can be used to complete an incomplete vaccination regimen or might be added to a previous completed schedule to extend protection. PMID:26772631

  17. The role of media and the Internet on vaccine adverse event reporting: a case study of HPV vaccination

    PubMed Central

    Eberth, Jan M.; Kline, Kimberly N.; Moskowitz, David; Montealegre, Jane; Scheurer, Michael E.

    2013-01-01

    Purpose This study aimed to determine the temporal association of print media coverage and Internet search activity with adverse events reports associated with the human papillomavirus vaccine Gardasil® (HPV4) and the meningitis vaccine Menactra® (MNQ) among U.S. adolescents. Methods We used moderated linear regression to test the relationships between print media reports in top circulating newspapers, Internet search activity, and reports to the Vaccine Adverse Event Reporting System (VAERS) for HPV4 and MNQ during the first 2.5 years post-FDA approval. Results Compared to MNQ, HPV4 had more coverage in the print media and Internet search activity, which corresponded with the frequency of VAERS reports. In February 2007, we observed a spike in print media for HPV4. Although media coverage waned, Internet search activity remained stable and predicted the rise in HPV4-associated VAERS reports. Conclusions We demonstrate that media coverage and Internet search activity, in particular, may promote increased adverse event reporting. Public health officials who have long recognized the importance of proactive engagement with news media must now consider strategies for meaningful participation in Internet discussions. PMID:24257032

  18. [Ethics and reproductive health: the issue of HPV vaccination].

    PubMed

    Matejić, Bojana; Kesić, Vesna

    2013-01-01

    The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the

  19. HPV and Cancer

    MedlinePlus

    ... of HPV HPV and Cancer HPV Cancer Screening HPV Vaccines HPV Vaccine Safety For Clinicians Know the Facts Continuing Education Provider Fact Sheets Schedules & Recommendations HPV Vaccine Coverage Data Commit to the Cause Tools for ...

  20. An exploration of individual- and population-level impact of the 2-dose HPV vaccination schedule in pre-adolescent girls.

    PubMed

    Donken, Robine; Bogaards, Johannes A; van der Klis, Fiona R M; Meijer, Chris J L M; de Melker, Hester E

    2016-06-01

    Since 2014, several countries have implemented a 2-dose schedule for Human papillomavirus (HPV) vaccination. Licensure of the 2-dose schedule was based on non-inferiority results from immunobridging studies, comparing the antibody levels of the 2-dose schedule in young girls to those of the 3-dose schedule in young adults. Since licensure, additional data on antibody levels and other aspects of the immune response and clinical effectiveness have become available. This review will discuss the current outcomes on immunogenicity and effectiveness together with an exploration on the population impact of 2-dose schedules from a cost-effectiveness perspective. The 2-dose schedule has important benefits, such as easier logistics, reduced expenditure, potentially higher acceptance and fewer side effects. Policymakers and registration authorities should consider whether these benefits outweigh the likely differences on individual- and population-level impact between the 2- and 3-dose schedules. PMID:27171128

  1. Correlates of human papillomavirus vaccine completion among adolescent girl initiators

    PubMed Central

    Rahman, Mahbubur; Laz, Tabassum H.; McGrath, Christine J.; Berenson, Abbey B.

    2016-01-01

    OBJECTIVE To examine correlates of vaccine series completion among young adolescent US girls who initiated the human papillomavirus (HPV) vaccine. METHODS We analyzed National Immunization Survey-Teens 2012 provider-verified data to examine correlates of HPV vaccine completion among 13-17 year old girls who initiated HPV vaccine in 2012 (N=4,548). RESULTS The weighted vaccine series completion rate among 13-17 year old girl initiators was 66.7% (95% confidence interval (CI), 64.0-69.3). Adolescent girls who were older, residents of the Northeast (adjusted prevalence ratio (aPR) 1.36, 95% CI 1.07-1.73), and had provider-verified seasonal influenza vaccination in the past year (aPR 1.67, 95% CI 1.32-2.11) and provider recommendation (aPR 1.40, 95% CI 1.10-1.77) were more likely to complete the 3-dose vaccine series. CONCLUSIONS Parents of younger adolescent girls need to be educated about the importance of completing the 3-dose HPV vaccine series. Provider recommendation for the vaccine would also facilitate series completion. PMID:25848128

  2. Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls

    PubMed Central

    Tsui, Jennifer; Gee, Gilbert C.; Rodriguez, Hector; Kominski, Gerald F.; Glenn, Beth A.; Singhal, Rita; Bastani, Roshan

    2012-01-01

    Background Little is known about whether neighborhood factors are associated with HPV vaccine uptake, especially among disadvantaged groups that can benefit most from the vaccine. Methods We used data collected from immigrant, low-income mothers of adolescent girls and data from the 2005–2009 American Community Survey to investigate the relationship between HPV vaccine initiation and neighborhood characteristics. We compared initiation rates across levels of neighborhood disadvantage and employed multilevel logistic regression models to examine contextual effects on uptake. Results Overall, 27% of girls (n=479) initiated the vaccine. Initiation rates were highest among girls from the most disadvantaged neighborhoods (30%), however, neighborhood factors were not independently associated with vaccine initiation after adjusting for individual factors. Mother’s awareness of HPV, age, and insurance status were strong predictors for initiation. Conclusions Future interventions should focus on improving awareness among low-income mothers as well as targeting vulnerable families outside the catchment area of public programs. PMID:23081659

  3. Quadrivalent Human Papillomavirus (HPV) Types 6, 11, 16, 18 Vaccine

    PubMed Central

    Garnock-Jones, Karly P.; Giuliano, Anna R.

    2015-01-01

    The quadrivalent HPV types 6, 11, 16, 18 vaccine (Gardasil®) is a recombinant vaccine comprising purified virus-like particles derived from the L1 capsid proteins of HPV types 6, 11, 16 and 18. The vaccine was highly immunogenic. Geometric mean titres (GMTs) and seroconversion rates for all four HPV types at month 7 in males aged 10–15 years were noninferior to those in females aged 16–23 years, and those in males aged 9–15 years were noninferior to those in females aged 9–15 years. In addition, GMTs and seroconversion rates in males aged 16–26 years receiving the vaccine were higher than those receiving amorphous aluminium hydroxyphosphate sulfate adjuvant (AAHS) control. The quadrivalent HPV vaccine was significantly more effective than AAHS control at decreasing the incidence of HPV 6-, 11-, 16- or 18-related external genital lesions (primary endpoint) in a randomized, double-blind, placebo-controlled, multicentre study in males aged 16–26 years. The most common clinical endpoint was HPV 6- and 11-related condyloma; efficacy was robust against these lesions. The vaccine is also expected to be protective against genital warts in males aged 9–15 years, as the immune response in males of this age group was noninferior to that in males aged 16–26 years. The quadrivalent HPV vaccine was generally well tolerated in males aged 9–26 years. The most common adverse events reported were injection-site related, and most of these were of mild to moderate severity. PMID:21443282

  4. Strategies for Developing Oral Vaccines for Human Papillomavirus (HPV) Induced Cancer using Nanoparticle mediated Delivery System.

    PubMed

    Uddin, Mohammad Nasir; Kouzi, Samir A; Hussain, Muhammad Delwar

    2015-01-01

    Human Papillomaviruses (HPV) are a diverse group of small non-enveloped DNA viruses. Some HPVs are classified as low-risk as they are very rarely associated with neoplasia or cancer in the general population, and cause lenient warts. Other HPVs are considered as high-risk types because they are responsible for several important human cancers, including cervical cancer, a large proportion of other anogenital cancers, and a growing number of head and neck cancers. Transmission of HPV occurs primarily by skin-to-skin contact. The risk of contracting genital HPV infection and cervical cancer is influenced by sexual activity. Currently two prophylactic HPV vaccines, Gardasil® (Merck, USA) and Cervarix® (GlaxoSmithKline, UK), are available and recommended for mass immunization of adolescents. However, these vaccines have limitations as they are expensive and require cold chain storage and trained personnel to administer them by injection. The use of nano or micro particulate vaccines could address most of these limitations as they are stable at room temperature, inexpensive to produce and distribute to resource poor regions, and can be administered orally without the need for adjuvants in the formulation. Also it is possible to increase the efficiency of these particulate vaccines by decorating the surface of the nano or micro particulates with suitable ligands for targeted delivery. Oral vaccines, which can be delivered using particulate formulations, have the added potential to stimulate mucosa-associated lymphoid tissue located in the digestive tract and the gut-associated lymphoid tissue, both of which are important for the induction of effective mucosal response against many viruses. In addition, oral vaccines provide the opportunity to reduce production and administration costs and are very patient compliant. This review elaborately discusses different strategies that can be pursued to develop a nano or micro particulate oral vaccine for HPV induced cancers and

  5. Ethics and the HPV Vaccine: Considerations for School Nurses

    ERIC Educational Resources Information Center

    Bennett, Mary P.

    2008-01-01

    School nurses are at the forefront of health care providers for many families of junior high and high school students and are used as primary sources of information and guidance about recommended student vaccinations. In the case of the relatively new vaccine for human papillomavirus (HPV), school nurses must be both knowledgeable about the…

  6. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2015.

    PubMed

    Reagan-Steiner, Sarah; Yankey, David; Jeyarajah, Jenny; Elam-Evans, Laurie D; Curtis, C Robinette; MacNeil, Jessica; Markowitz, Lauri E; Singleton, James A

    2016-01-01

    The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive vaccines to prevent diseases, including human papillomavirus (HPV)-associated cancers, pertussis, and meningococcal disease (1). To assess vaccination coverage among adolescents in the United States, CDC analyzed data collected regarding 21,875 adolescents through the 2015 National Immunization Survey-Teen (NIS-Teen).* During 2014-2015, coverage among adolescents aged 13-17 years increased for each HPV vaccine dose among males, including ≥1 HPV vaccine dose (from 41.7% to 49.8%), and increased modestly for ≥1 HPV vaccine dose among females (from 60.0% to 62.8%) and ≥1 quadrivalent meningococcal conjugate vaccine (MenACWY) dose (from 79.3% to 81.3%). Coverage with ≥1 HPV vaccine dose was higher among adolescents living in households below the poverty level, compared with adolescents in households at or above the poverty level.(†) HPV vaccination coverage (≥1, ≥2, or ≥3 doses) increased in 28 states/local areas among males and in seven states among females. Despite limited progress, HPV vaccination coverage remained lower than MenACWY and tetanus, diphtheria, and acellular pertussis vaccine (Tdap) coverage, indicating continued missed opportunities for HPV-associated cancer prevention. PMID:27561081

  7. Fewer Doses of HPV Vaccine Result in Immune Response Similar to Three-Dose Regimen

    MedlinePlus

    ... Releases NCI News Note Fewer doses of HPV vaccine result in immune response similar to three-dose ... that two doses of a human papillomavirus (HPV) vaccine, trademarked as Cervarix, resulted in similar serum antibody ...

  8. Vaccine Has Cut HPV Infection Rate in Teen Girls by Two-Thirds

    MedlinePlus

    ... medlineplus/news/fullstory_157399.html Vaccine Has Cut HPV Infection Rate in Teen Girls by Two-Thirds: ... News) -- Ten years of vaccinating against human papillomavirus (HPV) has cut infections from this cancer-causing virus ...

  9. HPV (Human Papillomavirus) vaccine - what you need to know [Gardasil®-9

    MedlinePlus

    ... taken in its entirety from the CDC HPV (Human Papillomavirus) Gardasil-9 Vaccine Information Statement (VIS): www. ... WHY GET VACCINATED? Gardasil-9 prevents human papillomavirus (HPV) ... Vaginal and vulvar cancers in females, and Anal cancer in ...

  10. A Review of Human Papillomavirus (HPV) Infection and HPV Vaccine-Related Attitudes and Sexual Behaviors among College-Aged Women in the United States

    ERIC Educational Resources Information Center

    Ratanasiripong, Nop T.

    2012-01-01

    Objective: To identify human papillomavirus (HPV) infection and HPV vaccine-related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to…

  11. Parental Acceptance of HPV Vaccine in Peru: A Decision Framework

    PubMed Central

    Bartolini, Rosario M.; Winkler, Jennifer L.; Penny, Mary E.; LaMontagne, D. Scott

    2012-01-01

    Objective and Method Cervical cancer is the third most common cancer affecting women worldwide and it is an important cause of death, especially in developing countries. Cervical cancer is caused by human papillomavirus (HPV) and can be prevented by HPV vaccine. The challenge is to expand vaccine availability to countries where it is most needed. In 2008 Peru’s Ministry of Health implemented a demonstration project involving 5th grade girls in primary schools in the Piura region. We designed and conducted a qualitative study of the decision-making process among parents of girls, and developed a conceptual model describing the process of HPV vaccine acceptance. Results We found a nonlinear HPV decision-making process that evolved over time. Initially, the vaccine’s newness, the requirement of written consent, and provision of information were important. If information was sufficient and provided by credible sources, many parents accepted the vaccine. Later, after obtaining additional information from teachers, health personnel, and other trusted sources, more parents accepted vaccination. An understanding of the issues surrounding the vaccine developed, parents overcome fears and rumors, and engaged in family negotiations–including hearing the girl’s voice in the decision-making process. The concept of prevention (cancer as danger, future health, and trust in vaccines) combined with pragmatic factors (no cost, available at school) and the credibility of the offer (information in the media, recommendation of respected authority figure) were central to motivations that led parents to decide to vaccinate their daughters. A lack of confidence in the health system was the primary inhibitor of vaccine acceptance. Conclusions Health personnel and teachers are credible sources of information and can provide important support to HPV vaccination campaigns. PMID:23144719

  12. National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.

    PubMed

    Durham, David P; Ndeffo-Mbah, Martial L; Skrip, Laura A; Jones, Forrest K; Bauch, Chris T; Galvani, Alison P

    2016-05-01

    Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms. PMID:27091978

  13. Comparison of the immunogenicity of Cervarix® and Gardasil® human papillomavirus vaccines for oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults

    PubMed Central

    Toft, Lars; Tolstrup, Martin; Müller, Martin; Sehr, Peter; Bonde, Jesper; Storgaard, Merete; Østergaard, Lars; Søgaard, Ole S

    2014-01-01

    Individuals infected with human immunodeficiency virus (HIV) have excess risk of developing human papillomavirus (HPV)-related disease. A substantial fraction of HPV-associated cancers is caused by HPV serotypes not included in the currently available vaccines. Among healthy women, both Cervarix® (HPV-16/18, GlaxoSmithKline Biologicals, GSK) and Gardasil® (HPV-6/11/16/18, Merck) have demonstrated partial cross-protection against certain oncogenic non-vaccine HPV-types. Currently, there are no available data on vaccine-induced cross-protection in men and little is known about cross-reactive immunity after HPV-vaccination of HIV-infected individuals. In an investigator-initiated trial, we randomized 91 HIV-positive men and women to receive vaccination with Cervarix® or Gardasil®. The HPV-DNA status of the participants was determined with pcr before and after immunization. Cross-reactive antibody responses against HPV-31, HPV-33, and HPV-45 were evaluated for up to 12 months using a pseudovirion-based neutralization assay (PBNA). Geometric mean antibody titers (GMTs) were compared among vaccine groups and genders at 7 and 12 months. Both vaccines induced anti-HPV-31, -33, and -45 neutralizing antibodies in participants who were seronegative and HPV-DNA negative for those types at study entry. Geometric mean antibody titers were comparable between vaccine groups. Interestingly, anti-HPV-31 and -33 antibody titers were higher among women compared with men at 7 and 12 months. In conclusion, both licensed HPV-vaccines induced cross-neutralizing antibodies against frequent oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults, and women had greater serological responses against HPV-31 and -33 compared with men. PMID:24553190

  14. School Nurses' Professional Practice in the HPV Vaccine Decision-Making Process

    ERIC Educational Resources Information Center

    Rosen, Brittany L.; Ashwood, Daniel; Richardson, George B.

    2016-01-01

    Because U.S. human papillomavirus (HPV) vaccination rates remain low, we evaluated school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, self-efficacy, intention, and professional practice regarding the HPV vaccine and determined if these variables influenced their professional practice concerning the HPV vaccine. We…

  15. HPV Vaccine and Latino Immigrant Parents: If They Offer It, We Will Get It.

    PubMed

    Aragones, Abraham; Genoff, Margaux; Gonzalez, Cynthia; Shuk, Elyse; Gany, Francesca

    2016-10-01

    HPV vaccination rates remain low in the fast growing Latino children population while we continue to observe large HPV-associated cancer disparities in the Latino population. In this study, we sought to elucidate Latino immigrant parents' barriers to obtaining the HPV vaccine for their children. Five focus groups were conducted with Latino immigrant parents of minors (i.e., 9-17 year old) who had not yet initiated the HPV vaccine series. Three major findings were identified from the focus groups: (1) low levels of awareness and knowledge of HPV and the HPV vaccine, (2) high confidence that parent can get the vaccine for their eligible child and (3) lack of provider recommendation as the main barrier to vaccination. Children of Latino immigrant parents could benefit from increased provider recommendation for the HPV vaccine while providing tailored HPV information to parents. PMID:26001843

  16. Social media microblogs as an HPV vaccination forum.

    PubMed

    Zhang, Chupei; Gotsis, Marientina; Jordan-Marsh, Maryalice

    2013-11-01

    The 2006 US FDA approval of the human papillomavirus (HPV) vaccine brought new hope for cancer prevention. Gardasil and Cervarix are widely available vaccines that can deter HPV infection, which causes 70% of cervical cancer. Acceptance of vaccination varies due to a lack of HPV awareness and HPV vaccine knowledge. Recent observations of the Chinese microblog "SinaWeibo" suggest a new approach to engage health professionals and consumer website bloggers. Websites that present the latest fashion, fitness or beauty news and ways to obtain "deals" have created informative blogs or online communities that appeal to female users. Some users raise health questions of their peers. Health professionals, as website bloggers, can introduce vaccine news or respond to conversations between bloggers and their followers. By transforming medical vocabulary into ordinary chat, microblogs may promote efficiency in vaccine education and communication. A web-based, interactive social media-microblog could offer an ideal platform to speed up information dissemination and increase targeted communication. PMID:23842072

  17. Social media microblogs as an HPV vaccination forum

    PubMed Central

    Zhang, Chupei; Gotsis, Marientina; Jordan-Marsh, Maryalice

    2013-01-01

    The 2006 US FDA approval of the human papillomavirus (HPV) vaccine brought new hope for cancer prevention. Gardasil and Cervarix are widely available vaccines that can deter HPV infection, which causes 70% of cervical cancer. Acceptance of vaccination varies due to a lack of HPV awareness and HPV vaccine knowledge. Recent observations of the Chinese microblog “SinaWeibo” suggest a new approach to engage health professionals and consumer website bloggers. Websites that present the latest fashion, fitness or beauty news and ways to obtain “deals” have created informative blogs or online communities that appeal to female users. Some users raise health questions of their peers. Health professionals, as website bloggers, can introduce vaccine news or respond to conversations between bloggers and their followers. By transforming medical vocabulary into ordinary chat, microblogs may promote efficiency in vaccine education and communication. A web-based, interactive social media-microblog could offer an ideal platform to speed up information dissemination and increase targeted communication. PMID:23842072

  18. Epidemiology of HPV 16 and Cervical Cancer in Finland and the Potential Impact of Vaccination: Mathematical Modelling Analyses

    PubMed Central

    Barnabas, Ruanne V; Laukkanen, Päivi; Koskela, Pentti; Kontula, Osmo; Lehtinen, Matti; Garnett, Geoff P

    2006-01-01

    Background Candidate human papillomavirus (HPV) vaccines have demonstrated almost 90%-100% efficacy in preventing persistent, type-specific HPV infection over 18 mo in clinical trials. If these vaccines go on to demonstrate prevention of precancerous lesions in phase III clinical trials, they will be licensed for public use in the near future. How these vaccines will be used in countries with national cervical cancer screening programmes is an important question. Methods and Findings We developed a transmission model of HPV 16 infection and progression to cervical cancer and calibrated it to Finnish HPV 16 seroprevalence over time. The model was used to estimate the transmission probability of the virus, to look at the effect of changes in patterns of sexual behaviour and smoking on age-specific trends in cancer incidence, and to explore the impact of HPV 16 vaccination. We estimated a high per-partnership transmission probability of HPV 16, of 0.6. The modelling analyses showed that changes in sexual behaviour and smoking accounted, in part, for the increase seen in cervical cancer incidence in 35- to 39-y-old women from 1990 to 1999. At both low (10% in opportunistic immunisation) and high (90% in a national immunisation programme) coverage of the adolescent population, vaccinating women and men had little benefit over vaccinating women alone. We estimate that vaccinating 90% of young women before sexual debut has the potential to decrease HPV type-specific (e.g., type 16) cervical cancer incidence by 91%. If older women are more likely to have persistent infections and progress to cancer, then vaccination with a duration of protection of less than 15 y could result in an older susceptible cohort and no decrease in cancer incidence. While vaccination has the potential to significantly reduce type-specific cancer incidence, its combination with screening further improves cancer prevention. Conclusions HPV vaccination has the potential to significantly decrease HPV

  19. Second-generation prophylactic HPV vaccines: current options and future strategies for vaccines development.

    PubMed

    Fruscalzo, Arrigo; Londero, Ambrogio P; Bertozzi, Serena; Lellè, Ralf J

    2016-02-01

    Two vaccines focused on the prevention of HPV-related diseases have been introduced in the last decade, the quadrivalent vaccine Gardasil and the bivalent vaccine Cervarix. They are targeted to prevent precancerous and cancerous lesions not only of the cervix, but also of the vulva, vagina, anal and head-neck region. Furthermore, the protection of the quadrivalent vaccine Gardasil includes also genital warts and recurrent respiratory Papillomatosis, two benign conditions with high socio-economic impact. Although their efficacy in reducing the burden of HPV-related pathologies has been already documented, second-generation HPV vaccines are being developed in order to overcome major limitations, above all the cost of production, distribution and acceptance, thus promoting an easier access to vaccination, especially in developing countries. Recently a new multivalent VLP vaccine active against nine HPV subtypes, called Gardasil 9 (Merck & Co., Inc., Whitehouse Station, NJ, USA), has been approved, showing promising preliminary results. In this article, we outline the strategies adopted for second-generation HPV vaccine engineering, the latest HPV vaccines available at this time, as well as those currently in development. PMID:26473283

  20. ETHICAL TRADEOFFS IN TRIAL DESIGN: CASE STUDY OF AN HPV VACCINE TRIAL IN HIV-INFECTED ADOLESCENT GIRLS IN LOWER INCOME SETTINGS

    PubMed Central

    LINDSEY, J. C.; SHAH, S. K.; SIBERRY, G. K.; JEAN-PHILIPPE, P.; LEVIN, M. J.

    2013-01-01

    The Declaration of Helsinki and the Council of the International Organization of Medical Sciences provide guidance on standards of care and prevention in clinical trials. In the current and increasingly challenging research environment, the ethical status of a trial design depends not only on protection of participants, but also on social value, feasibility, and scientific validity. Using the example of a study assessing efficacy of a vaccine to prevent human papilloma virus in HIV-1 infected adolescent girls in low resource countries without access to the vaccine, we compare several trial designs which rank lower on some criteria and higher on others, giving rise to difficult trade-offs. This case demonstrates the need for developing more nuanced guidance documents to help researchers balance these often conflicting criteria. PMID:23725055

  1. Identification of promiscuous HPV16-derived T helper cell epitopes for therapeutic HPV vaccine design.

    PubMed

    Grabowska, Agnieszka K; Kaufmann, Andreas M; Riemer, Angelika B

    2015-01-01

    Cervical carcinoma and several other human papillomavirus (HPV)-induced malignancies are a global public health problem, thus novel treatment modalities are urgently needed. Immunotherapy is an attractive option for treatment of HPV infection and HPV-mediated premalignant and malignant lesions. However, previous approaches--focusing on the induction of cytotoxic CD8+ T cells (CTLs)--have as yet not yielded clinical successes. Since CD4+ T cells have been shown to be crucial for the induction and maintenance of CTL responses, and more recently to be also important for direct anti-tumor immunity, human leukocyte antigen (HLA) class II-restricted epitopes are intensively investigated to improve the efficacy of peptide-based HPV immunotherapy. We here present an approach to identify promiscuous HPV16-derived CD4+ T helper epitopes, which are capable of inducing T cell immunity in a large proportion of the population. To this end, we combined HLA class II epitope prediction servers with in vitro immunological evaluation to identify HPV16 E2-, E5-, E6-, and E7-derived CD4+ T cell epitopes. Candidate selected HPV16-derived epitopes were found to be restricted by up to nine HLA-DR molecules. Furthermore, they were found to induce frequent and robust HPV16 peptide-specific Th1 responses in healthy donors, as monitored by interferon (IFN)-γ ELISPOT and cytokine secretion assays. Moreover, these selected peptides also induced specific IFN-γ T cell responses in blood from HPV16+ CIN2/3 and cervical carcinoma patients. We thus conclude that the identified T helper epitopes are valuable candidates for the development of a comprehensive therapeutic HPV vaccine. PMID:24824905

  2. Factors associated with HPV awareness among mothers of low-income ethnic minority adolescent girls in Los Angeles.

    PubMed

    Glenn, Beth A; Tsui, Jennifer; Singhal, Rita; Sanchez, Leah; Nonzee, Narissa J; Chang, L Cindy; Taylor, Victoria M; Bastani, Roshan

    2015-01-01

    Among caregivers of adolescent girls, awareness of human papillomavirus (HPV) is strongly associated with vaccine uptake. Little is known, however, about the predictors of HPV awareness among low-income ethnic minority groups in the U.S. The purpose of this study is to understand demographic factors associated with HPV awareness among low-income, ethnic minority mothers in Los Angeles County. We conducted a cross-sectional study of caregivers of adolescent girls through the Los Angeles County Department of Public Health Office of Women's Health's hotline. The majority of the participants were foreign-born (88%), one quarter lacked a usual source of care, and one quarter lacked public or private health insurance for their daughter. We found that one in three participants had never heard of HPV or the vaccine. Mothers that were unaware of HPV were significantly more likely to conduct the interview in a language other than English and to lack health insurance for their daughters. HPV vaccine awareness was much lower in our caregiver sample (61%) than in a simultaneous national survey of caregivers (85%). The associations between lack of awareness and use of a language other than English, as well as lack of health insurance for their daughter indicate the need for HPV vaccine outreach efforts tailored to ethnic minority communities in the U.S. PMID:25434792

  3. Use of HPV testing for cervical screening in vaccinated women--Insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study.

    PubMed

    Bhatia, Ramya; Kavanagh, Kimberley; Cubie, Heather Ann; Serrano, Itziar; Wennington, Holli; Hopkins, Mark; Pan, Jiafeng; Pollock, Kevin G; Palmer, Tim J; Cuschieri, Kate

    2016-06-15

    The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national "catch-up" programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25% for the DNA based assays and 32% for the RNA assay (p = 0.0008). All assays showed over 75% reduction of HPV16 and/or 18 (p < 0.0001) whereas the prevalence of non 16/18 HR-HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p < 0.0001). Clinically validated HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16/18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted. PMID:26845632

  4. Significantly Reduced Genoprevalence of Vaccine-Type HPV-16/18 Infections among Vaccinated Compared to Non-Vaccinated Young Women 5.5 Years after a Bivalent HPV-16/18 Vaccine (Cervarix®) Pilot Project in Uganda

    PubMed Central

    Berggren, Vanja; Wabinga, Henry; Lillsunde-Larsson, Gabriella; Helenius, Gisela; Kaliff, Malin; Karlsson, Mats; Kirimunda, Samuel; Musubika, Caroline; Andersson, Sören

    2016-01-01

    The objective of this study was to determine the prevalence and some predictors for vaccine and non-vaccine types of HPV infections among bivalent HPV vaccinated and non-vaccinated young women in Uganda. This was a comparative cross sectional study 5.5 years after a bivalent HPV 16/18 vaccination (Cervarix®, GlaxoSmithKline, Belgium) pilot project in western Uganda. Cervical swabs were collected between July 2014-August 2014 and analyzed with a HPV genotyping test, CLART® HPV2 assay (Genomica, Madrid Spain) which is based on PCR followed by microarray for determination of genotype. Blood samples were also tested for HIV and syphilis infections as well as CD4 and CD8 lymphocyte levels. The age range of the participants was 15–24 years and mean age was 18.6(SD 1.4). Vaccine-type HPV-16/18 strains were significantly less prevalent among vaccinated women compared to non-vaccinated women (0.5% vs 5.6%, p 0.006, OR 95% CI 0.08(0.01–0.64). At type-specific level, significant difference was observed for HPV16 only. Other STIs (HIV/syphilis) were important risk factors for HPV infections including both vaccine types and non-vaccine types. In addition, for non-vaccine HPV types, living in an urban area, having a low BMI, low CD4 count and having had a high number of life time sexual partners were also significant risk factors. Our data concurs with the existing literature from other parts of the world regarding the effectiveness of bivalent HPV-16/18 vaccine in reducing the prevalence of HPV infections particularly vaccine HPV- 16/18 strains among vaccinated women. This study reinforces the recommendation to vaccinate young girls before sexual debut and integrate other STI particularly HIV and syphilis interventions into HPV vaccination packages. PMID:27482705

  5. Significantly Reduced Genoprevalence of Vaccine-Type HPV-16/18 Infections among Vaccinated Compared to Non-Vaccinated Young Women 5.5 Years after a Bivalent HPV-16/18 Vaccine (Cervarix®) Pilot Project in Uganda.

    PubMed

    Kumakech, Edward; Berggren, Vanja; Wabinga, Henry; Lillsunde-Larsson, Gabriella; Helenius, Gisela; Kaliff, Malin; Karlsson, Mats; Kirimunda, Samuel; Musubika, Caroline; Andersson, Sören

    2016-01-01

    The objective of this study was to determine the prevalence and some predictors for vaccine and non-vaccine types of HPV infections among bivalent HPV vaccinated and non-vaccinated young women in Uganda. This was a comparative cross sectional study 5.5 years after a bivalent HPV 16/18 vaccination (Cervarix®, GlaxoSmithKline, Belgium) pilot project in western Uganda. Cervical swabs were collected between July 2014-August 2014 and analyzed with a HPV genotyping test, CLART® HPV2 assay (Genomica, Madrid Spain) which is based on PCR followed by microarray for determination of genotype. Blood samples were also tested for HIV and syphilis infections as well as CD4 and CD8 lymphocyte levels. The age range of the participants was 15-24 years and mean age was 18.6(SD 1.4). Vaccine-type HPV-16/18 strains were significantly less prevalent among vaccinated women compared to non-vaccinated women (0.5% vs 5.6%, p 0.006, OR 95% CI 0.08(0.01-0.64). At type-specific level, significant difference was observed for HPV16 only. Other STIs (HIV/syphilis) were important risk factors for HPV infections including both vaccine types and non-vaccine types. In addition, for non-vaccine HPV types, living in an urban area, having a low BMI, low CD4 count and having had a high number of life time sexual partners were also significant risk factors. Our data concurs with the existing literature from other parts of the world regarding the effectiveness of bivalent HPV-16/18 vaccine in reducing the prevalence of HPV infections particularly vaccine HPV- 16/18 strains among vaccinated women. This study reinforces the recommendation to vaccinate young girls before sexual debut and integrate other STI particularly HIV and syphilis interventions into HPV vaccination packages. PMID:27482705

  6. Chapter 14: HPV vaccine introduction in industrialized countries.

    PubMed

    Wright, Thomas C; Van Damme, Pierre; Schmitt, Heinz-Josef; Meheus, André

    2006-08-31

    Introduction of a vaccine requires the achievement of three initial milestones. These are licensure by a national control authority that determines the vaccine is safe and effective, development of recommendations for use by expert advisory bodies on immunization, and obtaining funding for vaccination. Once these milestones have been achieved, a successful vaccination program requires that a number of interlinked programmatic components be brought together in a coordinated fashion. These include vaccine purchase and supply, vaccination service delivery, high coverage rates, surveillance of the vaccination program, immunization finance policies and practices, and political will. Human papillomavirus (HPV) vaccination provides unique challenges in all of these areas because of the many gaps in our knowledge. PMID:16949999

  7. HPV Vaccination of College Males: Strategizing against HPV Infection in College Students

    ERIC Educational Resources Information Center

    Cunningham-Erves, Jennifer; Talbott, Laura L.

    2015-01-01

    The disease burden of the Human Papillomavirus (HPV) among females and its associated sequelae have been widely studied by social and behavioral science researchers and medical professionals. Approved for administration to males as young as nine years old, the vaccination of males continues to spark much debate when older age groups are brought…

  8. HPV knowledge, attitudes, and beliefs among Northern Plains American Indian adolescents, parents, young adults, and health professionals.

    PubMed

    Schmidt-Grimminger, Delf; Frerichs, Leah; Black Bird, Arlene E; Workman, Karen; Dobberpuhl, Mitchell; Watanabe-Galloway, Shinobu

    2013-06-01

    Native American women in the Northern Plains have a high prevalence of human papillomavirus (HPV) and high incidence of cervical disease and cervical cancer. HPV vaccination coverage is shown to be lower among nonwhite populations and disparity populations. We assessed HPV knowledge, attitudes, and beliefs towards HPV and HPV vaccination during a community-based participatory research project among tribal youth, young adults, parents, and health professionals. In 2009, we recruited a total of 73 individuals to participate in four tribal focus groups: tribal health providers, (n=10), Indian Health Service providers (n=7), young adult women ages 19-26 (n=22), girls (14-18) (n=18), and parents (n=16). Of these, 62 (84.93 %) completed a survey, which included 10 healthcare providers, 22 young adults, 14 teens, and 16 parents. We employed a qualitative thematic analysis of focus group transcript data and conducted frequency analysis of survey data, which were both reviewed and triangulated by a Community Advisory Board. Based on the results of this study, the tribal community advisory board identified local tribal settings for interventions to increase HPV vaccination coverage through health education classes and a school-based vaccination clinic. In addition to tribal community-wide education events to increase awareness of HPV disease, the HPV vaccine, provider-specific training was identified as a potential intervention. These community-based focus group findings underscore the importance of locally and cultural tailored educational interventions to further increase HPV knowledge and HPV vaccination among disparate populations like American Indian adolescent and young adult women. PMID:23564429

  9. Mothers’ human papilloma virus knowledge and willingness to vaccinate their adolescent daughters in Lagos, Nigeria

    PubMed Central

    Ezenwa, Beatrice N; Balogun, Mobolanle R; Okafor, Ifeoma P

    2013-01-01

    Introduction Human papillomavirus (HPV) is one of the most common sexually transmitted infections in sexually active adolescents and young women and has been implicated as a cause of the majority of cases of cervical cancer, which is the second most common cancer in women in Nigeria. HPV is preventable with the use of HPV vaccines. Objectives The objective of this study was to assess mothers’ HPV knowledge and their willingness to vaccinate their adolescent daughters in Lagos, Nigeria. Materials and methods This study was a community-based, descriptive cross-sectional study carried out in July, 2012 in Shomolu Local Government Area (LGA) of Lagos State, Nigeria. Multistage sampling method was employed to select the 290 respondents who participated in the study. Structured, pretested, interviewer-administered questionnaires were used for data collection. Data was analyzed with Epi Info™ version 7. Results The study revealed low awareness of HPV (27.9%) and HPV vaccines (19.7%) among the mothers that participated. There was a high awareness for cervical cancer but little knowledge of its link to HPV. Awareness and utilization of HPV vaccines increased with increasing educational level (P < 0.05). There was a high willingness and intention among the mothers to vaccinate their girls (88.9%) and to recommend the vaccine to others (91.0%). Accessibility and affordability of the HPV vaccines were found to be possible barriers to future utilization of the vaccines. Conclusion Despite low knowledge about HPV and HPV vaccines, mothers were willing to vaccinate their daughters. We recommend improving mothers’ knowledge by education and the possible inclusion of the vaccine in the national immunization schedule to eliminate the financial barrier. PMID:23874123

  10. The HPV Vaccine: Framing the Arguments "for" and "against" Mandatory Vaccination of All Middle School Girls

    ERIC Educational Resources Information Center

    Vamos, Cheryl A.; McDermott, Robert J.; Daley, Ellen M.

    2008-01-01

    Background: Human papillomavirus (HPV), the virus responsible for cervical cancer, is the most common viral sexually transmitted infection in the United States. A vaccine was approved in 2006 that is effective in preventing the types of HPV responsible for 70% of cervical cancers and 90% of genital warts. Proposals for routine and mandatory HPV…

  11. National and state vaccination coverage among adolescents aged 13-17 years--United States, 2012.

    PubMed

    2013-08-30

    At ages 11 through 12 years, the Advisory Committee on Immunization Practices (ACIP) recommends that preteens receive 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, 1 dose of meningococcal conjugate (MenACWY) vaccine, and 3 doses of human papillomavirus (HPV) vaccine. ACIP recommends administration of all age-appropriate vaccines during a single visit. ACIP also recommends that pre-teens and older adolescents receive an annual influenza vaccine as well as any overdue vaccines (e.g., varicella). To monitor vaccination coverage among persons aged 13-17 years, CDC analyzed data from the National Immunization Survey-Teen (NIS-Teen). This report highlights findings of that analysis. From 2011 to 2012, coverage increased for ≥1 Tdap vaccine dose (from 78.2% to 84.6%), ≥1 MenACWY vaccine dose (from 70.5% to 74.0%) and, among males, ≥1 HPV vaccine dose (from 8.3% to 20.8%). Among females, vaccination coverage estimates for each HPV vaccine series dose were similar in 2012 compared with 2011. Coverage varied substantially among states. Regarding Healthy People 2020 targets for adolescents, 36 states achieved targets for Tdap, 12 for MenACWY, and nine for varicella vaccine coverage. Large and increasing coverage differences between Tdap and other vaccines recommended for adolescents indicate that substantial missed opportunities remain for vaccinating teens, especially against HPV infection. Health-care providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap vaccine is given. In addition, whether for health problems or well-checks, providers, parents, and adolescents should use every health-care visit as an opportunity to review adolescents' immunization histories and ensure that every adolescent is fully vaccinated. PMID:23985496

  12. Benefits, cost requirements and cost-effectiveness of the HPV16,18 vaccine for cervical cancer prevention in developing countries: policy implications.

    PubMed

    Goldie, Sue J; O'Shea, Meredith; Diaz, Mireia; Kim, Sun-Young

    2008-11-01

    Approximately 70% of cases of cervical cancer worldwide are caused by genotypes 16 and 18 of human papillomavirus (HPV), which is sexually transmitted. With the availability of an effective vaccine against these HPV types, there is real hope for reducing the global burden of cervical cancer in developing countries. Stakeholders faced with decisions about where to invest money to improve health must consider the burden of disease caused by cervical cancer relative to other priorities and the comparative benefits of different interventions. We conducted a series of analyses to obtain information for agencies drafting immunisation policy recommendations, financing coordination mechanisms, and country decision-makers on the benefits, cost requirements and cost-effectiveness of the HPV16,18 vaccine. We found that making an HPV16,18 vaccine accessible to 70% of young adolescent girls in 72 of the poorest countries, China, Thailand, and all of Latin America and the Caribbean, could prevent the future deaths of more than four million women vaccinated over the next decade. Provided the cost per vaccinated girl is less than $10-$25, adolescent HPV16,18 vaccination would be cost-effective even in relatively poor countries. Concerns about financial costs and affordability highlight the need for lowering vaccine prices, cost-efficient mechanisms for delivery of vaccinations to adolescents, and creative sources of financing. PMID:19027626

  13. Vaccine-related internet search activity predicts H1N1 and HPV vaccine coverage: implications for vaccine acceptance.

    PubMed

    Kalichman, Seth C; Kegler, Christopher

    2015-01-01

    The Internet is a primary source for health-related information, and Internet search activity is associated with infectious disease outbreaks. The authors hypothesized that Internet search activity for vaccine-related information would predict vaccination coverage. They examined Internet search activity for H1N1 and human papilloma virus (HPV) disease and vaccine information in relation to H1N1 and HPV vaccine uptake. Google Insight for Search was used to assess the volume of Internet search queries for H1N1- and vaccine-related terms in the United States in 2009, the year of the H1N1 pandemic. Vaccine coverage data were also obtained from the Centers for Disease Control and Prevention at the state level for H1N1 vaccinations in 2009. These same measures were collected at the state level for HPV- and vaccine-related search terms in 2010 as well as HPV vaccine uptake in that year. Analyses showed that the search terms H1N1 and vaccine were correlated with H1N1 vaccine uptake; ordinal regression found the H1N1 search term was independently associated with H1N1 vaccine coverage. Similarly, the correlation between vaccine search volume and HPV coverage was significant; ordinal regression showed the search term vaccine independently predicted HPV vaccination coverage. This is among the first studies to show that Internet search activity is associated with vaccination coverage. The Internet should be exploited as an opportunity to dispel vaccine misinformation by providing accurate information to support vaccine decision making. PMID:25222149

  14. Impact of 2-, 4- and 9-valent HPV vaccines on morbidity and mortality from cervical cancer.

    PubMed

    Luckett, Rebecca; Feldman, Sarah

    2016-06-01

    Cervical cancer causes significant morbidity and mortality worldwide. Most cervical cancers are associated with oncogenic human papillomavirus (HPV), and vaccination with any of 3 available HPV vaccines is anticipated to greatly reduce the burden of cervical cancer. This review provides an overview of the burden of HPV, the efficacy and clinical effectiveness of the bivalent (HPV 16, 18), quadrivalent (HPV 6, 11, 16, 18) and 9vHPV (HPV 6, 11, 16, 1831, 33, 45, 52, 58) vaccines in order to assess the anticipated impact on cervical cancer. All three vaccines show high efficacy in prevention of vaccine-specific HPV-type infection and associated high-grade cervical dysplasia in HPV-naïve women. Early clinical effectiveness data for the bivalent and quadrivalent vaccine demonstrate reduced rates of HPV 16 and 18 prevalence in vaccinated cohorts; data evaluating cervical dysplasia and cervical procedures as outcomes will shed further light on the clinical effectiveness of both vaccines. The bivalent vaccine has demonstrated cross-protection to non-vaccine HPV types, including the types in the 9vHPV vaccine. No clinical effectiveness data is yet available for the 9vHPV vaccine.  While HPV vaccination has great promise to reduce cervical cancer morbidity and mortality, estimated benefits are largely theoretical at present. Large population-based clinical effectiveness studies will provide long-term immunogenicity and effectiveness, as well as assessment of cervical cancer as an endpoint, particularly as young vaccinated women enter the appropriate age range to initiate screening for cervical cancer. Strengthening screening and treatment programs will likely have the greatest impact in the short-term on cervical cancer morbidity and mortality. PMID:26588179

  15. School-based HPV immunization of young adolescents: effects of two brief health interventions.

    PubMed

    Rickert, Vaughn I; Auslander, Beth A; Cox, Dena S; Rosenthal, Susan L; Rupp, Richard E; Zimet, Gregory D

    2015-01-01

    Adolescent immunization rates for human papillomavirus (HPV) are low and interventions within school-based health centers (SBHCs) may increase HPV uptake and series completion. We examined the effect of a parent health message intervention on HPV vaccination intent, first dose uptake and series completion among adolescents who received care at SBHCs. Via computer-assisted telephone interviews (CATI), 445 parents of young adolescents were randomly assigned to 2 two-level interventions using a 2 × 2 design (rhetorical question (RQ) or no-RQ and one-sided or two-sided message). The RQ intervention involved asking the parent a question they were likely to endorse (e.g., "Do you want to protect your daughter from cervical cancer?") with the expectation that they would then behave in a manner consistent with their endorsement (i.e., agree to vaccinate). For the one-sided message, parents were given information that emphasized the safety and effectiveness of HPV vaccine, whereas the two-sided message acknowledged that some parents might have concerns about the vaccine, followed by reassurance regarding the safety and effectiveness. At CATI conclusion, parents indicated intentions to have their adolescents vaccinated. Parents who endorsed any intent were sent a consent form to return and all adolescents with signed returned consents were vaccinated at SBHCs. Medical records were reviewed for uptake/completion. Parents were 87% female; adolescents were 66% male and racially/ethnically diverse. 42.5% of parents indicated some intention to immunize, 51.4% were unsure, and 6.1% were not interested. 34% (n = 151) of adolescents received their first dose with series completion rates of 67% (n = 101). The RQ component of the intervention increased intention to vaccinate (RR = 1.45; 95%CI 1.16,1.81), but not first dose uptake or series completion. The 1-sided and 2-sided messages had no effect. This brief, RQ health intervention enhanced intent, but did not impact vaccination

  16. Human Papillomavirus Infection and Vaccination: Awareness and Knowledge of HPV and Acceptability of HPV Vaccine among Mothers of Teenage Daughters in Weihai, Shandong, China

    PubMed Central

    Sun, Jiandong; Li, Ruiying; Li, Meilan; Wang, Jianguang; Zhang, Dongfeng; Xu, Aiqiang

    2016-01-01

    In preparation for the introduction of human papillomavirus (HPV) vaccine, we investigated awareness and knowledge of HPV/HPV vaccine and potential acceptability to HPV vaccine among mothers with a teenage daughter in Weihai, Shandong, China. A cross-sectional survey was conducted in 2013 with a sample of 1850 mothers who had a daughter (aged 9–17 years) attending primary, junior and senior high schools. In the final sample (N = 1578, response rate 85.30%), awareness of HPV was reported by 305 (19.32%) mothers. Awareness varied significantly by daughter’s age (P<0.01), mother’s education level (P<0.01), mother’s occupation (P<0.01), household income (P<0.01) and residence type (P<0.01). Knowledge about HPV/HPV vaccine was poor with a mean total score of 3.56 (SD = 2.40) out of a possible score of 13. Mothers with a higher education level reported higher levels of knowledge (P = 0.02). Slightly more than one-fourth (26.49%) of mothers expressed their potential acceptability of HPV vaccine for their daughters. Acceptability increased along with increased daughters’ age (P<0.01), household income (P<0.01) and knowledge level (P<0.01). House wives and unemployed mothers had the highest acceptability (P<0.01). The most common reasons for not accepting HPV vaccination were “My daughter is too young to have risk of cervical cancer (30.95%)”, “The vaccine has not been widely used, and the decision will be made after it is widely used (24.91%)”, “Worry about the safety of the vaccine (22.85%)”. Awareness and knowledge of HPV/HPV vaccines are poor and HPV vaccine acceptability is low among these Chinese mothers. These results may help inform appropriate health education programs in this population. PMID:26766565

  17. Human Papillomavirus Infection and Vaccination: Awareness and Knowledge of HPV and Acceptability of HPV Vaccine among Mothers of Teenage Daughters in Weihai, Shandong, China.

    PubMed

    Yu, Yang; Xu, Minglei; Sun, Jiandong; Li, Ruiying; Li, Meilan; Wang, Jianguang; Zhang, Dongfeng; Xu, Aiqiang

    2016-01-01

    In preparation for the introduction of human papillomavirus (HPV) vaccine, we investigated awareness and knowledge of HPV/HPV vaccine and potential acceptability to HPV vaccine among mothers with a teenage daughter in Weihai, Shandong, China. A cross-sectional survey was conducted in 2013 with a sample of 1850 mothers who had a daughter (aged 9-17 years) attending primary, junior and senior high schools. In the final sample (N = 1578, response rate 85.30%), awareness of HPV was reported by 305 (19.32%) mothers. Awareness varied significantly by daughter's age (P<0.01), mother's education level (P<0.01), mother's occupation (P<0.01), household income (P<0.01) and residence type (P<0.01). Knowledge about HPV/HPV vaccine was poor with a mean total score of 3.56 (SD = 2.40) out of a possible score of 13. Mothers with a higher education level reported higher levels of knowledge (P = 0.02). Slightly more than one-fourth (26.49%) of mothers expressed their potential acceptability of HPV vaccine for their daughters. Acceptability increased along with increased daughters' age (P<0.01), household income (P<0.01) and knowledge level (P<0.01). House wives and unemployed mothers had the highest acceptability (P<0.01). The most common reasons for not accepting HPV vaccination were "My daughter is too young to have risk of cervical cancer (30.95%)", "The vaccine has not been widely used, and the decision will be made after it is widely used (24.91%)", "Worry about the safety of the vaccine (22.85%)". Awareness and knowledge of HPV/HPV vaccines are poor and HPV vaccine acceptability is low among these Chinese mothers. These results may help inform appropriate health education programs in this population. PMID:26766565

  18. HPV Vaccine Acceptance in a Clinic-Based Sample of Women in the Rural South

    ERIC Educational Resources Information Center

    Brandt, Heather M.; Sharpe, Patricia A.; McCree, Donna H.; Wright, Marcie S.; Davis, Jennifer; Hutto, Brent E.

    2009-01-01

    Background: Human papillomavirus (HPV) is a very common sexually transmitted infection linked to cervical disease. Vaccines for some types of HPV were in development at the time of the study. Purpose: The study examined HPV vaccine acceptability among underserved women in a rural region of the southeastern U.S. with high rates of cervical cancer…

  19. HPV vaccination syndrome. A questionnaire-based study.

    PubMed

    Martínez-Lavín, Manuel; Martínez-Martínez, Laura-Aline; Reyes-Loyola, Paola

    2015-11-01

    Isolated cases and small series have described the development of complex regional pain syndrome, postural orthostatic tachycardia, and fibromyalgia after human papillomavirus (HPV) vaccination. These illnesses are difficult to diagnose and have overlapping clinical features. Small fiber neuropathy and dysautonomia may play a major role in the pathogenesis of these entities. We used the following validated questionnaires to appraise the chronic illness that might appear after HPV vaccination: The 2010 American College of Rheumatology Fibromyalgia Diagnostic Criteria, COMPASS 31 dysautonomia questionnaire, and S-LANSS neuropathic pain form. These questionnaires and a "present illness" survey were e-mailed to persons who had the onset of a chronic ailment soon after HPV vaccination. Forty-five filled questionnaires from individuals living in 13 different countries were collected in a month's period. Mean (±SD) age at vaccination time was 14 ± 5 years. Twenty-nine percent of the cases had immediate (within 24 h) post-vaccination illness onset. The most common presenting complaints were musculoskeletal pain (66%), fatigue (57%), headache (57%), dizziness/vertigo (43%), and paresthesias/allodynia (36%). Fifty-three percent of affected individuals fulfill the fibromyalgia criteria. COMPASS-31 score was 43 ± 21, implying advanced autonomic dysfunction. Eighty-three percent of the patients who had ongoing pain displayed S-LANSS values >12, suggesting a neuropathic component in their pain experience. After a mean period of 4.2 ± 2.5 years post-vaccination, 93% of patients continue to have incapacitating symptoms and remain unable to attend school or work. In conclusion, a disabling syndrome of chronic neuropathic pain, fatigue, and autonomic dysfunction may appear after HPV vaccination. PMID:26354426

  20. Giving Boys a Shot: The HPV Vaccine's Portrayal in Canadian Newspapers.

    PubMed

    Perez, Samara; Fedoruk, Claire; Shapiro, Gilla K; Rosberger, Zeev

    2016-12-01

    In January 2012, the National Advisory Committee on Immunization (NACI) of Canada recommended that males aged 9-26 years receive the human papillomavirus (HPV) vaccine to protect against genital warts and HPV-associated cancers. Estimated HPV vaccine uptake rates for Canadian males are extremely low. Using a content analysis of Canadian newspaper articles, this study investigated what information about the HPV vaccine was relayed to the public, and how this content was portrayed following the 2012 male HPV vaccine recommendation. A search was conducted using Proquest Canadian Newsstand Complete for newspaper articles published between January 1, 2012, and September 1, 2014. Researchers coded 232 articles on several relevant dimensions: article information; epidemiological information; public policy information; article topic; article and title tone; and informant testimony. The majority of articles (93%) mentioned that girls are eligible for the HPV vaccine, whereas only half (49%) mentioned male eligibility. While most articles associated HPV with cervical cancer (85%), fewer indicated its relation to other HPV-associated cancers (59%) or genital warts (52%). Most articles (60%) were positive or neutral (22%) in tone toward the HPV vaccine, while few had mixed messages (11%) or were negative (6%). Less than 5% of articles reported on issues of morality, suggesting that fears that the HPV vaccine causes promiscuity have largely subsided. Notably, article tone toward male vaccination became progressively more positive over time. However, half of the articles did not mention the vaccine's approval for males, and articles tended to report HPV's relation to cervical cancer over other HPV-associated cancers. The Canadian public may thus be unaware of male eligibility and the importance of HPV vaccine for males. The collaboration of researchers, health care providers, and policymakers with journalists is critical in order to disseminate complete and accurate HPV and HPV

  1. Comparison of the immunogenicity of the human papillomavirus (HPV)-16/18 vaccine and the HPV-6/11/16/18 vaccine for oncogenic non-vaccine types HPV-31 and HPV-45 in healthy women aged 18–45 years

    PubMed Central

    Baron, Mira; Levin, Myron J; Chatterjee, Archana; Fox, Bradley; Scholar, Sofia; Rosen, Jeffrey; Chakhtoura, Nahida; Lebacq, Marie; van der Most, Robbert; Moris, Philippe; Giannini, Sandra L; Schuind, Anne; Datta, Sanjoy K; Descamps, Dominique

    2011-01-01

    Protection against oncogenic non-vaccine types (cross-protection) offered by human papillomavirus (HPV) vaccines may provide a significant medical benefit. Available clinical efficacy data suggest the two licensed vaccines [HPV-16/18 vaccine, GlaxoSmithKline Biologicals (GSK), and HPV-6/11/16/18 vaccine, Merck and Co., Inc.,] differ in terms of protection against oncogenic non-vaccine HPV types -31/45. The immune responses induced by the two vaccines against these two non-vaccine HPV types (cross-reactivity) was compared in an observer-blind study up to Month 24 (18 mo postvaccination), in women HPV DNA-negative and seronegative prior to vaccination for the HPV type analyzed [HPV-010 (NCT00423046)]. Geometric mean antibody titers (GMTs) measured by pseudovirion-based neutralization assay (PBNA) and enzyme-linked immunosorbent assay (ELISA ) were similar between vaccines for HPV-31/45. Seropositivity rates for HPV-31 were also similar between vaccines; however, there was a trend for higher seropositivity with the HPV-16/18 vaccine (13.0–16.7%) vs. the HPV-6/11/16/18 vaccine (0.0–5.0%) for HPV-45 with PBNA, but not ELISA . HPV-31/45 cross-reactive memory B-cell responses were comparable between vaccines. Circulating antigen-specific CD4+ T-cell frequencies were higher for the HPV-16/18 vaccine than the HPV-6/11/16/18 vaccine {HPV-31 [geometric mean ratio (GMR) = 2.0; p = 0.0002] and HPV-45 [GMR = 2.6; p = 0.0092]}, as were the proportion of T-cell responders (HPV-31, p = 0.0009; HPV-45, p = 0.0793). In conclusion, immune response to oncogenic non-vaccine HPV types -31/45 was generally similar for both vaccines with the exception of T-cell response which was higher with the HPV-16/18 vaccine. Considering the differences in cross-protective efficacy between the two vaccines, the results might provide insights into the underlying mechanism(s) of protection. PMID:22048172

  2. Adolescent Vaccination Performance in South Carolina Compared to the United States.

    PubMed

    Roberts, James R; Naifeh, Monique; Jacobson, Robert M; Hinton, Erin; O'Brien, Elizabeth; Rogacki, Brianna; Thompson, David; Margolis, Benyamin; Darden, Paul M

    National data on vaccine up-to-date (UTD) suggest that insufficient numbers of adolescents receive needed vaccines. This study analyzed public use data of the National Immunization Survey-Teen (NIS-Teen) from 2010 through 2013 for South Carolina (SC) adolescents and compared immunization rates to those of United States (US) adolescents. We also examined trends for each vaccine recommended for adolescents for both SC and US adolescents. UTD rates in SC adolescents for the quadrivalent meningococcal conjugate vaccine (MCV4) and the tetanus- diphtheria, acellular pertussis (Tdap) vaccine lag those of US adolescents, despite demonstrating a trend of improvement in SC adolescents from 45% to 69% for MCV and from 48% to 72% for Tdap. Human papillomavirus (HPV) vaccine UTD rates for SC adolescents demonstrated improvement over a 4 year period. HPV vaccination for SC girls improved when compared to the US, however UTD rates for both the SC and US were still well below the Healthy People 2020 goal of 80%. For all three vaccines, parental recall for a provider recommendation to vaccinate their adolescent was around or below 50%, except for HPV in females where it reached 65% in SC and 69% in the US. Differences between state and national rates may help SC providers focus on specific interventions needed to improve UTD rates. PMID:27141702

  3. The school nurse, the school and HPV vaccination: a qualitative study of factors affecting HPV vaccine uptake.

    PubMed

    Brabin, Loretta; Stretch, Rebecca; Roberts, Stephen A; Elton, Peter; Baxter, David; McCann, Rosemary

    2011-04-12

    School nurses in the United Kingdom are largely responsible for delivering the human papillomavirus (HPV) vaccine to 12-13 year old girls. In order to assess the impact of HPV vaccination on school nurses' roles, we gave a questionnaire to all 33 school nurses who offered Cervarix ™ in two Primary Care Trusts one year ahead of the national vaccine programme. Key organisational issues raised by the school nurses were the size of the team and its skill mix. A few found their schools uncooperative and were dissatisfied with mechanisms for problem resolution. On average, nurses spent an additional 69 h (0.80 h per child) on vaccine-related activities. In semi-qualitative interviews (n=17), school nurses complained of work overload and described the difficulties of establishing good relationships with some of their schools. Nurses expected schools to take some responsibility for ensuring good uptake and were frustrated when help was not forthcoming. We conclude that variation in uptake between schools in part reflects a difficult relationship with the school nurse which may be attributed to characteristics of the school, schools' attitudes towards health interventions, organisational problems, multiple school nurse roles and/or personal ability. Some of these issues will need to be addressed to ensure continued high vaccine coverage as HPV vaccination becomes a less prioritised, routine activity. PMID:21354481

  4. Attitude, Acceptability and Knowledge of HPV Vaccination among Local University Students in Hong Kong

    PubMed Central

    Chiang, Vico Chung Lim; Wong, Ho Ting; Yeung, Pui Chun Au; Choi, Yuk Ki; Fok, Michelle Sum Yue; Mak, Oi In; Wong, Hing Yu; Wong, Kim Ho; Wong, Shui Yan; Wong, Yee Shan; Wong, Eugene Ying Yeung

    2016-01-01

    The Human Papillomavirus (HPV) vaccine has the great potential to prevent HPV-related infections for millions of women and men worldwide. However, the success of the vaccine is highly dependent on the vaccination rate. Factors influencing the attitudes of undergraduate students towards HPV vaccination should be studied. This is a cross-sectional survey that was conducted to estimate the HPV vaccination rate among undergraduate students in Hong Kong, and to identify the predictors of their attitude towards HPV vaccination. The results showed that the HPV vaccination rate was 13.3%. Factors related to knowledge of vaccination were the main predictors of the students’ attitude towards vaccination (there were seven predictors, with B = 1.36 to 2.30; p < 0.05), followed by gender (B = −1.40; p < 0.05), acceptable maximum price (B = 0.35; p < 0.05), and willingness to receive the HPV vaccine if it can protect against cervical/anal cancer and genital warts (B = −1.90; p < 0.001). The regression model that was developed based on the predictors had a moderate effect size (adj-R2 = 0.33). To conclude, the HPV vaccination rate among undergraduate students in Hong Kong was low. They should be provided with more active education and activities to promote HPV vaccination to improve their knowledge on the subject. PMID:27187424

  5. Attitude, Acceptability and Knowledge of HPV Vaccination among Local University Students in Hong Kong.

    PubMed

    Chiang, Vico Chung Lim; Wong, Ho Ting; Yeung, Pui Chun Au; Choi, Yuk Ki; Fok, Michelle Sum Yue; Mak, Oi In; Wong, Hing Yu; Wong, Kim Ho; Wong, Shui Yan; Wong, Yee Shan; Wong, Eugene Ying Yeung

    2016-01-01

    The Human Papillomavirus (HPV) vaccine has the great potential to prevent HPV-related infections for millions of women and men worldwide. However, the success of the vaccine is highly dependent on the vaccination rate. Factors influencing the attitudes of undergraduate students towards HPV vaccination should be studied. This is a cross-sectional survey that was conducted to estimate the HPV vaccination rate among undergraduate students in Hong Kong, and to identify the predictors of their attitude towards HPV vaccination. The results showed that the HPV vaccination rate was 13.3%. Factors related to knowledge of vaccination were the main predictors of the students' attitude towards vaccination (there were seven predictors, with B = 1.36 to 2.30; p < 0.05), followed by gender (B = -1.40; p < 0.05), acceptable maximum price (B = 0.35; p < 0.05), and willingness to receive the HPV vaccine if it can protect against cervical/anal cancer and genital warts (B = -1.90; p < 0.001). The regression model that was developed based on the predictors had a moderate effect size (adj-R² = 0.33). To conclude, the HPV vaccination rate among undergraduate students in Hong Kong was low. They should be provided with more active education and activities to promote HPV vaccination to improve their knowledge on the subject. PMID:27187424

  6. Fewer doses of HPV vaccine result in immune response similar to three-dose regimen

    Cancer.gov

    NCI scientists report that two doses of a human papillomavirus (HPV) vaccine, trademarked as Cervarix, resulted in similar serum antibody levels against two of the most carcinogenic types of HPV (16 and 18), compared to a standard three dose regimen.

  7. Awareness of Human Papillomavirus Vaccine Among Adolescent African American Males Who Have Sex with Males: a Pilot Study.

    PubMed

    Onyeabor, Onyekachi S; Martin, Nicolle; Orish, Verner N; Sanyaolu, Adekunle O; Iriemenam, Nnaemeka C

    2015-09-01

    African American adolescent males who have sex with males (MSMs) have a high prevalence of sexually transmitted diseases (STDs) that has been directly linked to lack of access to primary care providers and reluctance to disclose their sexuality. The human papillomavirus (HPV) is the most common STD with more than 40 different serotypes and can lead to anal/genital warts as well as oral and genital cancers. The HPV vaccine if taken prior to an adolescent becoming sexually active serves a prophylactic function. The HPV vaccine is approved by the Food and Drug Administration (FDA) for girls and boys; however, HPV vaccination rates among adolescents within different minority and underserved communities have been disappointing even though these groups are disproportionately infected with the HPV virus and certain male-specific cancers. Little is known about the uptake of the vaccine among African American MSMs and thus the aim of this study. This qualitative study is based on the health belief model and assessed participants' level of awareness of HPV, the HPV vaccine, and HPV-related illnesses among 24 African American male adolescents between 16 and 18 years old who self identify as MSMs. As part of a larger study, two focus groups were conducted for African American MSMs. Participants failed to understand their potential risk for HPV given the higher rates of STD infection experienced by MSMs. They expressed very little knowledge of the HPV vaccine and are also not aware of the complications of HPV virus infection. However, they were very eager to know more about the virus and the vaccine. This study demonstrates the need for the development of health communication intervention and more research targeting African American MSMs and also the need for policy change towards making the HPV vaccine routine for males especially adolescents at no cost. PMID:26863459

  8. Relationship between Humoral Immune Responses against HPV16, HPV18, HPV31 and HPV45 in 12-15 Year Old Girls Receiving Cervarix® or Gardasil® Vaccine

    PubMed Central

    Godi, Anna; Bissett, Sara L.; Miller, Elizabeth; Beddows, Simon

    2015-01-01

    Background Human papillomavirus (HPV) vaccines confer protection against the oncogenic genotypes HPV16 and HPV18 through the generation of type-specific neutralizing antibodies raised against virus-like particles (VLP) representing these genotypes. The vaccines also confer a degree of cross-protection against HPV31 and HPV45, which are genetically-related to the vaccine types HPV16 and HPV18, respectively, although the mechanism is less certain. There are a number of humoral immune measures that have been examined in relation to the HPV vaccines, including VLP binding, pseudovirus neutralization and the enumeration of memory B cells. While the specificity of responses generated against the vaccine genotypes are fairly well studied, the relationship between these measures in relation to non-vaccine genotypes is less certain. Methods We carried out a comparative study of these immune measures against vaccine and non-vaccine genotypes using samples collected from 12–15 year old girls following immunization with three doses of either Cervarix® or Gardasil® HPV vaccine. Results The relationship between neutralizing and binding antibody titers and HPV-specific memory B cell levels for the vaccine genotypes, HPV16 and HPV18, were very good. The proportion of responders approached 100% for both vaccines while the magnitude of these responses induced by Cervarix® were generally higher than those following Gardasil® immunization. A similar pattern was found for the non-vaccine genotype HPV31, albeit at a lower magnitude compared to its genetically-related vaccine genotype, HPV16. However, both the enumeration of memory B cells and VLP binding responses against HPV45 were poorly related to its neutralizing antibody responses. Purified IgG derived from memory B cells demonstrated specificities similar to those found in the serum, including the capacity to neutralize HPV pseudoviruses. Conclusions These data suggest that pseudovirus neutralization should be used as the

  9. Less than 3 doses of the HPV vaccine - Review of efficacy against virological and disease end points.

    PubMed

    Basu, Partha; Bhatla, Neerja; Ngoma, Twalib; Sankaranarayanan, Rengaswamy

    2016-06-01

    World Health Organization (WHO) recommended 2 doses of the Human Papillomavirus (HPV) vaccine for girls below 15 y on the basis of the immune-bridging studies demonstrating non-inferior immune response of 2 doses in the adolescent girls compared to 3 doses in the young adult women in whom the efficacy against disease is established. The biological nature of the antigens (virus-like particles) constituting the HPV vaccine is responsible for the vigorous antibody response that may make the third dose redundant. The protection offered by 2 doses has been demonstrated in non-randomized clinical trials to be comparable to that offered by 3 doses against incident and persistent infections of vaccine targeted HPV types. However, results emerging from the ecological and nested case-control studies embedded in the population based screening programs of different countries indicate reduced efficacy of 2 doses against virological and disease end points. Some recent studies observed the protective effect of single dose of the vaccine against incident and persistent infections of the vaccine targeted HPV types to be similar to 3 doses in spite of immunological inferiority. The sample size, duration of follow-ups and number of events were limited in these studies. Longer follow ups of the less than 3 doses cohorts in the ongoing studies as well as appropriately designed and ethically justifiable randomized studies are needed to establish the protection offered by the alternative schedules at least beyond 10 y of vaccination. PMID:26933961

  10. HPV vaccine stimulates cytotoxic activity of killer dendritic cells and natural killer cells against HPV-positive tumour cells

    PubMed Central

    Van den Bergh, Johan M J; Guerti, Khadija; Willemen, Yannick; Lion, Eva; Cools, Nathalie; Goossens, Herman; Vorsters, Alex; Van Tendeloo, Viggo F I; Anguille, Sébastien; Van Damme, Pierre; Smits, Evelien L J M

    2014-01-01

    Cervarix™ is approved as a preventive vaccine against infection with the human papillomavirus (HPV) strains 16 and 18, which are causally related to the development of cervical cancer. We are the first to investigate in vitro the effects of this HPV vaccine on interleukin (IL)-15 dendritic cells (DC) as proxy of a naturally occurring subset of blood DC, and natural killer (NK) cells, two innate immune cell types that play an important role in antitumour immunity. Our results show that exposure of IL-15 DC to the HPV vaccine results in increased expression of phenotypic maturation markers, pro-inflammatory cytokine production and cytotoxic activity against HPV-positive tumour cells. These effects are mediated by the vaccine adjuvant, partly through Toll-like receptor 4 activation. Next, we demonstrate that vaccine-exposed IL-15 DC in turn induce phenotypic activation of NK cells, resulting in a synergistic cytotoxic action against HPV-infected tumour cells. Our study thus identifies a novel mode of action of the HPV vaccine in boosting innate immunity, including killing of HPV-infected cells by DC and NK cells. PMID:24979331

  11. School-Located Vaccination Clinics for Adolescents: Correlates of Acceptance Among Parents.

    PubMed

    Gargano, Lisa M; Weiss, Paul; Underwood, Natasha L; Seib, Katherine; Sales, Jessica M; Vogt, Tara M; Rask, Kimberly; Morfaw, Christopher; Murray, Dennis L; DiClemente, Ralph J; Hughes, James M

    2015-08-01

    Four vaccines are recommended by The Advisory Committee for Immunization Practices for adolescents: tetanus, diphtheria, acellular pertussis vaccine (Tdap), meningococcal conjugate vaccine (MCV4), human papillomavirus vaccine (HPV), and annual seasonal influenza vaccine. However, coverage among adolescents is suboptimal. School-located vaccination clinics (SLVCs) offer vaccines to students at school, increasing access. This study seeks to determine the relationship between attitudes of parents of middle- and high-school students and acceptance of SLVCs for all four adolescent recommended vaccines. We conducted a telephone and web-based survey among parents of students enrolled in six middle and five high schools in Georgia. Analyses were conducted to examine associations between parental attitudes and willingness to allow their child to be vaccinated at school. Tdap and influenza vaccine had the highest rates of parental SLVC acceptance while HPV vaccine had the lowest. Parents who accepted SLVCs had higher perceived severity of influenza, meningococcal, and HPV illnesses compared to parents who did not accept SLVC. Intention to vaccinate was associated with SLVC acceptance for Tdap [Adjusted OR (AOR) 7.38; 95% confidence interval (CI) 2.44-22.31], MCV4 (AOR 2.97; 95% CI 1.67-5.28), and HPV vaccines (AOR 7.61; 95% CI 3.43-16.89). Social norms were associated with acceptance of SLVCs for influenza vaccine (AOR 1.44; 95% CI 1.12-1.84). These findings suggest parents of adolescents are generally supportive of SLVCs for recommended adolescent vaccines. Perceived severity of illness and intention to get their adolescent vaccinated were the most consistent correlates of parental SLVC acceptance for all vaccines. Future SLVC planning should focus on perceptions of disease severity and benefits of vaccination. PMID:25528325

  12. Cervical cancer in India and HPV vaccination.

    PubMed

    Kaarthigeyan, K

    2012-01-01

    Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine's efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context. PMID:22754202

  13. Knowledge and acceptability of the HPV vaccine among ethnically diverse black women.

    PubMed

    Wilson, Rula; Brown, Diane R; Boothe, Makini A S; Harris, Caroline E S

    2013-08-01

    The purpose of the study was to examine HPV vaccine knowledge and acceptability among ethnically diverse Black women. Forty-four women were interviewed in 6 focus groups (2 African American, 2 English-speaking Caribbean, 1 Haitian, and 1 African). Thematic content analysis was used to generate common concepts and themes and to compare findings across groups. There was varied but limited knowledge and confusion across ethnic groups about the HPV infection and vaccine. African and Haitian women had the least knowledge. Overall, women were generally receptive toward the HPV vaccine for girls but unclear about the need to vaccinate boys. Concerns about the HPV vaccine were mainly related to side effects/safety and vaccinating children at a young age. Healthcare provider's recommendation of the vaccination was important for decision making. Educational interventions with Black women about HPV vaccination should recognize cultural beliefs that vary by ethnic group. PMID:23197180

  14. Issues surrounding HPV vaccine delivery in a multi-ethnic country in Asia: the physician's perspective.

    PubMed

    Wong, Li Ping

    2011-02-01

    The study was conducted to investigate issues surrounding human papillomavirus (HPV) vaccine delivery in a multi-ethnic, multi-religious and multi-cultural society. A qualitative in-depth interview study was conducted with a sample of 20 physicians. Physicians described the success of HPV vaccines recommendation as very poor. Many expressed reluctance to offer the vaccine to preadolescents. The most notable barrier to vaccination was the vaccine's high cost. Parents of eligible vaccinees were concerned about the efficacy and side effects of the new vaccine, while adult women have low risk perception for HPV infection. Promoters and inhibitors of HPV vaccination in our multi-ethnic, multi-religious and multi-cultural community were identified. This study suggests the need to strengthen the infrastructure necessary for HPV vaccine delivery and to specifically target poor underserved women. PMID:20431926

  15. Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya

    PubMed Central

    Masika, Moses Muia; Ogembo, Javier Gordon; Chabeda, Sophie Vusha; Wamai, Richard G.; Mugo, Nelly

    2015-01-01

    Background Vaccines against human papillomavirus (HPV) infection have the potential to reduce the burden of cervical cancer. School-based delivery of HPV vaccines is cost-effective and successful uptake depends on school teachers’ knowledge and acceptability of the vaccine. The aim of this study is to assess primary school teachers’ knowledge and acceptability of HPV vaccine and to explore facilitators and barriers of an ongoing Gavi Alliance-supported vaccination program in Kitui County, Kenya. Methods This was a cross-sectional, mixed methods study in Central Division of Kitui County where the Ministry of Health is offering the quadrivalent HPV vaccine to grade four girls. Data on primary school teachers’ awareness, knowledge and acceptability of HPV vaccine as well as facilitators and barriers to the project was collected through self-administered questionnaires and two focus group discussions. Results 339 teachers (60% female) completed the survey (62% response rate) and 13 participated in 2 focus group discussions. Vaccine awareness among teachers was high (90%), the level of knowledge about HPV and cervical cancer among teachers was moderate (48%, SD = 10.9) and females scored higher than males (50% vs. 46%, p = 0.002). Most teachers (89%) would recommend the vaccine to their daughter or close relatives. Those who would recommend the vaccine had more knowledge than those who would not (p = <0.001). The main barriers were insufficient information about the vaccine, poor accessibility of schools, absenteeism of girls on vaccine days, and fear of side effects. Conclusions Despite low to moderate levels of knowledge about HPV vaccine among school teachers, vaccine acceptability is high. Teachers with little knowledge on HPV vaccine are less likely to accept the vaccine than those who know more; this may affect uptake if not addressed. Empowering teachers to be vaccine champions in their community may be a feasible way of disseminating information about HPV

  16. Promoting Uptake of the HPV Vaccine: The Knowledge and Views of School Staff

    ERIC Educational Resources Information Center

    Rose, Sally B.; Lanumata, Tolotea; Lawton, Beverley A.

    2011-01-01

    Background: School-based human papillomavirus (HPV)/cervical cancer vaccination programs have been implemented widely, but few studies have investigated the knowledge and views of school staff about this new vaccine. Methods: Prior to the introduction of the HPV vaccine in 2009, we surveyed staff at 14 socioeconomically diverse schools to assess…

  17. Safety and immunogenicity of the quadrivalent HPV vaccine in female Systemic Lupus Erythematosus patients aged 12 to 26 years

    PubMed Central

    2013-01-01

    Background Women with SLE have higher rates of persistent human papilloma virus (HPV) infections and precancerous lesions than healthy women. HPV vaccine is safe and effective in healthy females aged 9–26 years. There are limited data on the safety and immunogenicity of HPV vaccine in females with SLE, and none in adolescents with SLE. Our study evaluates the safety and immunogenicity of recombinant quadrivalent HPV vaccine, Gardasil, in adolescents and young women with SLE. Methods This is a prospective, open-label study. Exclusion criteria included disease exacerbation within past 30 days; rituximab or cyclophosphamide within 6 months; pregnancy. Vaccine was administered at months 0, 2, and 6. Physical examination, SLEDAI scores and laboratory studies were performed at months 0, 2, 4, 6 and 7. Each patient’s SLEDAI scores and laboratory profile in the year prior to vaccine administration were used as controls for that patient. Primary outcome measures were change in SLEDAI and mean HPV antibody titers. Results 27 patients, 12 to 26 years, were enrolled; 20 completed the study. Nine had mild/moderate lupus flares. Mean SLEDAI scores decreased from 6.14 pre-vaccination to 4.49 post-vaccination (p = 0.01). Of 12 patients with lupus nephritis, two experienced worsening renal function during/after the study and progressed to renal failure within 18 months of the study. Both had Class IV lupus nephritis with high chronicity scores (≥ 8) on renal biopsies performed within one year prior to study entry. Seropositivity post-vaccine was >94% for HPV 6, 11, 16 and 18. Conclusions Quadrivalent HPV vaccine seems generally safe and well tolerated in this series of adolescents and young women with SLE, with no increase in mean SLEDAI scores. Progression to renal failure in two patients was most likely secondary to pre-existing severe renal chronicity and not secondary to HPV vaccination. Immunogenicity to the quadrivalent HPV vaccine was excellent, with the

  18. Predicting pediatricians' communication with parents about the human papillomavirus (hpv) vaccine: an application of the theory of reasoned action.

    PubMed

    Roberto, Anthony J; Krieger, Janice L; Katz, Mira L; Goei, Ryan; Jain, Parul

    2011-06-01

    This study examines the ability of the theory of reasoned action (TRA) and the theory of planned behavior (TPB) to predict whether or not pediatricians encourage parents to get their adolescent daughters vaccinated against the human papillomavirus (HPV). Four-hundred and six pediatricians completed a mail survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that pediatricians have positive attitudes, subjective norms, and perceived behavioral control toward encouraging parents to get their daughters vaccinated, that they intend to regularly encourage parents to get their daughters vaccinated against HPV in the next 30 days, and that they had regularly encouraged parents to get their daughters vaccinated against HPV in the past 30 days (behavior). Though the data were consistent with both the TRA and TPB models, results indicate that perceived behavioral control adds only slightly to the overall predictive power of the TRA, suggesting that attitudes and norms may be more important targets for interventions dealing with this topic and audience. No gender differences were observed for any of the individual variables or the overall fit of either model. These findings have important theoretical and practical implications for the development of health communication messages targeting health care providers in general, and for those designed to influence pediatricians' communication with parents regarding the HPV vaccine in particular. PMID:21424964

  19. Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

    PubMed Central

    Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

    2015-01-01

    Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the

  20. Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

    PubMed Central

    Herrero, Rolando; Quint, Wim; Hildesheim, Allan; Gonzalez, Paula; Struijk, Linda; Katki, Hormuzd A.; Porras, Carolina; Schiffman, Mark; Rodriguez, Ana Cecilia; Solomon, Diane; Jimenez, Silvia; Schiller, John T.; Lowy, Douglas R.; van Doorn, Leen-Jan; Wacholder, Sholom; Kreimer, Aimée R.

    2013-01-01

    Background Human papillomavirus (HPV) infection, particularly with type 16, causes a growing fraction of oropharyngeal cancers, whose incidence is increasing, mainly in developed countries. In a double-blind controlled trial conducted to investigate vaccine efficacy (VE) of the bivalent HPV 16/18 vaccine against cervical infections and lesions, we estimated VE against prevalent oral HPV infections 4 years after vaccination. Methods and Findings A total of 7,466 women 18–25 years old were randomized (1∶1) to receive the HPV16/18 vaccine or hepatitis A vaccine as control. At the final blinded 4-year study visit, 5,840 participants provided oral specimens (91·9% of eligible women) to evaluate VE against oral infections. Our primary analysis evaluated prevalent oral HPV infection among all vaccinated women with oral and cervical HPV results. Corresponding VE against prevalent cervical HPV16/18 infection was calculated for comparison. Oral prevalence of identifiable mucosal HPV was relatively low (1·7%). Approximately four years after vaccination, there were 15 prevalent HPV16/18 infections in the control group and one in the vaccine group, for an estimated VE of 93·3% (95% CI = 63% to 100%). Corresponding efficacy against prevalent cervical HPV16/18 infection for the same cohort at the same visit was 72·0% (95% CI = 63% to 79%) (p versus oral VE = 0·04). There was no statistically significant protection against other oral HPV infections, though power was limited for these analyses. Conclusions HPV prevalence four years after vaccination with the ASO4-adjuvanted HPV16/18 vaccine was much lower among women in the vaccine arm compared to the control arm, suggesting that the vaccine affords strong protection against oral HPV16/18 infection, with potentially important implications for prevention of increasingly common HPV-associated oropharyngeal cancer. ClinicalTrials.gov, Registry number NCT00128661 PMID:23873171

  1. The value of including boys in an HPV vaccination programme: a cost-effectiveness analysis in a low-resource setting.

    PubMed

    Kim, J J; Andres-Beck, B; Goldie, S J

    2007-11-01

    We assessed the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination programme against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, we developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. We assumed vaccination prevented HPV-16 and -18 infections in individuals not previously infected, and protection was lifelong. Coverage was varied from 0-90% in both genders, and cost per-vaccinated individual was varied from IUSD 25 to 400. At 90% coverage, vaccinating girls alone reduced cancer risk by 63%; including boys at this coverage level provided only 4% further cancer reduction. At a cost per-vaccinated individual of USD 50, vaccinating girls alone was vaccination programme. In a resource-constrained setting such as Brazil, our results support that the first priority in reducing cervical cancer mortality should be to vaccinate pre-adolescent girls. PMID:17923869

  2. Efficacy of the HPV-16/18 Vaccine: Final according to protocol results from the blinded phase of the randomized Costa Rica HPV-16/18 Vaccine Trial

    PubMed Central

    Hildesheim, Allan; Wacholder, Sholom; Catteau, Gregory; Struyf, Frank; Dubin, Gary; Herrero, Rolando

    2014-01-01

    Background A community-based randomized trial was conducted in Costa Rica to evaluate the HPV-16/18 AS04-adjuvanted vaccine (NCT00128661). The primary objective was to evaluate efficacy of the vaccine to prevent cervical intraepithelial neoplasia 2 or more severe disease (CIN2+) associated with incident HPV-16/18 cervical infections. Secondary objectives were to evaluate efficacy against CIN2+ associated with incident cervical infection by any oncogenic HPVs and to evaluate duration of protection against incident cervical infection with HPV-16/18. Vaccine safety and immunogenicity over the 4-year follow-up were also evaluated. Methods We randomized (3,727 HPV arm; 3,739 Control arm), vaccinated (HPV-16/18 or Hepatitis A) and followed (median 53.8 months) 7,466 healthy women aged 18-25 years. 5,312 women (2,635 HPV arm; 2,677 Control arm) were included in the according to protocol analysis for efficacy. The full cohort was evaluated for safety. Immunogenicity was considered on a subset of 354 (HPV-16) and 379 (HPV-18) women. HPV type was assessed by PCR on cytology specimens. Immunogenicity was assessed using ELISA and inhibition enzyme immunoassays. Disease outcomes were histologically confirmed. Vaccine efficacy and 95% confidence intervals (95%CI) were computed. Results Vaccine efficacy was 89.8% (95% CI: 39.5 - 99.5; N=11 events total) against HPV-16/18 associated CIN2+, 59.9% (95% CI: 20.7 - 80.8; N=39 events total) against CIN2+ associated with non-HPV-16/18 oncogenic HPVs and 61.4% (95% CI: 29.5-79.8; N=51 events total) against CIN2+ irrespective of HPV type. The vaccine had an acceptable safety profile and induced robust and long-lasting antibody responses. Conclusions Our findings confirm the high efficacy and immunogenicity of the HPV-16/18 vaccine against incident HPV infections and cervical disease associated with HPV-16/18 and other oncogenic HPV types. These results will serve as a benchmark to which we can compare future findings from ongoing extended

  3. The cost-effectiveness of HPV vaccination in addition to screening: a Dutch perspective.

    PubMed

    Setiawan, Didik; Luttjeboer, Jos; Westra, Tjalke Arend; Wilschut, Jan C; Suwantika, Auliya A; Daemen, Toos; Atthobari, Jarir; Wilffert, Bob; Postma, Maarten J

    2015-04-01

    Addition of the HPV vaccine to available cytological screening has been proposed to increase HPV-related cancer prevention. A comprehensive review on this combined strategy implemented in the Netherlands is lacking. For this review, we therefore analyzed all relevant studies on cost-effectiveness of HPV vaccines in combination with cervical screening in the Netherlands. Most of the studies agree that vaccination in pre-sexual-activity periods of life is cost-effective. Based on published sensitivity analyses, the incremental cost-effectiveness ratio was found to be mainly driven by vaccine cost and discount rates. Fewer vaccine doses, inclusion of additional benefits of these vaccines to prevent HPV-related non-cervical cancers and vaccination of males to further reduce the burden of HPV-induced cancers are three relevant options suggested to be investigated in upcoming economic evaluations. PMID:25482311

  4. Human Papillomavirus neutralizing and cross-reactive antibodies induced in HIV-positive subjects after vaccination with quadrivalent and bivalent HPV vaccines.

    PubMed

    Faust, Helena; Toft, Lars; Sehr, Peter; Müller, Martin; Bonde, Jesper; Forslund, Ola; Østergaard, Lars; Tolstrup, Martin; Dillner, Joakim

    2016-03-18

    Ninety-one HIV-infected individuals (61 men and 30 women) were randomized to vaccination either with quadrivalent (Gardasil™) or bivalent (Cervarix™) HPV vaccine. Neutralizing and specific HPV-binding serum antibodies were measured at baseline and 12 months after the first vaccine dose. Presence of neutralizing and binding antibodies had good agreement (average Kappa for HPV types 6, 11, 16, 18, 31, 33 and 45 was 0.65). At baseline, 88% of subjects had antibodies against at least one genital HPV. Following vaccination with Cervarix™, all subjects became seropositive for HPV16 and 18. After Gardasil™ vaccination, 96% of subjects seroconverted for HPV16 and 73% for HPV18. Levels of HPV16-specific antibodies were <1 international unit (IU) in 87% of study subjects before vaccination but >10IU in 85% of study subjects after vaccination. Antibodies against non-vaccine HPV types appeared after Gardasil™ vaccination for >50% of vaccinated females for HPV 31, 35 and 73 and for >50% of Cervarix™-vaccinated females for HPV 31, 33, 35, 45, 56 and 58. Cross-reactivity with non-genital HPV types was also detected. In conclusion, HIV-infected subjects responded to HPV vaccination with induction of neutralizing antibodies against both vaccine and non-vaccine types. PMID:26896686

  5. Sustained immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine administered as a two-dose schedule in adolescent girls: Five-year clinical data and modeling predictions from a randomized study

    PubMed Central

    Romanowski, Barbara; Schwarz, Tino F; Ferguson, Linda; Peters, Klaus; Dionne, Marc; Behre, Ulrich; Schulze, Karin; Hillemanns, Peter; Suryakiran, Pemmaraju; Thomas, Florence; Struyf, Frank

    2016-01-01

    In this randomized, partially-blind study (clinicaltrials.gov; NCT00541970), the licensed formulation of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine (20 μg each of HPV-16/18 antigens) was found highly immunogenic up to 4 y after first vaccination, whether administered as a 2-dose (2D) schedule in girls 9–14 y or 3-dose (3D) schedule in women 15–25 y. This end-of-study analysis extends immunogenicity and safety data until Month (M) 60, and presents antibody persistence predictions estimated by piecewise and modified power law models. Healthy females (age stratified: 9–14, 15–19, 20–25 y) were randomized to receive 2D at M0,6 (N = 240 ) or 3D at M0,1,6 (N = 239). Here, results are reported for girls 9–14 y (2D) and women 15–25 y (3D). Seropositivity rates, geometric mean titers (by enzyme-linked immunosorbent assay) and geometric mean titer ratios (GMRs; 3D/2D; post-hoc exploratory analysis) were calculated. All subjects seronegative pre-vaccination in the according-to-protocol immunogenicity cohort were seropositive for anti-HPV-16 and −18 at M60. Antibody responses elicited by the 2D and 3D schedules were comparable at M60, with GMRs close to 1 (anti-HPV-16: 1.13 [95% confidence interval: 0.82–1.54]; anti-HPV-18: 1.06 [0.74–1.51]). Statistical modeling predicted that in 95% of subjects, antibodies induced by 2D and 3D schedules could persist above natural infection levels for ≥ 21 y post-vaccination. The vaccine had a clinically acceptable safety profile in both groups. In conclusion, a 2D M0,6 schedule of the HPV-16/18 AS04-adjuvanted vaccine was immunogenic for up to 5 y in 9–14 y-old girls. Statistical modeling predicted that 2D-induced antibodies could persist for longer than 20 y. PMID:26176261

  6. Human papillomavirus vaccination in adolescence.

    PubMed

    Russell, Michelle; Raheja, Vinita; Jaiyesimi, Rotimi

    2013-11-01

    Cervical cancer is the third most common female cancer worldwide. It remains the highest ranking preventable cancer affecting women in developing countries. Cervical cancer is caused by sexual transmission of human papillomavirus (HPV). It is estimated that more than 80% of sexually active women will be infected with HPV in their lifetime, usually in their mid to late teens, 20s and early 30s. Persistence of high-risk oncogenic subtypes can lead to the development of precancerous change (cervical intraepithelial neoplasia (CIN)), which can ultimately lead to cervical cancer. Progression from CIN to cancer is slow in most cases, and it is believed that progression from CIN 3 to cancer at 10, 20 and 30 years is 16%, 25% and 31.3%, respectively. The cervical screening programme has been successful in reducing the incidence of cervical cancer by recognising early precancerous changes and treating them. A promising advance in women's health has been the development of a vaccine targeting high-risk oncogenic subtypes 16 and 18, which are responsible for 70% of all cervical cancers. Two HPV vaccines are available: Merck & Co.'s Gardasil(®) and GlaxoSmithKline's Cervarix(®). The aim of this programme is to provide three doses prior to sexual debut with the hope that it will reduce the rates of cervical cancer in the future. Women who are already sexually active can still be vaccinated, but, the vaccine has been shown to be less effective in them. Uptake remains a challenge for public health, and efforts should focus on educating parents about the association between HPV and cervical cancer. Routine vaccination of young men is a debatable issue and has been found to be less cost-effective, as the burden of disease such as anal and penile cancers in males is less than cervical cancers in women. Current evidence suggests that the HPV vaccination programme should focus on increasing and maintaining high coverage of vaccination in girls. There may, however, be some benefit in

  7. Factors Associated with College Students' Intentions to Vaccinate Their Daughters Against HPV: Protecting the Next Generation.

    PubMed

    Wilson, Kelly L; White, Alice; Rosen, Brittany L; Chiappone, Alethea; Pulczinski, Jairus C; Ory, Marcia G; Smith, Matthew Lee

    2016-10-01

    Human papillomavirus (HPV) is a contemporary public health concern because of its association with cervical cancer. Despite evidence about HPV vaccination benefits, debate surrounds whether or not to vaccinate American youth. While no nationwide mandate exists, understanding the behaviors and intentions of future parents may provide insight about our ability to protect the next generation of school-aged youth. The purposes of this study were to examine factors associated with unmarried college students' intentions to: (1) vaccinate their daughters against HPV and (2) give their daughters the choice about whether or not to be vaccinated. Data were analyzed from 1606 college students aged 18-26 using an internet-delivered questionnaire. Two binary logistic regression analyses were performed identifying predictor variables associated with participants' intentions when having daughters in the future to vaccinate them against HPV and whether or not they would let their daughters decide to get the vaccination. Relative to those who did not intend to vaccinate their daughters against HPV, participants who were female (OR 1.55, P = 0.018), sexually active (OR 1.62, P = 0.001), diagnosed with HPV (OR 2.64, P < 0.001), received a flu shot in the past 12 months (OR 1.63, P = 0.002), perceived the HPV vaccine to be safe (OR 1.19, P < 0.001), and supported HPV vaccination mandates for school-aged youth (OR 2.58, P < 0.001) were more likely to report intentions of vaccinating their daughters against HPV. Participants who were sexually active (OR 1.45, P = 0.002) and perceived the HPV vaccine to be safe (OR 1.05, P = 0.012) were more likely to report they would allow their daughters to choose whether to be vaccinated against HPV. Until HPV vaccination mandates are enacted, parental support of vaccines are among the most effective way of increasing vaccine uptake. Identifying HPV vaccination support among future parents has potential to inform parent vaccination

  8. College Women's Attitudes, Behaviors, and Beliefs Regarding the HPV Vaccine: Translation to Health Education Practice

    ERIC Educational Resources Information Center

    Caron, Rosemary M.; Kispert, Elisabeth; McGrath, Robert J.

    2008-01-01

    Background: Cervical cancer is primarily caused by the human papillomavirus (HPV) and is the second most common cause of cancer-related mortality among women. Purpose: College women may be at risk for contracting HPV based on their sexual behavior. An exploratory analysis was conducted, following the release of the HPV vaccine, Gardasil[R], to (1)…

  9. Efficacy of a bivalent HPV 16/18 vaccine against anal HPV16/18 infection among young women: a nested analysis within the Costa Rica Vaccine Trial

    PubMed Central

    Kreimer, Aimée R.; Gonzalèz, Paula; Katki, Hormuzd A.; Porras, Carolina; Schiffman, Mark; Rodriguez, Ana Cecilia; Solomon, Diane; Jimenez, Silvia; Schiller, John T.; Lowy, Douglas R.; van Doorn, Leen-Jan; Struijk, Linda; Quint, Wim; Chen, Sabrina; Wacholder, Sholom; Hildesheim, Allan; Herrero, Rolando

    2011-01-01

    Background Anal cancer remains rare (incidence of ∼1.5 per 100,000 women annually) but rates are increasing in many countries. Human papillomavirus-16 (HPV16) infection causes most cases. We evaluated vaccine efficacy (VE) of an ASO4-adjuvanted HPV16/18 vaccine against anal HPV16/18 infection. Methods In a randomized double-blind controlled trial designed to evaluate VE against persistent cervical HPV16/18 infections and associated precancerous lesions in Costa Rica, 4210 healthy women underwent anal specimen collection (4224 of 5968= 70.8% of eligible women) at the final blinded study visit 4 years after vaccination to evaluate anal HPV16/18 VE. Cervical HPV16/18 VE among the same women at the same visit was calculated as a comparator. For this ancillary work, analyses were conducted in a restricted cohort of women both cervical HPV16/18 DNA negative and HPV 16/18 seronegative prior at enrollment (N=1989), and in the full cohort (all women with an anal specimen). Findings In the restricted cohort, VE against prevalent HPV16/18 anal infection measured one-time, four-years post-vaccination was 83.6% (95%CI 66.7% to 92.8%), which was comparable to cervical HPV16/18 VE (87.9%, 95%CI 77.4% to 94.0%). In the full cohort, HPV16/18 VE was statistically lower at the anus (62.0%, 95%CI 47.1% to 73.1%) compared to the cervix (76.4%, 95%CI 67.0% to 83.5%) (p for anatomic-site interaction =0.03). Significant and comparable VE estimates against a composite endpoint of HPV31/33/45 (i.e.: cross-protection) was observed at the anus and cervix. Interpretation The ASO4-adjuvanted vaccine affords strong protection against anal HPV, particularly among women more likely to be HPV naïve at vaccination. Funding. The Costa Rica HPV Vaccine Trial is sponsored and funded by the NCI (contract N01-CP-11005), with funding support from the National Institutes of Health Office of Research on Women's Health, and conducted with support from the Ministry of Health of Costa Rica. Vaccine was

  10. Detection of human papillomavirus (HPV) L1 gene DNA possibly bound to particulate aluminum adjuvant in the HPV vaccine Gardasil.

    PubMed

    Lee, Sin Hang

    2012-12-01

    Medical practitioners in nine countries submitted samples of Gardasil (Merck & Co.) to be tested for the presence of human papillomavirus (HPV) DNA because they suspected that residual recombinant HPV DNA left in the vaccine might have been a contributing factor leading to some of the unexplained post-vaccination side effects. A total of 16 packages of Gardasil were received from Australia, Bulgaria, France, India, New Zealand, Poland, Russia, Spain and the United States. A nested polymerase chain reaction (PCR) method using the MY09/MY11 degenerate primers for initial amplification and the GP5/GP6-based nested PCR primers for the second amplification were used to prepare the template for direct automated cycle DNA sequencing of a hypervariable segment of the HPV L1 gene which is used for manufacturing of the HPV L1 capsid protein by a DNA recombinant technology in vaccine production. Detection of HPV DNA and HPV genotyping of all positive samples were finally validated by BLAST (Basic Local Alignment Search Tool) analysis of a 45-60 bases sequence of the computer-generated electropherogram. The results showed that all 16 Gardasil samples, each with a different lot number, contained fragments of HPV-11 DNA, or HPV-18 DNA, or a DNA fragment mixture from both genotypes. The detected HPV DNA was found to be firmly bound to the insoluble, proteinase-resistant fraction, presumably of amorphous aluminum hydroxyphosphate sulfate (AAHS) nanoparticles used as adjuvant. The clinical significance of these residual HPV DNA fragments bound to a particulate mineral-based adjuvant is uncertain after intramuscular injection, and requires further investigation for vaccination safety. PMID:23078778

  11. Exploring the role of ethnic identity on the attitudes towards HPV vaccine advertising among Puerto Ricans: A qualitative analysis

    PubMed Central

    Calo, William A.; Fernández, Maria E.; Fernández-Espada, Natalie; Colón-López, Vivian

    2013-01-01

    Despite the existence of guidelines recommending vaccination against the human papillomavirus (HPV) and widespread availability of the vaccine through the Vaccines for Children program, HPV vaccination rates among island Puerto Ricans are suboptimal. Advertising plays a central role in promoting HPV vaccination by increasing awareness of and knowledge about the vaccine; however, little is known about the influence of cultural factors on the impact of HPV messages delivered through the media. The aim of this qualitative study was to explore the role of ethnic identity on the attitudes towards HPV vaccine advertising among island Puerto Ricans. Five focus groups (n=23) were conducted with parents and non-vaccinated females. Our analysis found several themes that may influence attitudes towards HPV vaccine advertising among this population: physical ethnic similarity, relevance of information, and sociocultural congruence. Findings may assist in developing culturally appropriate health promotion programs and media to promote HPV vaccination among Puerto Ricans. PMID:24052477

  12. Understanding Public Perceptions of the HPV Vaccination Based on Online Comments to Canadian News Articles

    PubMed Central

    Feinberg, Yael; Pereira, Jennifer A.; Quach, Susan; Kwong, Jeffrey C.; Crowcroft, Natasha S.; Wilson, Sarah E.; Guay, Maryse; Lei, Yang; Deeks, Shelley L.

    2015-01-01

    Background Given the variation in human papillomavirus (HPV) vaccine coverage across Canada, and debate regarding delivery of HPV vaccines in Catholic schools, we studied online comments on Canadian news websites to understand public perceptions of HPV and HPV vaccine. Methods We searched English- and French-language Canadian news websites for 2012 articles that contained the terms “HPV” or “human papillomavirus.” Articles about HPV vaccinations that contained at least one comment were included. Two researchers independently coded comments, analyzing them for emerging themes. Results We identified 3073 comments from 1198 individuals in response to 71 news articles; 630 (52.6%) individuals expressed positive sentiments about HPV vaccination (2.5 comments/individual), 404 (33.7%) were negative (3.0 comments/individual), 34 (2.8%) were mixed (1.5 comments/individual) and 130 (10.8%) were neutral (1.6 comments/individual). Vaccine-supportive commenters believed the vaccine is safe and effective. Common themes in negative comments included concerns regarding HPV vaccine safety and efficacy, distrust of pharmaceutical companies and government, and belief that school-age children are too young for HPV vaccine. Many comments focused on whether the Catholic Church has the right to inform health policy for students, and discussion often evolved into debates regarding HPV and sexual behaviour. We noted that many individuals doubted the credibility of vaccine safety information. Conclusion The majority of commenters do not appear to be against HPV vaccination, but public health messaging that focuses on both the vaccine’s safety profile, and its use as a means to prevent cancer rather than sexually transmitted HPV infection may facilitate its acceptance. PMID:26053866

  13. HPV16/18 L1 VLP Vaccine Induces Cross-Neutralizing Antibodies that May Mediate Cross-Protection

    PubMed Central

    Kemp, Troy J.; Hildesheim, Allan; Safaeian, Mahboobeh; Dauner, Joseph G.; Pan, Yuanji; Porras, Carolina; Schiller, John T.; Lowy, Douglas R.; Herrero, Rolando; Pinto, Ligia A.

    2011-01-01

    Human papillomavirus (HPV) L1 VLP-based vaccines are protective against HPV vaccine-related types; however, the correlates of protection have not been defined. We observed that vaccination with Cervarix™ induced cross-neutralizing antibodies for HPV types for which evidence of vaccine efficacy has been demonstrated (HPV31/45) but not for other types (HPV52/58). In addition, HPV31/45 cross-neutralizing titers showed a significant increase with number of doses (HPV31, p<0.001; HPV45, p<0.001) and correlated with HPV16/18 neutralizing titers, respectively. These findings raise the possibility that cross-neutralizing antibodies are effectors of cross-protection observed for the HPV16/18 vaccine. PMID:21241731

  14. Debate Revives Old Arguments on HPV Vaccine

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2011-01-01

    The author reports on a Republican presidential debate which revives the contention over requiring middle school girls to be vaccinated against the virus that causes cervical cancer. At the September 12 debate, U.S. Representative Michele Bachmann, of Minnesota, and Rick Santorum, a former U.S. senator from Pennsylvania, attacked Texas Governor…

  15. Community Awareness of HPV Screening and Vaccination in Odisha

    PubMed Central

    Khanna, Niharika; Ramaseshan, Aparna; Arnold, Stephanie; Panigrahi, Kalpana; Macek, Mark D.; Padhi, Bijaya K.; Samanta, Diptirani; Senapati, Surendra N.; Panigrahi, Pinaki

    2015-01-01

    Introduction. A number of new technologies including cervical cancer screening and vaccination have introduced new tools in the fight against cervical cancer. Methods. This study was set in Odisha, India, at the Acharya Harihar Regional Cancer Center and study research infrastructure at the Asian Institute of Public Health. IRB approvals were obtained and a research assistant recruited 286 women aged 18–49 years, who provided informed consent and completed a survey tool. Data were entered into EpiData software and statistical analysis was conducted. Results. 76.3% women participants were married, 45.5% had sexual debut at age 21 or greater, 60.5% used contraception, 12.2% reported having a Pap smear in the past, and 4.9% reported having prior genital warts. Most, 68.8% had never heard of HPV and 11.9% were aware that HPV is the main cause of cervical cancer. 82.9% women thought that vaccinations prevent disease, and 74.8% said they make the decision to vaccinate their children. Conclusion. The Odisha community demonstrated a low level of knowledge about cervical cancer prevention, accepted vaccinations in the prevention of disease and screening, and identified mothers/guardians as the key family contacts. PMID:26783394

  16. HPV vaccines: their pathology-based discovery, benefits, and adverse effects.

    PubMed

    Nicol, Alcina F; de Andrade, Cecilia V; Russomano, Fabio B; Rodrigues, Luana S L; Oliveira, Nathalia S; Provance, David William; Nuovo, Gerard J

    2015-12-01

    The discovery of the human papillomavirus (HPV) vaccine illustrates the power of in situ-based pathologic analysis in better understanding and curing diseases. The 2 available HPV vaccines have markedly reduced the incidence of cervical intraepithelial neoplasias, genital warts, and cervical cancer throughout the world. Concerns about HPV vaccine safety have led some physicians, health care officials, and parents to refuse providing the recommended vaccination to the target population. The aims of the study were to discuss the discovery of HPV vaccine and review scientific data related to measurable outcomes from the use of HPV vaccines. The strong type-specific immunity against HPV in humans has been known for more than 25 years. Multiple studies confirm the positive risk benefit of HPV vaccination with minimal documented adverse effects. The most common adverse effect, injection site pain, occurred in about 10% of girls and was less than the rate reported for other vaccines. Use of HPV vaccine should be expanded into more diverse populations, mainly in low-resource settings. PMID:26321154

  17. How university students view human papillomavirus (HPV) vaccination: A cross-sectional study in Jinan, China.

    PubMed

    Zou, Huachun; Wang, Wei; Ma, Yuanyuan; Wang, Yongjie; Zhao, Fanghui; Wang, Shaoming; Zhang, Shaokai; Ma, Wei

    2016-01-01

    The acceptability of HPV vaccination among university students in China is not well understood. Our study was of cross-sectional study design. We collected a questionnaire about socio-demographic characteristics, knowledge of, attitude toward and acceptability of HPV vaccination. A total of 351 students were included in data analyses, among whom 47.6% were males and 70.0% aged 19-21. Only 10.3% had previously heard of HPV and 5.4% HPV vaccine. Male and female students were equally likely to accept HPV vaccine (71.8 vs 69.4%, p = 0.634) and recommend it to sexual partners (73.1 vs 76.7%, p = 0.441). The great majority of students could only afford RMB 300 (USD 50) or less for HPV vaccination. HPV vaccination acceptance was associated with being in year-one (Adjusted odds ratio (AOR)  = 3.78, 95% confidence interval (CI): 2.12-6.75), being from a key university (AOR = 1.88, 95%CI: 1.07-3.31), having heard of HPV-related morbidities (AOR = 1.88, 95% CI: 1.05-3.35), being concerned about HPV-related morbidities (AOR = 2.23, 95% CI: 1.16-4.27) and believing the vaccine should be given before first sexual contact (AOR = 2.44, 95% CI: 1.38-4.29). Female students were more likely to anticipate a late uptake of HPV vaccination (p = 0.002). The relatively lower levels of HPV knowledge but higher levels of vaccine acceptance among undergraduates highlighted the need for education on the roles of sexual behaviors in HPV transmission. PMID:26308701

  18. Impact of HPV vaccination on anogenital warts and respiratory papillomatosis.

    PubMed

    Wangu, Zoon; Hsu, Katherine K

    2016-06-01

    Human papillomavirus (HPV), the most common sexually transmitted infection in the US and worldwide, can cause cancers, anogenital warts (AGW), and recurrent respiratory papillomatosis (RRP) in men, women, and children. Global incidence of AGW ranges from 160-289 cases per 100,000 person-years and peaks in young men and women in the third decade of life. RRP has an estimated incidence of 3 per 1 million person-years in children. Pre-licensure trial efficacy, modeling and time-trend ecological studies have shown a significant short-term impact of 4vHPV vaccine. In girls aged 15-19 years, a previously published meta-analysis indicated that genital warts decreased significantly by 31%; stratified analysis revealed more substantial reductions in populations with high (≥50 %) vs. low (<50 % ) vaccination coverage (61% vs. 14%). Longer-term monitoring will reveal whether this impact continues under 9vHPV programs, and whether current declines in AGW are mirrored by declines in RRP. PMID:27217191

  19. HPV Vaccine Gardasil®-9: What You Need to Know

    MedlinePlus

    ... medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own, but serious reactions are also possible. Most people who get HPV vaccine do not have any serious problems with ...

  20. HPV vaccine acceptability in HIV-infected and HIV negative men who have sex with men (MSM) in Ireland.

    PubMed

    Sadlier, C; Lynam, A; O'Dea, S; Delamere, S; Quinlan, M; Clarke, S; Sheils, O; Bergin, C

    2016-06-01

    Background Men who have sex with men (MSM), particularly HIV-infected MSM are disproportionately affected by HPV infection and associated disease. The HPV vaccine has potential to greatly reduce the burden of HPV-associated disease including anal cancer in MSM. The efficacy of the HPV vaccine is dependent on high levels of vaccine uptake. The aim of this study was to examine HPV vaccine acceptability and factors influencing vaccine acceptability in MSM in Ireland. Methods A self-administered survey was distributed to HIV-infected and HIV negative MSM examining HPV vaccine acceptability and factors associated with vaccine acceptability. Logistic regression was used to identify key variables and predictors of HPV vaccine acceptability. Results 302 MSM participated in the study. Acceptability of HPV vaccine was 31% (unconditional), 51% (conditional on stated efficacy and a cost of €300), 65% (conditional on stated efficacy and a cost of €100) and 78% (conditional on stated efficacy and no cost). Cost was negatively associated with HPV vaccine acceptability (p<0.01) while knowledge of HPV vaccine efficacy was significantly associated with vaccine acceptability, even in the context of associated cost (p<0.01). Conclusions Acceptability of HPV vaccine in MSM in Ireland is high based on no cost vaccine and on stated vaccine efficacy (78%). Cost is negatively associated with vaccine acceptability. Understanding levels of knowledge of HPV infection, HPV associated disease and attitudes toward HPV vaccination are important as they will contribute to HPV vaccine acceptability among MSM and will help guide effective preventive programs. PMID:27153289

  1. Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination

    PubMed Central

    Ward, Harvey Rodrick Grenville

    2014-01-01

    Three young women who developed premature ovarian insufficiency following quadrivalent human papillomavirus (HPV) vaccination presented to a general practitioner in rural New South Wales, Australia. The unrelated girls were aged 16, 16, and 18 years at diagnosis. Each had received HPV vaccinations prior to the onset of ovarian decline. Vaccinations had been administered in different regions of the state of New South Wales and the 3 girls lived in different towns in that state. Each had been prescribed the oral contraceptive pill to treat menstrual cycle abnormalities prior to investigation and diagnosis. Vaccine research does not present an ovary histology report of tested rats but does present a testicular histology report. Enduring ovarian capacity and duration of function following vaccination is unresearched in preclinical studies, clinical and postlicensure studies. Postmarketing surveillance does not accurately represent diagnoses in adverse event notifications and can neither represent unnotified cases nor compare incident statistics with vaccine course administration rates. The potential significance of a case series of adolescents with idiopathic premature ovarian insufficiency following HPV vaccination presenting to a general practice warrants further research. Preservation of reproductive health is a primary concern in the recipient target group. Since this group includes all prepubertal and pubertal young women, demonstration of ongoing, uncompromised safety for the ovary is urgently required. This matter needs to be resolved for the purposes of population health and public vaccine confidence. PMID:26425627

  2. “Saving lives”: Adapting and adopting Human Papilloma Virus (HPV) vaccination in Austria

    PubMed Central

    Paul, Katharina T.

    2016-01-01

    Vaccination against the sexually transmitted Human Papilloma Virus (HPV), a necessary agent for the development of cervical cancer, has triggered much debate. In Austria, HPV policy turned from “lagging behind” in 2008 into “Europe's frontrunner” by 2013. Drawing on qualitative research, the article shows how the vaccine was transformed and made “good enough” over the course of five years. By means of tinkering and shifting storylines, policy officials and experts disassociated the vaccine from gender, vaccine manufacturers, and youth sexuality. Ultimately, the HPV vaccine functioned to strengthen the national immunization program. To this end, preventing an effective problematization of the extant screening program was essential. PMID:26921834

  3. Factors Influencing Mexican Women's Decisions to Vaccinate Daughters Against HPV in the United States and Mexico.

    PubMed

    Wentzell, Emily; Flores, Yvonne N; Salmerón, Jorge; Bastani, Roshan

    2016-01-01

    Mexican and Mexican-American women bear high cervical cancer burdens, yet relationships between mothers' experiences of vaccinating daughters against cervical cancer-causing human papillomavirus (HPV) on both sides of the border are unknown. We surveyed 400 Mexican-born women in Oxnard, California, United States and Cuernavaca, Morelos, Mexico, about their beliefs and practices regarding daughters' HPV vaccination, conducting in-depth interviews with 35 participants. Contextualizing interview findings in survey data, we identify key factors influencing mothers' experiences regarding daughters' HPV vaccination in both countries. Although US acculturation influenced some participants' concerns, US and Mexico participants overwhelmingly desired eventual vaccination; structural rather than cultural barriers limited vaccine uptake. PMID:27536936

  4. Physicians' experiences with HPV vaccine delivery: evidence from developing country with multiethnic populations.

    PubMed

    Wong, Li Ping

    2009-03-01

    Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use. PMID:19100803

  5. The role of anticipated regret and health beliefs in HPV vaccination intentions among young adults.

    PubMed

    Christy, Shannon M; Winger, Joseph G; Raffanello, Elizabeth W; Halpern, Leslie F; Danoff-Burg, Sharon; Mosher, Catherine E

    2016-06-01

    Although cognitions have predicted young adults' human papillomavirus (HPV) vaccine decision-making, emotion-based theories of healthcare decision-making suggest that anticipatory emotions may be more predictive. This study examined whether anticipated regret was associated with young adults' intentions to receive the HPV vaccine above and beyond the effects of commonly studied cognitions. Unvaccinated undergraduates (N = 233) completed a survey assessing Health Belief Model (HBM) variables (i.e., perceived severity of HPV-related diseases, perceived risk of developing these diseases, and perceived benefits of HPV vaccination), anticipatory emotions (i.e., anticipated regret if one were unvaccinated and later developed genital warts or HPV-related cancer), and HPV vaccine intentions. Anticipated regret was associated with HPV vaccine intentions above and beyond the effects of HBM variables among men. Among women, neither anticipated regret nor HBM variables showed consistent associations with HPV vaccine intentions. Findings suggest that anticipatory emotions should be considered when designing interventions to increase HPV vaccination among college men. PMID:26782668

  6. Human papillomavirus (HPV): college male’s knowledge, perceived risk, sources of information, vaccine barriers and communication

    PubMed Central

    Katz, Mira L.; Krieger, Janice L.; Roberto, Anthony J.

    2011-01-01

    Background Human papillomavirus (HPV) is a common sexually transmitted infection. With the U.S. Food and Drug Administration (FDA) approval of an indication for the HPV vaccine for males, it is important to assess male college student’s HPV knowledge, perceived risk, and sources of information, as well as HPV vaccine barriers and communication. Methods This was a cross-sectional survey study of 165 male college students. The participants completed a survey about HPV and the HPV vaccine. Results Among the 165 participants, most males had poor HPV knowledge, in that 132 (80.0%) reported having had sexual intercourse, but only 20 (12.1%) perceived being at risk for acquiring HPV. Information sources about HPV were commercials/advertisements, friends, news and health education programs. Concern about the HPV vaccine’s long-term effects and cost were the most frequently reported barriers. Most students reported having a regular healthcare provider, but had difficulty getting to their provider, and finding time to discuss the HPV vaccine with their provider. Additionally, most students reported relying on their parents when making medical decisions and being willing to discuss the HPV vaccine with their healthcare provider to make an informed decision about the vaccine. Conclusions Educational programs providing information about HPV, the HPV vaccine, and communication skills training are needed for male college students, parents, and healthcare providers. Findings from this study will guide the development of HPV vaccine messages and educational programs that should be tested in future research. PMID:21966351

  7. Message Framing, Perceived Susceptibility, and Intentions to Vaccinate Children Against HPV Among African American Parents.

    PubMed

    Nan, Xiaoli; Madden, Kelly; Richards, Adam; Holt, Cheryl; Wang, Min Qi; Tracy, Kate

    2016-07-01

    This research examines the interaction effect of message framing (gain vs. loss) and perceived susceptibility (i.e., perceived likelihood that one's child is at risk of contracting HPV) on African American parents' intentions to vaccinate their children against HPV. Results of an experiment (N = 193) in which parents were exposed to either a gain-framed or loss-framed message about HPV vaccination revealed a significant interaction between message framing and perceived susceptibility when parents were required to pay for the vaccine. The specific pattern of interaction suggested that parents who perceived their children to be at high risk of contracting HPV were more persuaded by the gain-framed message, whereas those who believed their children to be at low risk of contracting HPV were more persuaded by the loss-framed message. Implications of the findings for HPV vaccination messaging are discussed. PMID:26646190

  8. Eurogin Roadmap 2015: How has HPV knowledge changed our practice: Vaccines.

    PubMed

    Brotherton, Julia M L; Jit, Mark; Gravitt, Patti E; Brisson, Marc; Kreimer, Aimée R; Pai, Sara I; Fakhry, Carole; Monsonego, Joseph; Franceschi, Silvia

    2016-08-01

    This review is one of two complementary reviews that have been prepared in the framework of the Eurogin Roadmap 2015 to evaluate how knowledge about HPV is changing practices in HPV infection and disease control through vaccination and screening. In this review of HPV vaccine knowledge, we present the most significant findings of the past year which have contributed to our knowledge of the two HPV prophylactic vaccines currently in widespread use and about the recently licensed nonavalent HPV vaccine. Whereas anal cancer is dealt with in the companion mini-review on screening, we also review here the rapidly evolving evidence regarding HPV-associated head and neck cancer and priority research areas. PMID:26916230

  9. HPV vaccines for circumpolar health: summary of plenary session, “Opportunities for Prevention: Global HPV Vaccine” and “Human Papillomavirus Prevention: The Nordic Experience”

    PubMed Central

    Dunne, Eileen F.; Koch, Anders

    2013-01-01

    In this publication, we provide an overview of the presentations, “Opportunities for Prevention: Global HPV Vaccine” and “Human Papillomavirus Prevention: The Nordic Experience” as a part of the 15th International Congress on Circumpolar Health, held at Anchorage, Alaska, on August 8, 2012. We provide an overview of HPV, HPV vaccines and policy as well as the Nordic experience with HPV vaccine introduction.

  10. School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study

    PubMed Central

    Grandahl, Maria; Rosenblad, Andreas; Stenhammar, Christina; Tydén, Tanja; Westerling, Ragnar; Larsson, Margareta; Oscarsson, Marie; Andrae, Bengt; Dalianis, Tina; Nevéus, Tryggve

    2016-01-01

    of HPV, and increased the HPV vaccination rates in a diverse population of adolescents. Trial registration number NCT02280967; Results. PMID:26817639

  11. Barriers and facilitators to HPV vaccination of young women in high-income countries: a qualitative systematic review and evidence synthesis

    PubMed Central

    2014-01-01

    Background Vaccination against Human Papillomavirus (HPV) is recommended for adolescent young women prior to sexual debut to reduce cervical cancer related mortality and morbidity. Understanding factors affecting decision-making of HPV vaccination of young women is important so that effective interventions can be developed which address barriers to uptake in population groups less likely to receive the HPV vaccine. Methods We undertook a qualitative systematic review and evidence synthesis to examine decision-making relating to the HPV vaccination of young women in high-income countries. A comprehensive search of databases from inception to March 2012 was undertaken to identify eligible studies reporting the perspectives of key stakeholders including policy makers, professionals involved in programme, parents, and young women. Factors affecting uptake of the vaccine were examined at different levels of the socio-ecological model (policy, community, organisational, interpersonal and intrapersonal). Results Forty-one studies were included. Whether young women receive the HPV vaccine is strongly governed by the decisions of policy makers, healthcare professionals, and parents. These decisions are shaped by: financial considerations; social norms and values relating to sexual activity, and; trust in vaccination programmes and healthcare providers. Financial constraints may be overcome through universal healthcare systems offering the HPV vaccine free at the point of delivery. In the healthcare setting, judgements by healthcare professionals about whether to recommend the vaccine may restrict a young woman’s access to the vaccine irrespective of her own beliefs and preferences. Parents may decide not to allow their daughters to be vaccinated, based on cultural or religious perceptions about sexual activity. Conclusions Barriers to the uptake of the HPV vaccine have implications for young women’s future sexual, physical and reproductive health. Interventions to

  12. Fusion of CTLA-4 with HPV16 E7 and E6 Enhanced the Potency of Therapeutic HPV DNA Vaccine

    PubMed Central

    Gan, Lili; Jia, Rong; Zhou, Lili; Guo, Jihua; Fan, Mingwen

    2014-01-01

    Preventive anti-HPV vaccines are effective against HPV infection but not against existing HPV-associated diseases, including cervical cancer and other malignant diseases. Therefore, the development of therapeutic vaccines is urgently needed. To improve anti-tumor effects of therapeutic vaccine, we fused cytotoxic T-lymphocyte antigen 4 (CTLA-4) with HPV16 E7 and E6 as a fusion therapeutic DNA vaccine (pCTLA4-E7E6). pCTLA4-E7E6 induced significantly higher anti-E7E6 specific antibodies and relatively stronger specific CTL responses than the nonfusion DNA vaccine pE7E6 in C57BL/6 mice bearing with TC-1 tumors. pCTLA4-E7E6 showed relatively stronger anti-tumor effects than pE7E6 in therapeutic immunization. These results suggest that fusing CTLA-4 with E7E6 is a useful strategy to develop therapeutic HPV DNA vaccines. In addition, fusing the C-terminal of E7 with the N-terminal of E6 impaired the functions of both E7 and E6. PMID:25265018

  13. Therapeutic potential of an AcHERV-HPV L1 DNA vaccine.

    PubMed

    Lee, Hee-Jung; Yoon, Jong Kwang; Heo, Yoonki; Cho, Hansam; Cho, Yeondong; Gwon, Yongdae; Kim, Kang Chang; Choi, Jiwon; Lee, Jae Sung; Oh, Yu-Kyoung; Kim, Young Bong

    2015-06-01

    Cervical cancer is strongly associated with chronic human papillomavirus infections, among which HPV16 is the most common. Two commercial HPV vaccines, Gardasil and Cervarix are effective for preventing HPV infection, but cannot be used to treat existing HPV infections. Previously, we developed a human endogenous retrovirus (HERV)-enveloped recombinant baculovirus capable of delivering the L1 genes of HPV types 16, 18, and 58 (AcHERV-HP16/18/58L1, AcHERV-HPV). Intramuscular administration of AcHERVHPV vaccines induced a strong cellular immune response as well as a humoral immune response. In this study, to examine the therapeutic effect of AcHERV-HPV in a mouse model, we established an HPV16 L1 expressing tumor cell line. Compared to Cervarix, immunization with AcHERVHPV greatly enhanced HPV16 L1-specific cytotoxic T lymphocytes (CTL) in C57BL/6 mice. Although vaccination could not remove preexisting tumors, strong CTL activity retarded the growth of inoculated tumor cells. These results indicate that AcHERV-HPV could serve as a potential therapeutic DNA vaccine against concurrent infection with HPV 16, 18, and 58. PMID:26025174

  14. Using a Reasoned Action Approach to Examine US College Women's Intention to Get the HPV Vaccine

    ERIC Educational Resources Information Center

    Jozkowski, Kristen N.; Geshnizjani, Alireza

    2016-01-01

    Objective: Although at high risk of contracting the human papillomavirus (HPV), less than one-half of US college women have been vaccinated. The purpose of this study was to identify underlying factors influencing college women's intention to get the HPV vaccine via developing an instrument using the Reasoned Action Approach (RAA). Setting: Data…

  15. Using the Theory of Planned Behavior to Predict Mothers' Intentions to Vaccinate Their Daughters against HPV

    ERIC Educational Resources Information Center

    Askelson, Natoshia M.; Campo, Shelly; Lowe, John B.; Smith, Sandi; Dennis, Leslie K.; Andsager, Julie

    2010-01-01

    This study assessed mothers' intentions to vaccinate their daughters against human papillomavirus (HPV) using the theory of planned behavior (TPB). Experience with sexually transmitted infections (STIs), beliefs about the vaccine encouraging sexual activity, and perception of daughters' risk for HPV were also examined for a relationship with…

  16. The Evidence for Efficacy of HPV Vaccines: Investigations in Categorical Data Analysis

    ERIC Educational Resources Information Center

    Gibbs, Alison L.; Goossens, Emery T.

    2013-01-01

    Recent approval of HPV vaccines and their widespread provision to young women provide an interesting context to gain experience with the application of statistical methods in current research. We demonstrate how we have used data extracted from a meta-analysis examining the efficacy of HPV vaccines in clinical trials with students in applied…

  17. Human Papillomavirus (HPV) Signs and Symptoms

    MedlinePlus

    ... of HPV HPV and Cancer HPV Cancer Screening HPV Vaccines HPV Vaccine Safety For Clinicians Know the Facts Continuing Education Provider Fact Sheets Schedules & Recommendations HPV Vaccine Coverage Data Commit to the Cause Tools for ...

  18. School Nurses' Professional Practice in the HPV Vaccine Decision-Making Process.

    PubMed

    Rosen, Brittany L; Ashwood, Daniel; Richardson, George B

    2016-04-01

    Because U.S. human papillomavirus (HPV) vaccination rates remain low, we evaluated school nurses' knowledge, attitudes, perceptions of their role as opinion leaders, self-efficacy, intention, and professional practice regarding the HPV vaccine and determined if these variables influenced their professional practice concerning the HPV vaccine. We utilized a cross-sectional design by recruiting Ohio Association of School Nurses (OASN) members. Participants (n = 145) completed a paper survey during the OASN annual conference. Structural equation modeling was used to examine the proposed model. Our model yielded a well-fitting solution, χ2 = 1.118 (degrees of freedom = 2, p = .57). Knowledge had positive effects on intention and self-efficacy. Attitude had a positive effect on perception of role as opinion leaders. Intention to provide HPV vaccine education had a positive effect on professional practice. To develop school nurses' practice, interventions should center on increasing knowledge, attitudes, and intention toward providing HPV vaccine education. PMID:25962388

  19. Acceptance Of The HPV Vaccine Among Women, Parents, Community Leaders, and Healthcare Providers In Ohio Appalachia

    PubMed Central

    Katz, Mira L.; Reiter, Paul L.; Heaner, Sarah; Ruffin, Mack T.; Post, Douglas M.; Paskett, Electra D.

    2009-01-01

    To assess HPV vaccine acceptability, focus groups of women (18–26 years), parents, community leaders, and healthcare providers were conducted throughout Ohio Appalachia. Themes that emerged among the 23 focus groups (n=114) about the HPV vaccine were: barriers (general health and vaccine specific), lack of knowledge (cervical cancer and HPV), cultural attitudes, and suggestions for educational materials and programs. Important Appalachian attitudes included strong family ties, privacy, conservative views, and lack of trust of outsiders to the region. There are differences in HPV vaccine acceptability among different types of community members highlighting the need for a range of HPV vaccine educational materials/programs to be developed that are inclusive of the Appalachian culture. PMID:19389447

  20. Social Networks Influence Hispanic College Women’s HPV Vaccine Uptake Decision-making Processes

    PubMed Central

    Stephens, Dionne P.; Thomas, Tami L.

    2014-01-01

    This qualitative study was designed to assess current and preferred social networks that influence human papillomavirus (HPV) vaccine decision making in a sample of Hispanic college women. Individual, semi-structured interviews were conducted with 41 Hispanic college women attending a large southeastern Hispanic-serving institution. Television commercials and discussions with mothers were found to be the most influential social networks for current HPV vaccination beliefs. Internet sites, close family members, and healthcare providers’ communications were preferred social networks for HPV vaccine information. Perceived accessibility and sense of comfort influenced the order in which these social networks’ communications would be accepted. Findings suggest that Hispanic college women utilize specific social networks to gather information and make decisions about HPV vaccination. Continued efforts are needed to promote further understanding of the purpose of the HPV vaccine via these preferred sources of information. PMID:25599082

  1. Update on Adolescent Immunizations.

    PubMed

    Schreier, Rebecca; Halady, Tasia; Bishop, Nina; Chatterjee, Archana

    2016-02-01

    Timely and complete adolescent vaccination remains an elusive public health goal. Three infections for which routine adolescent vaccination is recommended in the U.S. are pertussis, meningococcal disease and human papillomavirus (HPV). These infections and the Tdap, meningococcal and HPV vaccines recommended for adolescents are reviewed in this article. PMID:26999915

  2. Evaluating the Early Benefit of Quadrivalent HPV Vaccine on Genital Warts in Belgium: A Cohort Study

    PubMed Central

    Dominiak-Felden, Geraldine; Gobbo, Corrado; Simondon, François

    2015-01-01

    Genital warts (GWs) are common, with about 5% to 10% of people having at least one episode in their lifetime. They develop about 2–3 months after infection with human papillomavirus (HPV) genotypes 6 and 11. The prophylactic quadrivalent HPV vaccine (qHPV), protects against HPV6/11 infections and diseases. In Belgium, HPV vaccines started to be reimbursed in 2007 and have been fully reimbursed since December 2008 for women 12 to 18 years old. This study aimed at evaluating the real-life benefit of qHPV vaccine introduction in Belgium on GWs by measuring both vaccine impact (VI) at a population level and the direct effect of the qHPV vaccine at an individual level (vaccine effectiveness (VE)), using data from a large sick-fund (MLOZ) reimbursement database. A first reimbursement for imiquimod (most common first-line GWs treatment in Belgium) was used as a surrogate for a first GWs episode; reimbursement of qHPV vaccine was used as surrogate for vaccination. VI was estimated by comparing the incidence of GWs before and after qHPV vaccine introduction in Belgium (ecologic evaluation). VE was assessed by comparing GWs incidences in vaccinated vs. unvaccinated women, among women eligible for HPV vaccination. VI was evaluated in 9,223,384 person-years. Overall, GWs incidence rates decreased significantly between the pre- and post-vaccination periods (-8.1% (95% CI: -15.3; -0.3) for men and women aged 18–59 years. This decrease was highest in women targeted by the HPV vaccination programme (-72.1% (95% CI: -77.9; -64.7) in women aged 16–22 years, with a 43% vaccine uptake in 2013). A significant decrease was also observed in men aged 16-22 years (-51.1%, 95%CI: -67.6; -26.2), suggesting herd-protection. VE was evaluated in 369,881 person-years. Age-adjusted VE for fully vaccinated women was 88.0% (95% CI: 79.4; 93.0). VE was higher when the first dose was given younger and remained high for over 4 years post-vaccination in all ages. High VI and VE of the qHPV

  3. Estimating the clinical benefits of vaccinating boys and girls against HPV-related diseases in Europe

    PubMed Central

    2013-01-01

    Background HPV is related to a number of cancer types, causing a considerable burden in both genders in Europe. Female vaccination programs can substantially reduce the incidence of HPV-related diseases in women and, to some extent, men through herd immunity. The objective was to estimate the incremental benefit of vaccinating boys and girls using the quadrivalent HPV vaccine in Europe versus girls-only vaccination. Incremental benefits in terms of reduction in the incidence of HPV 6, 11, 16 and 18-related diseases (including cervical, vaginal, vulvar, anal, penile, and head and neck carcinomas and genital warts) were assessed. Methods The analysis was performed using a model constructed in Microsoft®Excel, based on a previously-published dynamic transmission model of HPV vaccination and published European epidemiological data on incidence of HPV-related diseases. The incremental benefits of vaccinating 12-year old girls and boys versus girls-only vaccination was assessed (70% vaccine coverage were assumed for both). Sensitivity analyses around vaccine coverage and duration of protection were performed. Results Compared with screening alone, girls-only vaccination led to 84% reduction in HPV 16/18-related carcinomas in females and a 61% reduction in males. Vaccination of girls and boys led to a 90% reduction in HPV 16/18-related carcinomas in females and 86% reduction in males versus screening alone. Relative to a girls-only program, vaccination of girls and boys led to a reduction in female and male HPV-related carcinomas of 40% and 65%, respectively and a reduction in the incidence of HPV 6/11-related genital warts of 58% for females and 71% for males versus girls-only vaccination. Conclusions In Europe, the vaccination of 12-year old boys and girls against HPV 6, 11, 16 and 18 would be associated with substantial additional clinical benefits in terms of reduced incidence of HPV-related genital warts and carcinomas versus girls-only vaccination. The incremental

  4. Facebook for Health Promotion: Female College Students' Perspectives on Sharing HPV Vaccine Information Through Facebook

    PubMed Central

    Tsark, JoAnn; Campo, Shelly; Teti, Michelle

    2015-01-01

    Facebook, a social network site, has been widely used among young adults. However, its potential to be used as a health promotion medium has not been fully examined. This study explored Facebook's potential for sharing human papillomavirus (HPV) vaccine information among female college students in Hawai‘i. Culturally tailored flyers and handouts were developed and distributed at one large university in Hawai‘i to recruit female college students between the age of 18 and 26 having an active Facebook account. Three focus group meetings were conducted to gather student perspectives about how information about HPV vaccine may be best shared via Facebook. We found that students believed Facebook is a good awareness tool but they needed more knowledge about the HPV vaccine to feel comfortable sharing the information. Participants preferred forwarding information to chatting about HPV. Some participants expressed concern that their Facebook friends would think the HPV vaccine information they forwarded on Facebook is spam. Participants suggested prefacing the posted HPV vaccine information with a personal note in their own words to make the message more interesting and relevant to their Facebook friends. Future interventions using Facebook to promote HPV vaccine could provide students with HPV vaccine information from credible sources and ask students to attach personal testimonials or endorsements while forwarding the information on Facebook. PMID:25954600

  5. Facebook for Health Promotion: Female College Students' Perspectives on Sharing HPV Vaccine Information Through Facebook.

    PubMed

    Zhang, Ni; Tsark, JoAnn; Campo, Shelly; Teti, Michelle

    2015-04-01

    Facebook, a social network site, has been widely used among young adults. However, its potential to be used as a health promotion medium has not been fully examined. This study explored Facebook's potential for sharing human papillomavirus (HPV) vaccine information among female college students in Hawai'i. Culturally tailored flyers and handouts were developed and distributed at one large university in Hawai'i to recruit female college students between the age of 18 and 26 having an active Facebook account. Three focus group meetings were conducted to gather student perspectives about how information about HPV vaccine may be best shared via Facebook. We found that students believed Facebook is a good awareness tool but they needed more knowledge about the HPV vaccine to feel comfortable sharing the information. Participants preferred forwarding information to chatting about HPV. Some participants expressed concern that their Facebook friends would think the HPV vaccine information they forwarded on Facebook is spam. Participants suggested prefacing the posted HPV vaccine information with a personal note in their own words to make the message more interesting and relevant to their Facebook friends. Future interventions using Facebook to promote HPV vaccine could provide students with HPV vaccine information from credible sources and ask students to attach personal testimonials or endorsements while forwarding the information on Facebook. PMID:25954600

  6. Emergency medicine physician attitudes toward HPV vaccine uptake in an emergency department setting

    PubMed Central

    Hill, Mandy; Okugo, Glory

    2014-01-01

    A physician's recommendation is the most effective published method of motivating HPV vaccination initiation. The emergency department (ED) is the 'public health safety net', and often the only access to care for underserved populations. Recommendation of the HPV vaccine in the ED is a potential avenue to improve vaccination rates among sub-populations who do not have access to routine medical care. We assessed willingness of EM physicians to recommend the vaccine, target high-risk women, and disclose perceived barriers to vaccination in the ED. A cross sectional study using an 11-item survey, was used to assess physician attitudes toward recommending the HPV vaccine in an ED setting to age eligible patients. 67.4% stated they would recommend the vaccine, 23.9% were neutral, and 8.7% would not recommend the vaccine to age eligible patients in the ED. 41% noted lack of adequate reimbursement for vaccination as a barrier to vaccination in the ED (P < 0.05). Physicians were comfortable targeting women at high risk for cervical cancer for vaccination (P < 0.05). EM physicians are comfortable targeting high-risk women for HPV vaccination in an ED setting. Support of EM physicians in the national effort to improve HPV vaccine uptake is an important step in eradicating a largely preventable yet lethal cancer. PMID:25483493

  7. Parents' opinions of mandatory Human Papillomavirus (HPV) vaccination: does ethnicity matter?

    PubMed Central

    Pierre-Joseph, Natalie; Marquez, Cecilia; Iloka, Sandra; Clark, Jack A.

    2010-01-01

    Objective To explore parents' opinions of school-entry requirements for Human Papillomavirus (HPV) vaccination. Methods We interviewed parents of vaccine-eligible girls attending medical appointments in an urban academic medical center and an affiliated community health center. We used qualitative methods to explore parents' opinions about mandating routine childhood vaccines and HPV vaccine, as well as their feelings about vaccinating their own daughters against HPV. Results 19 Caucasian, 18 African-American, 12 Afro-Caribbean, 3 African, and 21 Latino parents participated. Nearly all parents had allowed their children to receive routine vaccinations and expressed support for mandating these vaccines. Most parents also vaccinated their daughters against HPV: 100% of Caucasian parents, 90% of African-American parents, 73% of Afro-Caribbean/African parents, and 90% of Latino parents. Only 11% of Caucasian parents supported HPV vaccine mandates, however, compared with 78% of African-American, 60% of Afro-Caribbean/African and 90% of Latino parents. Immigrants supported mandates more frequently than U.S.-born parents. Most Caucasian parents opposed mandatory HPV vaccination because they believed the HPV vaccine should be an individual decision as the virus could only be spread by sexual contact. African-American, Afro-Caribbean, African and Latino parents generally viewed mandates as the most effective way to protect their daughters from cervical cancer. Latino parents gave special importance to protecting their daughters from sexually transmitted infections. Conclusions Parents from different racial and ethnic backgrounds expressed unique perspectives about mandatory HPV vaccination, and Caucasians were less likely than parents of other races/ethnicities to support vaccine mandates. PMID:21051001

  8. Determinants of Acceptance and Subsequent Uptake of the HPV Vaccine in a Cohort in Eldoret, Kenya

    PubMed Central

    Vermandere, Heleen; Naanyu, Violet; Mabeya, Hillary; Vanden Broeck, Davy; Michielsen, Kristien; Degomme, Olivier

    2014-01-01

    The development of Human Papillomavirus (HPV) vaccines provides new opportunities in the fight against cervical cancer. Many acceptability studies have revealed high interest in these vaccines, but acceptance is only a precursor of behavior, and many factors, at personal, community and provider level, may inhibit the translation of willingness to vaccinate into actual uptake. Through a longitudinal study in Eldoret, Kenya, HPV vaccine acceptability was measured before a vaccination program (n = 287) and vaccine uptake, as reported by mothers, once the program was finished (n = 256). In between baseline and follow-up, a pilot HPV vaccination program was implemented via the GARDASIL Access Program, in which parents could have their daughter vaccinated for free at the referral hospital. The program was promoted at schools: Health staff informed teachers who were then asked to inform students and parents. Even though baseline acceptance was very high (88.1%), only 31.1% of the women reported at follow-up that their daughter had been vaccinated. The vaccine was declined by 17.7%, while another 51.2% had wanted the vaccination but were obstructed by practical barriers. Being well-informed about the program and baseline awareness of cervical cancer were independently associated with vaccine uptake, while baseline acceptance was correlated in bivariate analysis. Side effects were of great concern, even among those whose daughter was vaccinated. Possible partner disapproval lowered acceptance at baseline, and women indeed reported at follow-up that they had encountered his opposition. In Kenya, women prove to be very willing to have their daughter vaccinated against cervical cancer. However, in this study, uptake was more determined by program awareness than by HPV vaccine acceptance. School-based vaccination might improve coverage since it reduces operational problems for parents. In addition, future HPV vaccination campaigns should address concerns about side

  9. Determinants of acceptance and subsequent uptake of the HPV vaccine in a cohort in Eldoret, Kenya.

    PubMed

    Vermandere, Heleen; Naanyu, Violet; Mabeya, Hillary; Vanden Broeck, Davy; Michielsen, Kristien; Degomme, Olivier

    2014-01-01

    The development of Human Papillomavirus (HPV) vaccines provides new opportunities in the fight against cervical cancer. Many acceptability studies have revealed high interest in these vaccines, but acceptance is only a precursor of behavior, and many factors, at personal, community and provider level, may inhibit the translation of willingness to vaccinate into actual uptake. Through a longitudinal study in Eldoret, Kenya, HPV vaccine acceptability was measured before a vaccination program (n = 287) and vaccine uptake, as reported by mothers, once the program was finished (n = 256). In between baseline and follow-up, a pilot HPV vaccination program was implemented via the GARDASIL Access Program, in which parents could have their daughter vaccinated for free at the referral hospital. The program was promoted at schools: Health staff informed teachers who were then asked to inform students and parents. Even though baseline acceptance was very high (88.1%), only 31.1% of the women reported at follow-up that their daughter had been vaccinated. The vaccine was declined by 17.7%, while another 51.2% had wanted the vaccination but were obstructed by practical barriers. Being well-informed about the program and baseline awareness of cervical cancer were independently associated with vaccine uptake, while baseline acceptance was correlated in bivariate analysis. Side effects were of great concern, even among those whose daughter was vaccinated. Possible partner disapproval lowered acceptance at baseline, and women indeed reported at follow-up that they had encountered his opposition. In Kenya, women prove to be very willing to have their daughter vaccinated against cervical cancer. However, in this study, uptake was more determined by program awareness than by HPV vaccine acceptance. School-based vaccination might improve coverage since it reduces operational problems for parents. In addition, future HPV vaccination campaigns should address concerns about side

  10. Informed consent for HPV vaccination: a relational approach.

    PubMed

    Gottvall, Maria; Tydén, Tanja; Larsson, Margareta; Stenhammar, Christina; Höglund, Anna T

    2015-03-01

    The aim of this study was to explore the relational aspects of the consent process for HPV vaccination as experienced by school nurses, based on the assumption that individuals have interests related to persons close to them, which is not necessarily to be apprehended as a restriction of autonomy; rather as a voluntary and emotionally preferred involvement of their close ones. Thirty Swedish school nurses were interviewed in five focus groups, before the school based vaccination program had started in Sweden. The empirical results were discussed in light of theories on relational autonomy. The school nurses were convinced that parental consent was needed for HPV vaccination of 11-year-old girls, but problems identified were the difficulty to judge when a young person is to be regarded as autonomous and what to do when children and parents do not agree on the decision. A solution suggested was that obtaining informed consent in school nursing is to be seen as a deliberative process, including the child, the parents and the nurse. The nurses described how they were willing strive for a dialogue with the parents and negotiate with them in the consent process. Seeing autonomy as relational might allow for a more dialogical approach towards how consent is obtained in school based vaccination programs. Through such an approach, conflicts of interests can be made visible and become possible to deal with in a negotiating dialogue. If the school nurses do not focus exclusively on accepting the individual parent's choice, but strive to engage in a process of communication and deliberation, the autonomy of the child might increase and power inequalities might be reduced. PMID:23275146

  11. Understanding differences in predictions of HPV vaccine effectiveness: A comparative model-based analysis.

    PubMed

    Van de Velde, Nicolas; Brisson, Marc; Boily, Marie-Claude

    2010-07-26

    Mathematical models of HPV vaccine effectiveness and cost-effectiveness have produced conflicting results. The aim of this study was to use mathematical models to compare and isolate the impact of the assumptions most commonly made when modeling the effectiveness of HPV vaccines. Our results clearly show that differences in how we model natural immunity, herd immunity, partnership duration, HPV types, and waning of vaccine protection lead to important differences in the predicted effectiveness of HPV vaccines. These results are important and useful to assist modelers/health economists in choosing the appropriate level of complexity to include in their models, provide epidemiologists with insight on key data necessary to increase the robustness of model predictions, and help decision makers better understand the reasons underlying conflicting results from HPV models. PMID:20573580

  12. Control of HPV-associated tumors by innovative therapeutic HPV DNA vaccine in the absence of CD4+ T cells

    PubMed Central

    2014-01-01

    Human papillomavirus (HPV) infections are particularly problematic for HIV + and solid organ transplant patients with compromised CD4+ T cell-dependent immunity as they produce more severe and progressive disease compared to healthy individuals. There are no specific treatments for chronic HPV infection, resulting in an urgent unmet need for a modality that is safe and effective for both immunocompromised and otherwise normal patients with recalcitrant disease. DNA vaccination is attractive because it avoids the risks of administration of live vectors to immunocompromised patients, and can induce potent HPV-specific cytotoxic T cell responses. We have developed a DNA vaccine (pNGVL4a-hCRTE6E7L2) encoding calreticulin (CRT) fused to E6, E7 and L2 proteins of HPV-16, the genotype associated with approximately 90% vaginal, vulvar, anal, penile and oropharyngeal HPV-associated cancers and the majority of cervical cancers. Administration of the DNA vaccine by intramuscular (IM) injection followed by electroporation induced significantly greater HPV-specific immune responses compared to IM injection alone or mixed with alum. Furthermore, pNGVL4a-hCRTE6E7L2 DNA vaccination via electroporation of mice carrying an intravaginal HPV-16 E6/E7-expressing syngeneic tumor demonstrated more potent therapeutic effects than IM vaccination alone. Of note, administration of the DNA vaccine by IM injection followed by electroporation elicited potent E6 and E7-specific CD8+ T cell responses and antitumor effects despite CD4+ T cell-depletion, although no antibody response was detected. While CD4+ T cell-depletion did reduce the E6 and E7-specific CD8+ T cell response, it remained sufficient to prevent subcutaneous tumor growth and to eliminate circulating tumor cells in a model of metastatic HPV-16+ cancer. Thus, the antibody response was CD4-dependent, whereas CD4+ T cell help enhanced the E6/E7-specific CD8+ T cell immunity, but was not required. Taken together, our data suggest that

  13. Potential cost-effectiveness of the nonavalent human papillomavirus (HPV) vaccine.

    PubMed

    Drolet, Mélanie; Laprise, Jean-François; Boily, Marie-Claude; Franco, Eduardo L; Brisson, Marc

    2014-05-01

    Randomized clinical trials are currently examining the efficacy of a nonavalent human papillomavirus (HPV) vaccine, including HPV-types 6/11/16/18/31/33/45/52/58. Evidence on the cost-effectiveness of the nonavalent is required for timely policy-decisions. We compared the potential cost-effectiveness of the nonavalent and quadrivalent HPV vaccines. We used a multi-type individual-based transmission-dynamic model of HPV infection and diseases, 70-year time-horizon, 3% discount rate and healthcare payer perspective. We calibrated the model to Canadian sexual behavior and epidemiologic data, and estimated Quality-Adjusted Life-Years (QALYs) lost and costs ($CAN 2010) from the literature. Under base-case assumptions (vaccinating 10-year-old girls, 80% coverage, 95$/dose, vaccine-type efficacy = 95%, cross-protection for the quadrivalent vaccine, duration of vaccine-type protection (cross-protection) = 20 (10) years), using the quadrivalent and nonavalent vaccines is estimated to cost $15,528 [12,056; 19,140] and $12,203 [9,331; 17,292] per QALY-gained, respectively. At equal price, the nonavalent vaccine is more cost-effective than the quadrivalent vaccine, even when assuming both shorter duration of protection (nonavalent = 20 years vs. quadrivalent = lifelong) and lower vaccine-type efficacy (nonavalent = 85% vs. quadrivalent = 95%). However, the additional cost per dose of the nonavalent vaccine should not exceed $11 to remain more cost-effective than the quadrivalent vaccine, and $24 to represent a cost-effective alternative to the quadrivalent vaccine (using a $40,000/QALY-gained threshold). The nonavalent vaccine can be a cost-effective alternative to the quadrivalent vaccine, even in scenarios where nonavalent vaccine efficacy is 85%. However, because most cervical cancers are caused by HPV-16/18, it is unlikely that the nonavalent would be used if its efficacy against these types is lower than current HPV vaccines. PMID:24174175

  14. Tracking the global spread of vaccine sentiments: The global response to Japan's suspension of its HPV vaccine recommendation

    PubMed Central

    Larson, Heidi J; Wilson, Rose; Hanley, Sharon; Parys, Astrid; Paterson, Pauline

    2014-01-01

    In June 2013 the Japanese Ministry of Health, Labor, and Welfare (MHLW) suspended its HPV vaccination recommendation after a series of highly publicized alleged adverse events following immunization stoked public doubts about the vaccine's safety. This paper examines the global spread of the news of Japan's HPV vaccine suspension through online media, and takes a retrospective look at non-Japanese media sources that were used to support those claiming HPV vaccine injury in Japan. Methods: Two searches were conducted. One searched relevant content in an archive of Google Alerts on vaccines and vaccine preventable diseases. The second search was conducted using Google Search on January 6th 2014 and on July 18th 2014, using the keywords, “HPV vaccine Japan” and “cervical cancer vaccine Japan.” Both searches were used as Google Searches render more (and some different) results than Google Alerts. Results: Online media collected and analyzed totalled 57. Sixty 3 percent were published in the USA, 23% in Japan, 5% in the UK, 2% in France, 2% in Switzerland, 2% in the Philippines, 2% in Kenya and 2% in Denmark. The majority took a negative view of the HPV vaccine, the primary concern being vaccine safety. Discussion: The news of Japan's suspension of the HPV vaccine recommendation has traveled globally through online media and social media networks, being applauded by anti-vaccination groups but not by the global scientific community. The longer the uncertainty around the Japanese HPV vaccine recommendation persists, the further the public concerns are likely to travel. PMID:25483472

  15. HPV Infection in Cervical and Other Cancers in Saudi Arabia: Implication for Prevention and Vaccination.

    PubMed

    Alsbeih, Ghazi

    2014-01-01

    Human papillomavirus (HPV) is closely associated with cervical cancer that the incidence of this tumor is regarded as a surrogate marker for HPV infection in countries lacking epidemiological studies. HPV is also implicated in subsets of anogenital and oropharyngeal cancers. Although cervical cancer is the third most common cancer in women worldwide, its reported incidence is low in Saudi Arabia, ranking number 12 between all cancers in females and accounts only for 2.4% of all new cases, despite the lack of national screening programs. However, the limited available studies from Saudi Arabia indicate that HPV prevalence and genotypes' distribution in invasive cervical cancer show similar pattern as in the world. Cytology screening (Pap smear) and HPV vaccinations are the two preventive measures against cervical cancer. The two available vaccines are effective against the two most common HPV genotypes (HPV-16 and -18). Since 92% of cervical tumors in the Kingdom are infected with HPV of which 78% are HPV-16 and -18 genotypes, vaccination is expected to protect against more than two-third of cervical cancers in Saudi Arabia. Nevertheless, due to its low incidence (2.1/100,000 women), a proper cost-effectiveness analysis is required to justify the implementation of a costly vaccine bearing in mind that HPV could potentially be associated with about 3% of all cancers. However, further studies are needed to ascertain the real prevalence of HPV at the population level at large, its association with various types of cancers, and also the impact of local tradition and emerging behavioral trends that could affect HPV transmission and consequently the effectiveness of applying national vaccination program. PMID:24744990

  16. HPV Infection in Cervical and Other Cancers in Saudi Arabia: Implication for Prevention and Vaccination

    PubMed Central

    Alsbeih, Ghazi

    2014-01-01

    Human papillomavirus (HPV) is closely associated with cervical cancer that the incidence of this tumor is regarded as a surrogate marker for HPV infection in countries lacking epidemiological studies. HPV is also implicated in subsets of anogenital and oropharyngeal cancers. Although cervical cancer is the third most common cancer in women worldwide, its reported incidence is low in Saudi Arabia, ranking number 12 between all cancers in females and accounts only for 2.4% of all new cases, despite the lack of national screening programs. However, the limited available studies from Saudi Arabia indicate that HPV prevalence and genotypes’ distribution in invasive cervical cancer show similar pattern as in the world. Cytology screening (Pap smear) and HPV vaccinations are the two preventive measures against cervical cancer. The two available vaccines are effective against the two most common HPV genotypes (HPV-16 and -18). Since 92% of cervical tumors in the Kingdom are infected with HPV of which 78% are HPV-16 and -18 genotypes, vaccination is expected to protect against more than two-third of cervical cancers in Saudi Arabia. Nevertheless, due to its low incidence (2.1/100,000 women), a proper cost-effectiveness analysis is required to justify the implementation of a costly vaccine bearing in mind that HPV could potentially be associated with about 3% of all cancers. However, further studies are needed to ascertain the real prevalence of HPV at the population level at large, its association with various types of cancers, and also the impact of local tradition and emerging behavioral trends that could affect HPV transmission and consequently the effectiveness of applying national vaccination program. PMID:24744990

  17. Quadrivalent HPV vaccine effectiveness against high-grade cervical lesions by age at vaccination: A population-based study.

    PubMed

    Herweijer, Eva; Sundström, Karin; Ploner, Alexander; Uhnoo, Ingrid; Sparén, Pär; Arnheim-Dahlström, Lisen

    2016-06-15

    Human papillomavirus (HPV) types 16/18, included in HPV vaccines, contribute to the majority of cervical cancer, and a substantial proportion of cervical intraepithelial neoplasia (CIN) grades 2/3 or worse (CIN2+/CIN3+) including adenocarcinoma in situ or worse. The aim of this study was to quantify the effect of quadrivalent HPV (qHPV) vaccination on incidence of CIN2+ and CIN3+. A nationwide cohort of girls and young women resident in Sweden 2006-2013 and aged 13-29 (n = 1,333,691) was followed for vaccination and histologically confirmed high-grade cervical lesions. Data were collected using the Swedish nationwide healthcare registers. Poisson regression was used to calculate incidence rate ratios (IRRs) and vaccine effectiveness [(1-IRR)x100%] comparing fully vaccinated with unvaccinated individuals. IRRs were adjusted for attained age and parental education, and stratified on vaccination initiation age. Effectiveness against CIN2+ was 75% (IRR = 0.25, 95%CI = 0.18-0.35) for those initiating vaccination before age 17, and 46% (IRR = 0.54, 95%CI = 0.46-0.64) and 22% (IRR = 0.78, 95%CI = 0.65-0.93) for those initiating vaccination at ages 17-19, and at ages 20-29, respectively. Vaccine effectiveness against CIN3+ was similar to vaccine effectiveness against CIN2+. Results were robust for both women participating to the organized screening program and for women at prescreening ages. We show high effectiveness of qHPV vaccination on CIN2+ and CIN3+ lesions, with greater effectiveness observed in girls younger at vaccination initiation. Continued monitoring of impact of HPV vaccination in the population is needed in order to evaluate both long-term vaccine effectiveness and to evaluate whether the vaccination program achieves anticipated effects in prevention of invasive cervical cancer. PMID:26856527

  18. Compensation programs after withdrawal of the recommendation for HPV vaccine in Japan.

    PubMed

    Yuji, Koichiro; Nakada, Haruka

    2016-05-01

    HPV vaccinations were recommended with the backing of a Japanese government subsidy program in 2010, and were included in the National Immunization Program in April 2013. However, the Ministry of Health, Labour, and Welfare withdrew the recommendation for the HPV vaccination in June 2013. We investigated HPV vaccine injury compensation programs for both the national and local governments. Approximately 3.38 million girls were vaccinated, and 2,584 complained of health problems. The majority of these received the vaccine shot as a non-routine vaccination. In total, 98 people developed health problems and applied for assistance from 2011 to 2014, but no cases have been processed since October 2014. Several local governments are providing their own compensation program for cases of vaccine adverse reactions, but the number is extremely low (16 of 1,741 municipalities and 1 of 47 prefectures). The local governments that are providing compensation are largely those where HPV vaccine victim support groups are prominent. The confusion regarding the national program for HPV vaccine injury was caused by the discrepancy between the compensation programs for those vaccinated under the immunization law and for those who received voluntary vaccinations. The establishment of a new compensation program might be key to finding a lasting resolution. PMID:26513303

  19. Efficacy of Vaccination against HPV Infections to Prevent Cervical Cancer in France: Present Assessment and Pathways to Improve Vaccination Policies

    PubMed Central

    Ribassin-Majed, Laureen; Lounes, Rachid; Clémençon, Stephan

    2012-01-01

    Background Seventy percent of sexually active individuals will be infected with Human Papillomavirus (HPV) during their lifetime. These infections are incriminated for almost all cervical cancers. In France, 3,068 new cases of cervical cancer and 1,067 deaths from cervical cancer occurred in 2005. Two vaccines against HPV infections are currently available and vaccination policies aim to decrease the incidence of HPV infections and of cervical cancers. In France, vaccine coverage has been reported to be low. Methods We developed a dynamic model for the heterosexual transmission of Human Papillomavirus types 16 and 18, which are covered by available vaccines. A deterministic model was used with stratification on gender, age and sexual behavior. Immunity obtained from vaccination was taken into account. The model was calibrated using French data of cervical cancer incidence. Results In view of current vaccine coverage and screening, we expected a 32% and 83% reduction in the incidence of cervical cancers due to HPV 16/18, after 20 years and 50 years of vaccine introduction respectively. Vaccine coverage and screening rates were assumed to be constant. However, increasing vaccine coverage in women or vaccinating girls before 14 showed a better impact on cervical cancer incidence. On the other hand, performing vaccination in men improves the effect on cervical cancer incidence only moderately, compared to strategies in females only. Conclusion While current vaccination policies may significantly decrease cervical cancer incidence, other supplementary strategies in females could be considered in order to improve vaccination efficacy. PMID:22427828

  20. The use of urine in the follow-up of HPV vaccine trials

    PubMed Central

    Vorsters, Alex; Van Keer, Severien; Van Damme, Pierre

    2015-01-01

    Prevention and treatment of human papillomavirus related cervical cancer through vaccination is a relative new field with many scientific, technological and implementational challenges requiring numerous new clinical trials. The initial prophylactic HPV vaccine trials allowed to set new end-points based on persistent infection in order to determine vaccine efficacy for prevention of cervical cancer. Major progress has been made regarding detection of HPV DNA in urine and high correlations between urinary HPV DNA and cervical infections have been established. Urine sampling has a number of assets such as its non-invasive character, and allowing for self-collection at home creating options to simplify follow-up of HPV in women participating in HPV vaccine efficacy trials. The current reported variability in urinary HPV sampling and detection can be overcome through relative simple sampling and testing guidelines. Determining persistent infection or lack of therapy response by urinary HPV detection may be an interesting approach to assess a viral end-point in HPV prophylactic and therapeutic vaccine efficacy trials for women. PMID:25664398

  1. HPV

    MedlinePlus

    Human papillomaviruses (HPV) are common viruses that can cause warts. There are more than 100 types of HPV. Most are harmless, but about 30 types put ... either low-risk or high-risk. Low-risk HPV can cause genital warts. High-risk HPV can ...

  2. HPV vaccine hesitancy: Findings from a statewide survey of healthcare providers

    PubMed Central

    McRee, Annie-Laurie; Gilkey, Melissa B.; Dempsey, Amanda F.

    2014-01-01

    Introduction Healthcare provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy. Method A statewide sample (n=575) of Minnesota healthcare providers (20% pediatricians, 47% family medicine physicians, 33% nurse practitioners) completed our online survey in April 2013. Results Only 76% of healthcare providers reported routinely recommending HPV vaccine for girls ages 11-12, and far fewer (46%) did so for boys (p<.001). A majority of providers reported asking questions about parents' concerns (74%), but many lacked time to probe reasons (47%) or felt that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p<.05). Discussion Findings suggest that providers' perceptions of hesitancy may discourage them from routinely recommending HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates. PMID:25017939

  3. A Cluster-Randomized Trial to Evaluate a Mother-Daughter Dyadic Educational Intervention for Increasing HPV Vaccination Coverage in American Indian Girls.

    PubMed

    Winer, Rachel L; Gonzales, Angela A; Noonan, Carolyn J; Buchwald, Dedra S

    2016-04-01

    We evaluated whether delivering educational presentations on human papillomavirus (HPV) to American Indian mothers affected HPV vaccination rates in their adolescent daughters. In March-April 2012, we recruited Hopi mothers or female guardians with daughters aged 9-12 years for a cluster-randomized intervention study on the Hopi Reservation. Participants attended mother-daughter dinners featuring educational presentations for mothers on either HPV (intervention) or juvenile diabetes (control) and completed baseline surveys. Eleven months later, we surveyed mothers on their daughters' HPV vaccine uptake. We also reviewed aggregated immunization reports from the Indian Health Service to assess community-level HPV vaccination coverage from 2007 to 2013. Ninety-seven mother-daughter dyads participated; nine mothers reported that their daughters completed the three-dose HPV vaccination series before recruitment. Among the remaining mothers, 63 % completed the follow-up survey. Adjusting for household income, the proportion of daughters completing vaccination within 11 months post-intervention was similar in the intervention and control groups (32 vs. 28 %, adjusted RR = 1.2, 95 % confidence interval (CI) 0.6-2.3). Among unvaccinated daughters, those whose mothers received HPV education were more likely to initiate vaccination (50 vs. 27 %, adjusted RR = 2.6, 95 % CI 1.4-4.9) and complete three doses (adjusted RR = 4.0, 95 % CI 1.2-13.1) than girls whose mothers received diabetes education. Community-level data showed that 80 % of girls aged 13-17 years and 20 % of girls aged 11-12 completed the vaccination series by 2013. HPV vaccine uptake in Hopi girls aged 13-17 years is significantly higher than the U.S. national average. Brief educational presentations on HPV delivered to American Indian mothers might increase HPV vaccination rates in daughters aged 9-12 years. PMID:26399648

  4. Increasing Cervical Cancer and Human Papillomavirus Prevention Knowledge and HPV Vaccine Uptake through Mother/Daughter Education.

    PubMed

    Obulaney, Patricia A; Gilliland, Irene; Cassells, Holly

    2016-01-01

    This evidence-based initiative assessed the impact of language-appropriate cervical cancer and human papillomavirus (HPV) prevention education on knowledge level and HPV vaccine uptake among mothers and their daughters. Forty-one mother/daughter dyads from a low-cost, faith-based clinic for the uninsured in southeastern Texas participated in the nurse practitioner-led cervical cancer prevention educational sessions. Spanish was the primary language for the majority of participating mothers. The project produced appreciable knowledge increase and HPV vaccine uptake intent. Aggregate HPV vaccine uptake numbers for the clinic increased considerably compared to HPV vaccine administration prior to educational intervention. PMID:26813054

  5. Guidelines of the Italian Society for Virology on HPV testing and vaccination for cervical cancer prevention

    PubMed Central

    Barzon, Luisa; Giorgi, Colomba; Buonaguro, Franco M; Palù, Giorgio

    2008-01-01

    Objective To provide guidelines for health-care providers on strategies for cervical cancer prevention based on HPV testing and anti-HPV vaccination. Outcomes Overall efficacy of different preventive strategies, assessing reduction in the incidence of invasive cervical cancer and precancerous lesions. Evidence Medline and the Cochrane Database were searched for articles in English on subjects related to HPVs, HPV diagnosis, HPV anogenital lesions, cervical cancer, HPV testing, and HPV vaccines, in order to elaborate an up-dated document. Relevant Italian Government publications and position papers from appropriate health and family planning organizations were also reviewed. Values The quality of the evidence and ranking of recommendations for practice were rated using criteria defined by SIV, which were adapted from the Canadian Task Force on Preventive Health Care. PMID:19087272

  6. HPV Vaccination Among Young Adult Women: A Perspective From Appalachian Kentucky

    PubMed Central

    Head, Katharine J.; Vanderpool, Robin C.

    2013-01-01

    Introduction Few studies have assessed barriers to human papillomavirus (HPV) vaccination uptake and adherence, particularly among women of Appalachian Kentucky, a population with higher rates of cervical cancer, lower rates of HPV vaccination, and lower socioeconomic status compared with the rest of the nation. The objective of this study was to address women’s reasons for declining the HPV vaccine and, among women who initiated the vaccine series, barriers to completion of the 3-dose regimen. Methods We recruited 17 women aged 18 to 26 from a Federally Qualified Health Center who participated in in-depth, semistructured telephone interviews. All interviews were audio-recorded and transcribed verbatim; analysis of the interview transcripts was an iterative process conducted by all 3 authors. Results We identified 3 primary barriers: 1) a knowledge gap wherein women are both uninformed and misinformed about cervical cancer, HPV, and the HPV vaccine, all of which affect vaccination behaviors; 2) environmental and tangible barriers (transportation and prioritizing health over other responsibilities such as child care, work, and school); and 3) ambiguous information sources, which contribute to misinformation and subsequently affect vaccination decisions. Conclusion Health professionals should use clear and purposeful communication about how cervical cancer develops, the purpose and safety of the HPV vaccine, and the necessity of completing the 3-dose series. Health promotion campaigns and services tailored for young women in Appalachian Kentucky that focus on increasing knowledge and eliminating barriers are needed. PMID:23391293

  7. Human Papillomavirus (HPV) Risk Factors, Vaccination Patterns, and Vaccine Perceptions among a Sample of Male College Students

    ERIC Educational Resources Information Center

    Fontenot, Holly B.; Collins Fantasia, Heidi; Charyk, Anna; Sutherland, Melissa A.

    2014-01-01

    Objective: To examine human papillomavirus (HPV) vaccination rates, including initiation and completion of the vaccine series, and barriers to vaccination in a sample of male college students. Participants: Male students between the ages of 18 and 25 who reported being currently or previously sexually active (N = 735). Methods: A cross-sectional…

  8. Focal epithelial hyperplasia by human papillomavirus (HPV)-32 misdiagnosed as HPV-16 and treated with combination of retinoids, imiquimod and quadrivalent HPV vaccine.

    PubMed

    Gemigniani, Franco; Hernández-Losa, Javier; Ferrer, Berta; García-Patos, Vicente

    2015-12-01

    Focal epithelial hyperplasia (FEH) or Heck's disease is a rare, benign and asymptomatic mucosal proliferation associated with human papillomavirus (HPV) infection, mainly with genotypes 13 and 32. We report a florid case of FEH in an 11-year-old Haitian girl with systemic lupus erythematosus receiving immunosuppressive therapy. Cryotherapy was previously performed on numerous occasions with no results. We decided to prescribe a non-invasive and more comfortable treatment. A combination of topical retinoid and imiquimod cream was well tolerated and led to an important improvement. The evidence of infection by HPV-16 detected by polymerase chain reaction (PCR) technique, prompted us to prescribe the quadrivalent HPV vaccine (types 6, 11,16 and 18). Subsequent PCR sequencing with generic primers GP5-GP6 and further BLAST comparative analysis confirmed that genomic viral sequence in our case truly corresponded with HPV-32. This molecular misdiagnosis can be explained by the similarity between genomic sequences of both HPV-16 and -32 genotypes. At the 1-year follow up, we observed total clinical improvement and no recurrences of the disease. Complete healing in this case may correspond to a potential action of topical retinoid, imiquimod and the cross-protection mechanism of the quadrivalent HPV vaccine. PMID:26047065

  9. Perception of Human Papillomavirus Infection, Cervical Cancer and HPV Vaccination in North Indian Population

    PubMed Central

    Hussain, Showket; Nasare, Vilas; Kumari, Malasha; Sharma, Shashi; Khan, Mohammad Aijaz; Das, Bhudev C.; Bharadwaj, Mausumi

    2014-01-01

    Background Human Papillomavirus (HPV) -associated cervical cancer is the second-most common cancer in women worldwide but it is the most frequent gynaecological cancer and cancer associated death in India women. The objective of this study was to assess knowledge about cervical cancer, HPV, HPV vaccine, HPV vaccine acceptance among school and undergraduates students and their parent’s perception about acceptance of HPV vaccine in Northern part of India (Delhi and NCR regions). Materials and Methods A qualitative questionnaire based survey among 2500 urban/rural students aged 12–22 years was conducted. Results Overall, a low frequency (15%) of HPV and cervical cancer awareness was observed in students and their parents. However, the awareness was much higher in females belonging to urban setup compared to boys with a perception that HPV causes cervical cancer in women only. Additionally, only (13%) participants who were aware of cervical cancer and HPV) were willing to accept HPV vaccination. Apparently, parents of female students were two times more willing to accept HPV vaccination for their ward than male students (p<0.001; OR 95%CI = 2.09 (1.58–2.76). Conclusion Cervical cancer and HPV awareness among school, undergraduate students and also to their parents was found to be very low in this part of India. The level of awareness and education appears to be insignificant determinants in rural compared to urban setup. Better health education will be needed to maximize public awareness for cervical cancer prevention. PMID:25386964

  10. Phase II studies to select the formulation of a multivalent HPV L1 virus-like particle (VLP) vaccine

    PubMed Central

    Luxembourg, Alain; Brown, Darron; Bouchard, Celine; Giuliano, Anna R; Iversen, Ole-Erik; Joura, Elmar A; Penny, Mary E; Restrepo, Jaime A; Romaguera, Josefina; Maansson, Roger; Moeller, Erin; Ritter, Michael; Chen, Joshua

    2015-01-01

    Our objective was to develop a multivalent prophylactic HPV vaccine that protects against infection and disease caused by HPV16/18 (oncogenic types in existing prophylactic vaccines) plus additional oncogenic types by conducting 3 Phase II studies comparing the immunogenicity (i.e., anti-HPV6/11/16/18 geometric mean titers [GMT]) and safety of 7 vaccine candidates with the licensed quadrivalent HPV6/11/16/18 vaccine (qHPV vaccine) in young women ages 16–26. In the first study (Study 1), subjects received one of 3 dose formulations of an 8-valent HPV6/11/16/18/31/45/52/58 vaccine or qHPV vaccine (control). In Study 2, subjects received one of 3 dose formulations (termed low-, mid-, and high-dose formulations, respectively) of a 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine (9vHPV vaccine) or qHPV vaccine (control). In Study 3, subjects concomitantly received qHPV vaccine plus 5-valent HPV31/33/45/52/58 or qHPV vaccine plus placebo (control). All vaccines were administered at day 1/month 2/month 6. In studies 1 and 3, anti-HPV6/11/16/18 GMTs at month 7 were non-inferior in the experimental arms compared with the control arm; however, there was a trend for lower antibody responses for all 4 HPV types. In Study 2, this immune interference was overcome with the mid- and high-dose formulations of the 9vHPV vaccine by increasing antigen and adjuvant doses. In all 3 studies, all vaccine candidates were strongly immunogenic with respect to HPV31/33/45/52/58 and were well tolerated. Based on the totality of the results, the middle dose formulation of the 9vHPV vaccine was selected for Phase III evaluation. Each 0.5mL dose contains 30μg/40μg/60μg/40μg/20μg/20μg/20μg/20μg/20μg of HPV6/11/16/18/31/33/45/52/58 virus-like particles, and 500μg of amorphous aluminum hydroxyphosphate sulfate adjuvant.ClinicalTrials.gov numbers NCT00260039, NCT00543543, and NCT00551187. PMID:25912208

  11. Phase II studies to select the formulation of a multivalent HPV L1 virus-like particle (VLP) vaccine.

    PubMed

    Luxembourg, Alain; Brown, Darron; Bouchard, Celine; Giuliano, Anna R; Iversen, Ole-Erik; Joura, Elmar A; Penny, Mary E; Restrepo, Jaime A; Romaguera, Josefina; Maansson, Roger; Moeller, Erin; Ritter, Michael; Chen, Joshua

    2015-01-01

    Our objective was to develop a multivalent prophylactic HPV vaccine that protects against infection and disease caused by HPV16/18 (oncogenic types in existing prophylactic vaccines) plus additional oncogenic types by conducting 3 Phase II studies comparing the immunogenicity (i.e., anti-HPV6/11/16/18 geometric mean titers [GMT]) and safety of 7 vaccine candidates with the licensed quadrivalent HPV6/11/16/18 vaccine (qHPV vaccine) in young women ages 16-26. In the first study (Study 1), subjects received one of 3 dose formulations of an 8-valent HPV6/11/16/18/31/45/52/58 vaccine or qHPV vaccine (control). In Study 2, subjects received one of 3 dose formulations (termed low-, mid-, and high-dose formulations, respectively) of a 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine (9vHPV vaccine) or qHPV vaccine (control). In Study 3, subjects concomitantly received qHPV vaccine plus 5-valent HPV31/33/45/52/58 or qHPV vaccine plus placebo (control). All vaccines were administered at day 1/month 2/month 6. In studies 1 and 3, anti-HPV6/11/16/18 GMTs at month 7 were non-inferior in the experimental arms compared with the control arm; however, there was a trend for lower antibody responses for all 4 HPV types. In Study 2, this immune interference was overcome with the mid- and high-dose formulations of the 9vHPV vaccine by increasing antigen and adjuvant doses. In all 3 studies, all vaccine candidates were strongly immunogenic with respect to HPV31/33/45/52/58 and were well tolerated. Based on the totality of the results, the middle dose formulation of the 9vHPV vaccine was selected for Phase III evaluation. Each 0.5mL dose contains 30μg/40μg/60μg/40μg/20μg/20μg/20μg/20μg/20μg of HPV6/11/16/18/31/33/45/52/58 virus-like particles, and 500μg of amorphous aluminum hydroxyphosphate sulfate adjuvant.ClinicalTrials.gov numbers NCT00260039, NCT00543543, and NCT00551187. PMID:25912208

  12. Strategies to vaccinate against cancer of the cervix: feasibility of a school-based HPV vaccination program in Peru.

    PubMed

    Penny, Mary; Bartolini, Rosario; Mosqueira, N Rocio; LaMontagne, D Scott; Mendoza, Maria Ana; Ramos, Irma; Winkler, Jennifer L; Villafana, Jose; Janmohamed, Amynah; Jumaan, Aisha O

    2011-07-12

    Operational research using a mixed method, cross-sectional, case-study approach assessed the feasibility and health system impact of large-scale implementation of human papillomavirus (HPV) vaccination into routine vaccine delivery by the Ministry of Health in Peru. The strategy was school-based vaccination of fifth grade girls in 527 primary schools in Piura region. Our evaluation showed that school-based HPV vaccination is feasible without major changes in existing health systems. This was reflected in the opinions of health personnel, the lack of impact on other vaccine coverage, and the high HPV vaccine coverage documented in routine records and by an independent community-based survey. PMID:21609748

  13. Cost-effectiveness of vaccination with a quadrivalent HPV vaccine in Germany using a dynamic transmission model

    PubMed Central

    2012-01-01

    Introduction Persistent infections with human papillomavirus (HPV) are a necessary cause of cervical cancer and are responsible for important morbidity in men and women. Since 2007, HPV vaccination has been recommended and funded for all girls aged 12 to 17 in Germany. A previously published cost-effectiveness analysis, using a static model, showed that a quadrivalent HPV vaccination programme for 12-year-old girls in Germany would be cost effective. Here we present the results from a dynamic transmission model that can be used to evaluate the impact and cost-effectiveness of different vaccination schemas. Methods We adapted a HPV dynamic transmission model, which has been used in other countries, to the German context. The model was used to compare a cervical cancer screening only strategy with a strategy of combining vaccination of females aged 12–17 years old and cervical cancer screening, based on the current recommendations in Germany. In addition, the impact of increasing vaccination coverage in this cohort of females aged 12–17 years old was evaluated in sensitivity analysis. Results The results from this analysis show that the current quadrivalent HPV vaccination programme of females ages 12 to 17 in Germany is cost-effective with an ICER of 5,525€/QALY (quality adjusted life year). The incremental cost-effectiveness ratio (ICER) increased to 10,293€/QALY when the vaccine effects on HPV6/11 diseases were excluded. At steady state, the model predicted that vaccinating girls aged 12 to 17 could reduce the number of HPV 6/11/16/18-related cervical cancers by 65% and genital warts among women and men by 70% and 48%, respectively. The impact on HPV-related disease incidence and costs avoided would occur relatively soon after initiating the vaccine programme, with much of the early impact being due to the prevention of HPV6/11-related genital warts. Conclusions These results show that the current quadrivalent HPV vaccination and cervical cancer screening

  14. The Acceptability of Human Papillomavirus (HPV) Vaccination among Women with Physical Disabilities

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Chen, Si-Fan; Lin, Lan-Ping; Hsu, Shang-Wei; Chang, Mao-Jung; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to explore awareness and acceptability of human papillomavirus (HPV) vaccination and to identify factors influencing HPV acceptability among women with physical disabilities in Taiwan. The study participants were 438 adult women with physical disabilities, aged 18-69 years. The participants were all officially registered as…

  15. Younger age at initiation of the human papillomavirus (HPV) vaccination series is associated with higher rates of on-time completion.

    PubMed

    St Sauver, Jennifer L; Rutten, Lila J Finney; Ebbert, Jon O; Jacobson, Debra J; McGree, Michaela E; Jacobson, Robert M

    2016-08-01

    Vaccination rates for human papillomavirus (HPV) have remained disappointingly low. It is critical to identify methods to increase on-time vaccine series completion rates (before 13 or 15years). To determine whether younger age (9 to 10years of age) at HPV vaccine series initiation was associated with improved on-time completion rates compared to initiation at 11 to 12years, we examined the prevalence of on-time HPV vaccine series completion rates from August 2006 through December 2012 in a large, population-based cohort of children and adolescents (aged 9.5 to 27years) residing in Olmsted County, MN on December 31, 2012 (n=36,223). We compared age at vaccine initiation between individuals who successfully completed both 2 and 3 doses of the vaccination series on-time (before age 13.5 or 15.0years) using multivariate logistic regression. On-time completion of both 2 and 3 doses of the vaccine series by age 13.5 or 15.0years was significantly associated with initiation at 9 to 10years as compared to 11 to 12years after adjusting for sex, race, insurance status, frequent health care visits, and year of first vaccination (all p<.01). Interventions focused on beginning the vaccination series at 9 to 10years of age may result in higher rates of timely series completion. PMID:26930513

  16. Understanding sub-optimal HPV vaccine uptake among ethnic minority girls

    PubMed Central

    Bastani, Roshan; Glenn, Beth; Tsui, Jennifer; Chang, L. Cindy; Marchand, Erica; Taylor, Victoria M.; Singhal, Rita

    2011-01-01

    Background The introduction of HPV vaccines represents a breakthrough in the primary prevention of cervical cancer. However, little is known about vaccination uptake and correlates among U.S. low-income, ethnic minority and immigrant populations who may benefit most from the vaccine. Methods Telephone interviews (N=490) were conducted in six languages between January and November 2009 among mothers of vaccine-eligible girls (ages 9–18) using the Los Angeles County Department of Public Health, Office of Women’s Health service referral hotline. HPV and vaccine awareness, knowledge, beliefs, barriers, and daughter’s vaccine receipt were assessed. Results The sample consisted of low-income, uninsured, ethnic minority and immigrant women. Only 29% of daughters initiated the vaccine and 11% received all three doses. No ethnic differences were observed in initiation or completion rates. Ethnic differences were observed in HPV awareness, perceived risk, and other immunization related beliefs. The strongest predictor of initiation was vaccine awareness (OR=12.00). Daughter’s age and reporting a younger acceptable age for vaccination were positively associated with initiation. Mothers of unvaccinated girls reported lacking information about the vaccine to make a decision (66%) and not knowing where they could obtain the vaccine (74%). Conclusion Vaccination rates in this sample were lower than state and national estimates, and were associated with low levels of vaccine awareness. Interventions, including culturally targeted messaging, may be helpful for enhancing HPV vaccine knowledge, modifying vaccine-related beliefs and increasing uptake. Impact Our findings provide valuable guidance for developing interventions to address sub-optimal HPV vaccination in high risk groups. PMID:21602307

  17. Sustained efficacy, immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine

    PubMed Central

    Naud, Paulo S; Roteli-Martins, Cecilia M; De Carvalho, Newton S; Teixeira, Julio C; de Borba, Paola C; Sanchez, Nervo; Zahaf, Toufik; Catteau, Gregory; Geeraerts, Brecht; Descamps, Dominique

    2014-01-01

    HPV-023 (NCT00518336; ClinicalTrial.gov) is a long-term follow-up of an initial double-blind, randomized (1:1), placebo-controlled study (HPV-001, NCT00689741) evaluating the efficacy against human papillomavirus (HPV)-16/18 infection and associated cyto-histopathological abnormalities, persistence of immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine. Among the women, aged 15–25 years, enrolled in HPV-001 and who participated in the follow-up study HPV-007 (NCT00120848), a subset of 437 women from five Brazilian centers participated in this 36-month long-term follow-up (HPV-023) for a total of 113 months (9.4 years). During HPV-023, anti-HPV-16/18 antibodies were measured annually by enzyme-linked immunosorbent assay (ELISA) and pseudovirion-based neutralisation assay (PBNA). Cervical samples were tested for HPV DNA every 6 months, and cyto-pathological examinations were performed annually. During HPV-023, no new HPV-16/18-associated infections and cyto-histopathological abnormalities occurred in the vaccine group. Vaccine efficacy (VE) against HPV-16/18 incident infection was 100% (95%CI: 66.1, 100). Over the 113 months (9.4 years), VE was 95.6% (86.2, 99.1; 3/50 cases in vaccine and placebo groups, respectively) against incident infection, 100% (84·1, 100; 0/21) against 6-month persistent infection (PI); 100% (61·4, 100; 0/10) against 12-month PI; 97·1% (82.5, 99.9; 1/30) against ≥ ASC-US; 95·0% (68.0, 99.9; 1/18) against ≥ LSIL; 100% (45.2, 100; 0/8) against CIN1+; and 100% (–128.1, 100; 0/3) against CIN2+ associated with HPV-16/18. All vaccinees remained seropositive to HPV-16/18, with antibody titers remaining several folds above natural infection levels, as measured by ELISA and PBNA. There were no safety concerns. To date, these data represent the longest follow-up reported for a licensed HPV vaccine. PMID:25424918

  18. Human Papillomavirus (HPV) Vaccine Availability, Recommendations, Cost, and Policies Among Health Departments in Seven Appalachian States

    PubMed Central

    Katz, Mira L.; Reiter, Paul L.; Kluhsman, Brenda C.; Kennedy, Stephenie; Dwyer, Sharon; Schoenberg, Nancy; Johnson, Andy; Ely, Gretchen; Roberto, Karen A.; Lengerich, Eugene J.; Brown, Pamela; Paskett, Electra D.; Dignan, Mark

    2009-01-01

    Telephone interviews of health department personnel in six states and review of an immunization database from one state were conducted to assess human papillomavirus (HPV) vaccine availability, recommendations, cost, policies, and educational materials in health departments in seven Appalachian states. Most (99.1%) health departments (n=234) reported receiving patient requests for the HPV vaccine, and only two (1%) health departments reported that they did not provide the vaccine for patients. HPV vaccine supply was reported to not meet demand in 10.5% (24/228) of health departments due to high costs. Level (state, region, county) at which policy about the HPV vaccine was determined, vaccine recommendations, costs, and available educational materials varied among states. This study documented variation in vaccine availability, recommendations, cost, policies, and educational materials in Appalachian health departments that could significantly affect vaccine distribution. Findings highlight the need for more comprehensive and consistent policies that maximize accessibility of the HPV vaccine to women, especially those in underserved areas. PMID:19446191

  19. Mass media coverage of HPV vaccination in Romania: a content analysis.

    PubMed

    Penţa, Marcela A; Băban, Adriana

    2014-12-01

    Romania has the highest cervical cancer burden in Europe. Despite the implementation of two human papillomavirus (HPV) vaccination programmes, the uptake remained extremely low and the programmes were discontinued. Given that media are a common source of information for the public and may influence vaccination decisions, this article sought to explore the content and quality of HPV vaccine media coverage in Romania. We conducted a content analysis of 271 media reports (from newspapers, magazines, videos and informational websites) published online between November 2007 and January 2012. Overall, results indicated that 31.4% of the materials were neutral, 28% were negative or extremely negative, 17% were mixed, while 23.6% were positive towards the vaccine. The most dominant vaccine-related concerns were side effects and insufficient testing. Elementary information about the vaccine and HPV was constantly left out and sometimes inaccuracies were found. Negatively disposed reports were more likely to contain incorrect data about vaccine efficacy and less likely to provide comprehensive information about the vaccine and HPV-related diseases. Some dimensions of media coverage varied across time and media outlets. The present findings suggest that educational interventions are greatly needed as a response to suboptimal and incomplete media coverage of HPV vaccination. PMID:24890190

  20. Evaluation of Human Papillomavirus Type Replacement Post-vaccination Must Account for Diagnostic Artifacts: Masking of HPV52 by HPV16 in Anogenital Specimens

    PubMed Central

    Tota, Joseph E.; Ramanakumar, Agnihotram V.; Villa, Luisa L.; Richardson, Harriet; Burchell, Ann N.; Koushik, Anita; Mayrand, Marie-Hélène; Coutlée, François; Franco, Eduardo L.

    2014-01-01

    It has been hypothesized that, following a reduction in human papillomavirus (HPV) vaccine-targeted genotypes, an increase in prevalence of other HPV types may occur due to reduced competition during natural infection. Any apparent post-vaccination increase must be distinguished from diagnostic artifacts consequent to consensus PCR assays failing to detect HPV types present in low copy numbers in co-infected specimens (under the assumption that with a drop in vaccine-preventable types there may be increased detection of previously “masked” types). We reanalyzed anogenital specimens to evaluate unmasking of HPV52 that may be caused by elimination of HPV16. Using highly sensitive type-specific real-time HPV52 PCR, we retested 1,200 anogenital specimens (all HPV52 negative according to consensus PCR assays) from six epidemiologic studies (200 specimens/study; 100 HPV16+/study). Multivariate logistic regression, with adjustment for age and number of sexual partners was used to evaluate the association between HPV16 positivity and detection of HPV52. In our pooled analysis (n=1,196), presence of HPV16 was positively associated with HPV52 detection (adjusted OR=1.47, 95% CI 0.76-2.82). In our separate (study specific) analyses, a statistically significant association was observed in one study that included HIV infected males (HIPVIRG study; adjusted OR=3.82, 95% CI 1.19-12.26). We observed a positive association between HPV16 viral load (tertiles) and detection of HPV52 (P for trend=0.003). These results indicate that diagnostic artifacts, resulting from unmasking of HPV52, may occur in some settings in the evaluation of HPV type replacement. Additional studies exploring the extent and severity of unmasking are needed. PMID:25277793

  1. Applying a Simple Model of Cost Effectiveness Study of HPV Vaccine for Iran

    PubMed Central

    Khatibi, Mohsen; Rasekh, Hamid Reza

    2015-01-01

    HPV vaccine has been recently added to the Iran Drug List, so decision makers need information beyond that available from RCTs to recommend funding for this vaccination. Modeling and economic studies have addressed some of those information needs. We reviewed cost effectiveness studies to find a suitable model for Iranian population to determine the potential cost effectiveness of HPV vaccine program based on domestic available epidemiologic data. Articles were obtained from an extensive literature search to determine the cost effectiveness of implementing an HPV vaccination program with routine cervical cancer screening. A total of 64 studies were included in this review. Although the studies used different model structures, baseline parameters and assumptions (either a Markov, Hybrid, or Dynamic model). Most of the proposed cost effectiveness models need to model the probability of HPV acquisition, the possible progression from HPV infection to CIN I, CIN II, CIN III and cervical cancer, the probability of HPV transmission which are not available in Iranian epidemiologic data. Based on the available epidemiologic data in Iran, the simplified and it requires substantially fewer assumptions than the other more complex Markov and hybrid models, therefore we decided to use this model for the evaluation of cost effectiveness of HPV vaccine in Iran. PMID:25901173

  2. Poor HPV vaccine-related awareness and knowledge among Utah Latinas overdue for recommended cancer screenings.

    PubMed

    Fowler, Brynn; Bodson, Julia; Warner, Echo L; Dyer, Jane; Kepka, Deanna

    2016-08-01

    Individuals overdue for recommended cancer screenings may not be receiving adequate cancer prevention education. Since Latinas have the highest incidence of cervical cancer among all racial/ethnic groups, human papillomavirus (HPV) vaccination education is especially important for this population. The correlates of HPV vaccine-related awareness and knowledge were assessed among Latinas who were overdue for recommended cancer screenings. N = 206 Latinas who were overdue for recommended cancer screenings were recruited by health educators from local community groups. Bivariate analyses and multivariable regression models were used to investigate factors associated with HPV vaccine-related awareness and knowledge among participants as well as to assess correlates of HPV vaccine receipt for eligible children of participants. In multivariable regression analyses, years living in the U.S. (p = 0.05) and health insurance status (p = 0.03) were significantly related to HPV vaccine-related knowledge measures. Age (p < 0.01), birthplace (p = 0.02), years living in the U.S. (p = 0.05), annual household income (p = 0.05), cervical cancer screening status (p = 0.03), and HPV vaccine-related knowledge measures (p < 0.01) were significantly associated with HPV vaccination outcomes for eligible daughters of participants. Cervical cancer screening status (p = 0.02) and HPV vaccine-related knowledge measures (p = 0.01) were significantly associated with HPV vaccination outcomes for eligible sons of participants. Results indicate poor HPV vaccine-related awareness and knowledge among Latinas. Interventions to improve HPV vaccine-related awareness and knowledge in Utah's growing Latino population should target vulnerable individuals (e.g., not employed outside the home, less educated, less acculturated, poor, uninsured, overdue for cervical cancer screening) by using materials that are culturally sensitive, linguistically appropriate, and easily accessible. PMID

  3. Timing of HPV vaccine intervals among United States teens with consideration to the current ACIP schedule and the WHO 2-dose schedule.

    PubMed

    Cloessner, Emily A; Stokley, Shannon; Yankey, David; Markowitz, Lauri E

    2016-06-01

    The current recommendation for human papillomavirus (HPV) vaccination in the United States is for 3 doses to be administered over a 6 month period. In April 2014, the World Health Organization (WHO) recommended adoption of a 2-dose schedule, with doses spaced a minimum of 6 months apart, for teens who begin the series before age 15. We analyzed data from the 2013 National Immunization Survey-Teen to examine the timing of second and third dose receipt among US adolescents. All analyses were restricted to adolescents age 13-17 y who had adequate provider data. The Wilcoxon-Mann-Whitney test measured differences in time to receive vaccine doses among demographic and socioeconomic groups. Logistic regression identified socioeconomic characteristics associated with receiving the second dose of HPV vaccine at least 6 months after the first dose. The median time for teens to receive the second dose of HPV vaccine was 2.6 months after the first dose, and the median time to receive the third dose was 4.9 months after the second dose. Minority teens and teens living below the poverty level took significantly longer to receive doses. Among teens that initiated the HPV vaccine series before age 15 y, 28.6% received the second dose at least 6 months after the first dose. If these teens, who met the WHO criteria for up-to-date HPV vaccination, were classified as having completed the vaccination series, overall coverage in the US would increase 3.9 percentage points, with African American and Hispanic teens having the greatest increases in coverage. PMID:26587886

  4. Population-based enrolment of adolescents in a long-term follow-up trial of human papillomavirus vaccine efficacy.

    PubMed

    Lehtinen, M; Idänpään-Heikkilä, I; Lunnas, T; Palmroth, J; Barr, E; Cacciatore, R; Isaksson, R; Kekki, M; Koskela, P; Kosunen, E; Kuortti, M; Lahti, L; Liljamo, T; Luostarinen, T; Apter, D; Pukkala, E; Paavonen, J

    2006-04-01

    We evaluated a study setting for assessment of the long-term vaccine efficacy (VE) of human papillomavirus (HPV) virus-like-particle (VLP) vaccine against cervical carcinoma. A total of 22,412 16- to 17-year old adolescent women from seven cities in Finland were invited by letter to participate in a phase III study of a quadrivalent HPV (types 6, 11, 16, 18) VLP vaccine, between September 2002 and March 2003. A total of 30,947 18-year old women were invited to participate as unvaccinated controls. These women were asked about their willingness to participate in an HPV vaccination trial and to fill a health questionnaire. These three population-based cohorts of adolescent women, including women vaccinated with HPV vaccine or placebo vaccine and unvaccinated control women, are systematically followed over time. The study cohort database will be linked with the Finnish Cancer Registry using cervical carcinoma in situ (CIS) and invasive cervical carcinoma (ICC) as endpoints. Assuming that the cumulative incidence of CIS and ICC over 15 years is 0.45%, and that there is no loss to follow-up, and power of 80%, the determination of 70% total VE will require 3357 HPV vaccine recipients, 3357 placebo vaccine recipients, and 6714 unvaccinated controls. At the baseline, 2632 (12%) of the invited adolescents volunteered to the phase III vaccination trial, and 6790 (22%) responded to the questionnaire study. During a recruitment period of 10 months, 874 HPV vaccine recipients, 875 placebo recipients and 1919 unvaccinated controls were enrolled. Population-based enrollment of large cohorts of vaccinated and unvaccinated adolescents for passive registry-based follow-up with cervical carcinoma as the end-point is feasible and currently going on in Finland. PMID:16595046

  5. Topics associated with conflict in print news coverage of the HPV vaccine during 2005 to 2009.

    PubMed

    Casciotti, Dana M; Smith, Katherine C; Klassen, Ann Carroll

    2014-01-01

    HPV vaccines represent a significant advancement for cancer prevention, but vaccination against a sexually transmitted infection and possible vaccine mandates have created considerable negative publicity. We sought to understand media portrayal of vaccine-related controversy, and potential influences on attitudes and vaccine acceptance. We analyzed characteristics of media coverage of the HPV vaccine in 13 US newspapers between June 2005-May 2009, as well as relationships between conflict and pro-vaccine tone and specific story characteristics. The four-year timeframe was selected to capture coverage during the development of the vaccine, the period immediately pre- and post-approval, and the time of widespread recommendation and initial uptake. This allowed the exploration of a range of issues and provided an understanding of how coverage changed over time. Analysis included 447 news stories and opinion pieces, the majority of which were published in 2007. Most articles were positive (pro-vaccine) in tone, prompted by research/scientific advancement or legislative activities. We deemed 66% of all stories conflict-containing. Fewer articles from 2005-2006 and 2008-2009 contained conflict than those from 2007, suggesting a peak period of concern, followed by gradual acceptance of the HPV vaccine. Legislative activities and content related to sexual activity were sources of conflict in HPV vaccine media messages. Health communication strategies can be improved by understanding and addressing potential sources of conflict in news coverage of public health initiatives. PMID:25668659

  6. Topics associated with conflict in print news coverage of the HPV vaccine during 2005 to 2009

    PubMed Central

    Casciotti, Dana M; Smith, Katherine C; Klassen, Ann Carroll

    2015-01-01

    HPV vaccines represent a significant advancement for cancer prevention, but vaccination against a sexually transmitted infection and possible vaccine mandates have created considerable negative publicity. We sought to understand media portrayal of vaccine-related controversy, and potential influences on attitudes and vaccine acceptance. We analyzed characteristics of media coverage of the HPV vaccine in 13 US newspapers between June 2005-May 2009, as well as relationships between conflict and pro-vaccine tone and specific story characteristics. The four-year timeframe was selected to capture coverage during the development of the vaccine, the period immediately pre- and post-approval, and the time of widespread recommendation and initial uptake. This allowed the exploration of a range of issues and provided an understanding of how coverage changed over time. Analysis included 447 news stories and opinion pieces, the majority of which were published in 2007. Most articles were positive (pro-vaccine) in tone, prompted by research/scientific advancement or legislative activities. We deemed 66% of all stories conflict-containing. Fewer articles from 2005–2006 and 2008–2009 contained conflict than those from 2007, suggesting a peak period of concern, followed by gradual acceptance of the HPV vaccine. Legislative activities and content related to sexual activity were sources of conflict in HPV vaccine media messages. Health communication strategies can be improved by understanding and addressing potential sources of conflict in news coverage of public health initiatives. PMID:25668659

  7. Perceptions of and barriers to vaccinating daughters against Human Papillomavirus (HPV) among mothers in Hong Kong

    PubMed Central

    2014-01-01

    Background Significant others are noted to be remarkable influences in modelling children’s and young people’s health perceptions and their adoption of health behaviour. The vaccinations which a child receives are shown to be significantly influenced by his or her parents. However, there is a paucity of Chinese-based studies. When discussing the Human Papillomavirus (HPV) vaccine, very few studies examine the perceptions of Chinese parents regarding the vaccine as a preventive health measure, and even fewer examine how these perceptions of the vaccine and sexual values influence their motivations in encouraging their children to be vaccinated. In view of the literature gap, this article investigates the perceptions of Hong Kong mothers in regard to vaccinating their daughters against HPV in Hong Kong. Methods A qualitative research approach with individual semi-structured interviews was conducted with 35 mothers aged 30 to 60 years old with daughter(s) between 9 and 17 years old. Results Six connected themes emerged. The participants commonly perceived the HPV vaccination as being unnecessary for their daughters in view of their young age. They worried that it would encourage their daughters to engage in premarital sex, and perceived the vaccination to be potentially harmful to health. Also, their low perceived risk of HPV in addition to the lack of reassurance from their health care providers failed to convince the participants that the vaccination was important for their daughters’ health. Finally, the participants found the vaccine to be expensive and perceived it to have little protection value in comparison to other optional vaccines. Conclusion The sampled mothers did not have a positive perception of the HPV vaccine. The cultural association between receiving the vaccination and premarital sex was prevalent. Bounded by their cultural values, the participants also had many misconceptions regarding the vaccine and the transmission of HPV, which

  8. Completion of the Human Papillomavirus (HPV) Vaccine Series among Insured Females, 2006–2009

    PubMed Central

    Hirth, Jacqueline M.; Tan, Alai; Wilkinson, Gregg S.; Berenson, Abbey B.

    2012-01-01

    Background Completion of the human papillomavirus (HPV) vaccine in a large proportion of young females is an important goal to prevent anogenital cancers associated with HPV. This study examines whether the proportion of insured women who complete the vaccine series has changed across time, and how provider type and age at initiation affects completion. Methods This retrospective cohort study used administrative data from a private insurance company. This study included 271,976 female initiators of the HPV vaccine who had been continuously enrolled in their respective insurance plan 365 days after vaccine initiation. Multivariate logistic regression was used to determine the odds of completing the vaccine series within 365 days after initiation. Results Females 13–18 years, 19–26 years, and ≥27 years old were less likely than 9–12 year olds to complete their HPV vaccine series. Obstetricians/gynecologists were more likely to administer vaccines to completers than pediatricians, while clinics, nurses, family care practitioners, and specialists were less likely to administer initial vaccines to completers compared to pediatricians. This study also found that 9–12 year olds and 13–18 year olds had lower odds of completing the HPV vaccine series for each subsequent year than those 19–26 years and ≥27 years old. Conclusions Among insured females in the US, the proportion of females that complete the HPV vaccine is dropping over time, especially among younger females that are specifically targeted to receive the vaccine. Physicians need to stress the importance of completing all three vaccinations to their patients. PMID:22544681

  9. "You're never really off time": Healthcare providers' interpretations of optimal timing for HPV vaccination.

    PubMed

    Henrikson, Nora B; Tuzzio, Leah; Gilkey, Melissa B; McRee, Annie-Laurie

    2016-12-01

    Healthcare providers have a strong influence on human papillomavirus (HPV) vaccination decisions, yet they often fail to recommend the vaccine to the 11- and 12-year-olds who are targeted by practice guidelines. We sought to understand how providers interpret and value age-based guidelines. We conducted a secondary analysis of data from two qualitative studies of healthcare providers' HPV vaccination attitudes and practices. Participants were physicians, nurse practitioners, and physician assistants in Minnesota (n = 27) and in Washington (n = 17) interviewed in 2012 and 2014 respectively. Verbatim transcripts from each study were analyzed independently using content analysis, and collective findings were then jointly analyzed. The research team worked via consensus to derive codes and describe representative themes. A high proportion of providers reported either a lack of concern about HPV vaccine completion, or concern beginning several years past the recommended target age. Many providers perceived a gradient of HPV vaccination timeliness ranging from age 12 to 26. Instead of age-based recommendations, providers timed recommendations based on perceptions of access to care and patient risk. They often offered "gentle" recommendations and deferred vaccination discussions as a tool to building trust with families. Interventions aimed at helping providers deliver effective recommendations for timely HPV vaccination are needed. Our findings suggest that changing the norm of provider culture to one in which "catch-up" schedules are seen as a suboptimal way to achieve vaccine uptake may be an important goal. PMID:27413667

  10. Parental decisional strategies regarding HPV vaccination before media debates: a focus group study.

    PubMed

    Hofman, Robine; van Empelen, Pepijn; Vogel, Ineke; Raat, Hein; van Ballegooijen, Marjolein; Korfage, Ida J

    2013-01-01

    Before the introduction of the human papillomavirus (HPV) vaccine, decisional strategies and factors that could guide HPV vaccination intentions were explored. The authors conducted 4 focus group discussions with 36 parents of children 8-15 years of age. Three groups consisted primarily of Dutch parents and 1 group of only Turkish parents. Discussions followed a semi-structured question route. Results showed that some parents used an approach of systematically seeking information as a way to prepare a decision, whereas others merely relied on trust in the message source. In general, parents believed that it was important to protect their child against negative outcomes that could result from vaccinating or not, and they felt that it is their responsibility to decide about uptake. Perceived susceptibility, vaccine effectiveness, and possibility of serious side effects were most important in the HPV vaccination decision-making process. In conclusion, parents perceived a lack of information and felt insecure about the vaccine's safety and effectiveness. This may result in ambivalent feelings toward HPV vaccination, which, in turn, may lead to postponing decisions about uptake. To facilitate informed decision making, which requires central processing, personally relevant messages about the knowns and unknowns regarding the effects of HPV vaccination should be provided. PMID:23521231

  11. Evaluation of Systemic and Mucosal Anti-HPV16 and 18 Antibody Responses from Vaccinated Women

    PubMed Central

    Kemp, Troy J.; García-Piñeres, Alfonso; Falk, Roni T.; Poncelet, Sylviane; Dessy, Francis; Giannini, Sandra L.; Rodriguez, Ana Cecilia; Porras, Carolina; Herrero, Rolando; Hildesheim, Allan; Pinto, Ligia A.

    2014-01-01

    Ideal methods to monitor HPV neutralizing antibodies induced by vaccination have not been established yet. Here, we evaluated systemic and cervical antibody levels induced by HPV16/18 AS04-adjuvanted vaccine (GlaxoSmithKline Biologicals) using a secreted alkaline phosphatase neutralization assay (SEAP) and ELISA. Serum and cervical secretions from 50 vaccinated women were used to assess 1) overall assay reproducibility, 2) inter-assay and inter-specimen correlation; 3) correlations between month 1 and month 12 titers. Strong correlations between SEAP-NA and ELISA were observed (serum anti-HPV16/18, ρ=0.91/0.85; cervix anti-HPV16/18, ρ=0.84/0.89). Systemic and cervical antibody measures also correlated well (ρ range: 0.64 – 0.75); except at mid-cycle (ρ range: 0.28 – 0.65). Correlations between antibody levels at one and twelve months following the start of vaccination were poor (ρ range: 0.16 – 0.38). In conclusion, HPV16/18 VLP-based ELISA is a reliable and valid method to monitor anti-HPV16/18 neutralizing potential for the first year following vaccination; however, additional studies will be required to better define the effects of the time on cycle and patterns of antibody response over time following vaccination. PMID:18541349

  12. Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination

    PubMed Central

    2013-01-01

    Background Our aim is to provide a state-of-the-art overview of knowledge on sex (biological) and gender (sociocultural) aspects of Human papillomavirus (HPV) and cervical cancer for educational purposes. Considerable disparities exist in cervical cancer incidences between different subgroups of women. We provide an outline on the crucial issues and debates based on the recent literature published in leading gender medicine journals. Intersectionality was applied in order to help categorise the knowledge. Methods Key terms (HPV, cervical cancer) were screened in Gender Medicine, Journal of Women’s Health and Women & Health from January 2005-June 2012. Additional searches were conducted for topics insufficiently mentioned, such as HPV vaccination of boys. In total, 71 publications were included (56 original papers, four reviews, six reports, three commentaries, one editorial and one policy statement). Results Research reveals complexity in the way various subgroups of women adhere to cervical screening. Less educated women, older women, uninsured women, homeless women, migrant women facing language barriers, women who have sex with women and obese women participate in Pap smears less frequently. A series of barriers can act to impede decisions to vaccinate against HPV. Conclusions Both male and female controlled preventive methods and treatment measures should be developed in order to tackle HPV infection and different strategies are needed for different subgroups. A substantial discussion and research on alternative methods of prevention was and is lacking. In future research, sex and gender aspects of HPV-related diseases of boys and men as well as subgroup differences in HPV risk need to be addressed. PMID:23394214

  13. Safety and immunogenicity of a quadrivalent human papillomavirus vaccine in HIV-infected and HIV-negative adolescents and young adults.

    PubMed

    Giacomet, Vania; Penagini, Francesca; Trabattoni, Daria; Viganò, Alessandra; Rainone, Veronica; Bernazzani, Giada; Bonardi, Claudia Maria; Clerici, Mario; Bedogni, Giorgio; Zuccotti, Gian Vincenzo

    2014-09-29

    Human papillomavirus (HPV) infection is highly prevalent and can lead to cancer; the development of safe and efficacious vaccines for HPV is a major public health concern. The two licensed HPV vaccines contain recombinant virus-like particles of HPV 16 and 18; one of such vaccines also protects against HPV types 6 and 11 which cause genital warts. We determined safety and immunogenicity of quadrivalent HPV vaccine in HIV-infected and HIV-negative adolescents and young adults, aged 13-27 years. The seroconversion rate, assessed by antibody titers, 1 month after the administration of the third vaccine dose was 0.85 (95% CI 0.75-0.95) in the HIV-infected group and 0.91 (0.83-0.99) in the HIV-negative subjects (p=0.52). The vaccine was generally safe and well tolerated; the most common side effect was local pain and the most frequent systemic side effect was headache. This is the first report on response to HPV vaccination in both female and male HIV-infected adolescents and young adults and highlights that this population may benefit from HPV immunoprophylaxis. Further studies are needed to examine the long term efficacy of this vaccine in HIV-infected individuals. PMID:25149430

  14. Do Florida Medicaid providers' barriers to HPV vaccination vary based on VFC program participation?

    PubMed

    Malo, Teri L; Hassani, Donna; Staras, Stephanie A S; Shenkman, Elizabeth A; Giuliano, Anna R; Vadaparampil, Susan T

    2013-05-01

    This study aimed to determine if physicians' perceived barriers to human papillomavirus (HPV) vaccination were associated with participation in the federal Vaccines for Children (VFC) program. A sample of 800 Florida Medicaid providers was randomly selected from the Florida Medicaid Master Provider File. A cross-sectional study was conducted using a 27-item survey that included 13 potential barriers to immunizing Medicaid patients against HPV, including concerns about vaccine safety and efficacy, discussing sexuality, vaccinated teens practicing riskier sexual behaviors, cost and reimbursement, ensuring 3-dose series completion, and school attendance requirements associated with HPV vaccination. Pearson χ(2) tests were conducted to investigate differences between each barrier and VFC program participation. Data were analyzed for 449 physicians. Compared to non-VFC providers, VFC providers were significantly less likely to somewhat or strongly agree that the following were barriers to vaccination: the cost of stocking the HPV vaccine (p = 0.0011), lack of adequate reimbursement for HPV vaccination (p < 0.0001), and lack of timely reimbursement for HPV vaccination (p < 0.0001). After adjusting for provider specialty and number of years since completion of residency training, VFC status remained significantly associated with the barrier regarding lack of adequate reimbursement for vaccination such that non-VFC providers had a 2.6-fold (95% confidence interval, 1.1-5.8) greater odds of somewhat or strongly agreeing that this barrier applied to them. Increasing participation in the VFC program may decrease physicians' cost-related barriers, which may increase the number of children vaccinated on time according to the recommended schedule. PMID:22569945

  15. Health and Economic Implications of HPV Vaccination in the United States

    PubMed Central

    Kim, Jane J.; Goldie, Sue J.

    2009-01-01

    BACKGROUND The cost-effectiveness of prophylactic vaccination against human papillomavirus types 16 (HPV-16) and 18 (HPV-18) is an important consideration for guidelines for immunization in the United States. METHODS We synthesized epidemiologic and demographic data using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls (at 12 years of age) and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). We examined the health benefits of averting other HPV-16–related and HPV-18–related cancers, the prevention of HPV-6–related and HPV-11–related genital warts and juvenile-onset recurrent respiratory papillomatosis by means of the quadrivalent vaccine, the duration of immunity, and future screening practices. RESULTS On the assumption that the vaccine provided lifelong immunity, the cost-effectiveness ratio of vaccination of 12-year-old girls was $43,600 per quality-adjusted life-year (QALY) gained, as compared with the current screening practice. Under baseline assumptions, the cost-effectiveness ratio for extending a temporary catch-up program for girls to 18 years of age was $97,300 per QALY; the cost of extending vaccination of girls and women to the age of 21 years was $120,400 per QALY, and the cost for extension to the age of 26 years was $152,700 per QALY. The results were sensitive to the duration of vaccine-induced immunity; if immunity waned after 10 years, the cost of vaccination of preadolescent girls exceeded $140,000 per QALY, and catch-up strategies were less cost-effective than screening alone. The cost-effectiveness ratios for vaccination strategies were more favorable if the benefits of averting other health conditions were included or if screening was delayed and performed at less frequent intervals and with more sensitive tests; they were less favorable if vaccinated girls were preferentially screened more

  16. Is There an Association Between Maternal Pap Test Use and Adolescent Human Papillomavirus Vaccination? Implications and Contribution

    PubMed Central

    Monnat, Shannon M.; Wallington, Sherrie Flynt

    2014-01-01

    Purpose To identify the association between mother’s recent receipt of a Pap test and daughter’s uptake and completion of the three-shot human papillomavirus (HPV) vaccination series. Methods We used cross-sectional data from the 2008 to 2010 Behavioral Risk Factor Surveillance System from 9 U.S. states and Puerto Rico and logistic regression models to examine the association between mother’s receipt of a Pap test in the past 3 years and daughter’s uptake and completion of the three-shot HPV vaccination series among adolescent girls aged 9-17 years (N = 4,776). Results Approximately one-quarter of adolescent girls began the HPV vaccination series, and 13.6% completed the three-shot series. Uptake and completion were more likely among girls whose mothers had obtained a Pap test within the past 3 years—for HPV uptake, odds ratio: 1.342, 95% confidence interval: 1.073-1.692; for HPV completion, odds ratio: 1.904; 95% confidence interval: 1.372-2.721—but the relationship between mother’s recent Pap test and vaccine uptake was explained by the mother’s use of a personal doctor and obtaining a routine physical examination in the past year. Conclusions HPV vaccination uptake and completion were more likely among adolescent girls whose mothers obtained a recent Pap test. Interventions designed to educate mothers on the importance of HPV vaccination and to facilitate relationships between physicians and mothers may prove successful at increasing HPV vaccination among adolescent girls. PMID:23332487

  17. Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)–Associated Cancers and HPV Vaccination Coverage Levels

    PubMed Central

    2013-01-01

    Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year’s report includes incidence trends for human papillomavirus (HPV)–associated cancers and HPV vaccination (recommended for adolescents aged 11–12 years). Methods Data on cancer incidence were obtained from the CDC, NCI, and NAACCR, and data on mortality were obtained from the CDC. Long- (1975/1992–2009) and short-term (2000–2009) trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Prevalence of HPV vaccination coverage during 2008 and 2010 and of Papanicolaou (Pap) testing during 2010 were obtained from national surveys. Results Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2000 to 2009. Overall incidence rates decreased in men but stabilized in women. Incidence rates increased for two HPV-associated cancers (oropharynx, anus) and some cancers not associated with HPV (eg, liver, kidney, thyroid). Nationally, 32.0% (95% confidence interval [CI] = 30.3% to 33.6%) of girls aged 13 to 17 years in 2010 had received three doses of the HPV vaccine, and coverage was statistically significantly lower among the uninsured (14.1%, 95% CI = 9.4% to 20.6%) and in some Southern states (eg, 20.0% in Alabama [95% CI = 13.9% to 27.9%] and Mississippi [95% CI = 13.8% to 28.2%]), where cervical cancer rates were highest and recent Pap testing prevalence was the lowest. Conclusions The overall trends in declining cancer death rates continue. However, increases

  18. The politics of HPV vaccination policy formation in the United States.

    PubMed

    Abiola, Sara E; Colgrove, James; Mello, Michelle M

    2013-08-01

    This article explores the political dimensions of policy formation for the human papillomavirus (HPV) vaccine through case studies of six states: California, Indiana, New Hampshire, New York, Texas, and Virginia. Using thematic content analysis of semistructured key informant interviews with policy stakeholders, newspaper articles, and archival materials, we describe the trajectory of public health policy developments for HPV immunization and analyze key influences on policy outcomes through the theoretical lens of the Multiple Streams framework. Specifically, we examine factors influencing the extent to which HPV was perceived as a problem meriting policy action; political forces that facilitated and impeded policy adoption, including interest-group opposition and structural and ideological features of the states' political environments; and factors affecting which policy alternatives received consideration. We find that effective policy entrepreneurship played a critical role in determining policy outcomes. We conclude by discussing lessons from the case of HPV vaccination for future efforts to craft vaccination policies. PMID:23645875

  19. Human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for the prevention of cervical cancer and HPV-related diseases.

    PubMed

    Skinner, S Rachel; Apter, Dan; De Carvalho, Newton; Harper, Diane M; Konno, Ryo; Paavonen, Jorma; Romanowski, Barbara; Roteli-Martins, Cecilia; Burlet, Nansa; Mihalyi, Attila; Struyf, Frank

    2016-01-01

    Vaccines are available against human papillomavirus (HPV), the causal agent of cervical and other cancers. Efficacy data from the HPV-16/18 AS04-adjuvanted vaccine clinical trial program were reviewed. Six randomized, controlled phase II/III trials evaluating cervical endpoints enrolled women from diverse populations and geographical locations. The program analyzed extensively the cohorts most relevant from a public health perspective: the total vaccinated cohort (TVC), approximating a general population including those with existing or previous HPV infection, and TVC-naïve, approximating a population of young women before sexual debut. Results show that the vaccine reduces HPV-16/18 infection and associated cervical endpoints in women regardless of age, location, or sexual experience. It provides cross-protection against some non-vaccine oncogenic HPV types and types causing genital warts, and may be effective against vulvar, oral, and anal HPV infection. Early epidemiology data following its introduction suggest a decline in the prevalence of vaccine and some non-vaccine HPV types. PMID:26902666

  20. Collateral Damage and Critical Turning Points: Public Health Implications of HPV Vaccine News Coverage for Boys and Men in 2011.

    PubMed

    Krakow, Melinda; Rogers, Brian

    2016-09-01

    In 2009, the Food and Drug Administration (FDA) officially expanded approval of the Gardasil vaccine to include human papillomavirus (HPV) vaccination for boys and men, and in 2011, the Centers for Disease Control and Prevention (CDC) issued a formal recommendation for routine vaccination for this population. Despite these efforts, HPV vaccination rates for boys and men continue to fall short of public health targets. While news was breaking about the benefits of the HPV vaccine for boys and men, public attention shifted as a result of political debates concerning the vaccine. This study examines a pivotal time period for public health in which the vaccine became officially recommended for boys and men and at the same time became the center of political controversies in the lead-up to the 2012 presidential campaign. The current study extends previous research and presents a content analysis of newspaper articles (N = 154) about the HPV vaccine for the year 2011. Results indicate that the lack of comprehensive coverage of HPV and the HPV vaccine found in previous studies continued in this year. Results shed light on key political events that may have functioned to overshadow the recommendation of the HPV vaccine for boys and men. The implications of this pattern of news coverage can inform public health efforts to address low rates of HPV vaccination uptake among boys and men in present day. PMID:26799666

  1. Human papillomavirus infection in Bhutan at the moment of implementation of a national HPV vaccination programme

    PubMed Central

    2014-01-01

    Background Cervical cancer is the most common female cancer in Bhutan, the first low/middle-income country to implement a national human papillomavirus (HPV) vaccination programme. Methods To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2,505 women aged 18–69 years from the general population, and biopsies from 211 cervical intraepithelial neoplasia grade 3 (CIN3) and 112 invasive cervical cancer (ICC) cases. Samples were tested for HPV using GP5+/6+ PCR. Results Among the general population, HPV prevalence was 26%, being highest (33%) in women ≤24 years, but remaining above 15% in all age-groups. Determinants of HPV included age, marital status, and number of sexual partners. Among the eight percent with cytological abnormalities, 24 CIN3 and 4 ICC were histologically confirmed. Even after additional testing with a sensitive E7 PCR, no infections with vaccine-targeted HPV types were detected in the few vaccinated women (n = 34) compared to 6% prevalence in unvaccinated women of similar age (p = 0 · 215). Conclusion Based upon type-specific prevalence among biopsies, at least 70% of ICC in Bhutan are theoretically preventable by HPV16/18 vaccination, but screening programmes should be expanded among older women, who have an important underlying burden of CIN3 and ICC. PMID:25047665

  2. Promotora outreach, education and navigation support for HPV vaccination to Hispanic women with unvaccinated daughters

    PubMed Central

    Parra-Medina, Deborah; Morales-Campos, Daisy Y.; Mojica, Cynthia; Ramirez, Amelie G.

    2015-01-01

    Background Cervical cancer disparities persist in the predominantly Hispanic population of South Texas, and Hispanic girls are less likely to initiate and complete the three-dose HPV vaccine series. Culturally relevant interventions are needed to eliminate these disparities and improve HPV vaccine initiation and completion. Subjects We enrolled 372 Hispanic women from South Texas’ Cameron and Hidalgo counties with a daughter aged 11–17 who had not received HPV vaccine. Intervention All participants received an HPV vaccine educational brochure in their preferred language (English or Spanish) and were invited to participate in the Entre Madre e Hija (EMH) program, a culturally relevant cervical cancer prevention program. EMH participants (n= 257) received group health education, referral and navigation support from a promotora (a trained, culturally competent community health worker). Those who declined participation in EMH received the brochure only (n=115). Results Eighty-four percent of enrolled participants initiated the HPV vaccine, and no differences were observed between EMH program and brochure-only participants. Compared to brochure-only participants, EMH participants were more likely to complete the vaccine series [Adj. OR=2.24, 95% CI (1.25, 4.02)]. In addition, participants who were employed and insured had lower odds of completing the vaccine series [Adj. OR=.45, 95% CI (.21 – .96); Adj. OR=.36, 95% CI (.13 – .98), respectively]. Conclusion All enrolled participants had high vaccine initiation rates (>80%); however, EMH program participants were more likely to complete the vaccine series. HPV vaccine promotion efforts that include referral and navigation support in addition to education show promise. PMID:24898942

  3. Promotora Outreach, Education and Navigation Support for HPV Vaccination to Hispanic Women with Unvaccinated Daughters.

    PubMed

    Parra-Medina, Deborah; Morales-Campos, Daisy Y; Mojica, Cynthia; Ramirez, Amelie G

    2015-06-01

    Cervical cancer disparities persist in the predominantly Hispanic population of South Texas, and Hispanic girls are less likely to initiate and complete the three-dose human papillomavirus (HPV) vaccine series. Culturally relevant interventions are needed to eliminate these disparities and improve HPV vaccine initiation and completion. We enrolled 372 Hispanic women from South Texas' Cameron and Hidalgo counties with a daughter, aged 11-17, who had not received HPV vaccine. All participants received an HPV vaccine educational brochure in their preferred language (English or Spanish) and were invited to participate in the Entre Madre e Hija (EMH) program, a culturally relevant cervical cancer prevention program. EMH participants (n = 257) received group health education, referral and navigation support from a promotora (a trained, culturally competent community health worker). Those who declined participation in EMH received the brochure only (n = 115). Eighty-four percent of enrolled participants initiated the HPV vaccine, and no differences were observed between EMH program and brochure-only participants. Compared to brochure-only participants, EMH participants were more likely to complete the vaccine series [adjusted odds ratio (adj. OR) = 2.24, 95% CI (1.25, 4.02)]. In addition, participants who were employed and insured had lower odds of completing the vaccine series [adj. OR = 0.45, 95% CI (0.21-0.96); adj. OR = 0.36, 95% CI (0.13-0.98), respectively]. All enrolled participants had high vaccine initiation rates (>80%); however, EMH program participants were more likely to complete the vaccine series. HPV vaccine promotion efforts that include referral and navigation support in addition to education show promise. PMID:24898942

  4. The effects of message framing and risk perceptions for HPV vaccine campaigns: focus on the role of regulatory fit.

    PubMed

    Park, Sun-Young

    2012-01-01

    This study investigates the effects of framing and risk perception, and their interaction effects on human papillomavirus (HPV) vaccination. Based on a 2 (message frames) × 2 (perceived risk) experimental design, the interaction effects reveal the effectiveness of loss- (vs. gain-) framed messages would be maximized for high (vs. low) perceived risk condition. Based on regulatory fit principles the synergy effects are shown in terms of attitudes toward advertising and HPV vaccination, HPV vaccination intention, and ad-promoted behavioral intention. The findings indicate right message appeals should be selected for the right target audiences in the setting of HPV vaccine promotions. PMID:23210670

  5. A qualitative study of HPV vaccine acceptability among health workers, teachers, parents, female pupils, and religious leaders in northwest Tanzania

    PubMed Central

    Remes, Pieter; Selestine, Veronica; Changalucha, John; Ross, David A.; Wight, Daniel; de Sanjosé, Silvia; Kapiga, Saidi; Hayes, Richard J.; Watson-Jones, Deborah

    2012-01-01

    Background As human papillomavirus (HPV) vaccines become available in developing countries, acceptability studies can help to better understand potential barriers and facilitators of HPV vaccination and guide immunisation programs. Methods Prior to a cluster-randomised phase IV trial of HPV vaccination delivery strategies in Mwanza Region, Tanzania, qualitative research was conducted to assess attitudes and knowledge about cervical cancer and HPV, and acceptability of and potential barriers to HPV vaccination of Tanzanian primary schoolgirls. Semi-structured interviews (n = 31) and group discussions (n = 12) were conducted with a total of 169 respondents (parents, female pupils, teachers, health workers and religious leaders). Results While participants had heard of cancer in general, most respondents had no knowledge of cervical cancer, HPV, or HPV vaccines. Only health workers had heard of cervical cancer but very few knew its cause or had any awareness about HPV vaccines. After participants were provided with information about cervical cancer and HPV vaccination, the majority stated that they would support HPV vaccination of their daughter to protect them against cervical cancer. Opt-out consent for vaccination was considered acceptable. Most preferred age-based vaccination, saying this would target more girls before sexual debut than class-based vaccination. Potential side effects and infertility concerns were raised by 5/14 of participating male teachers. Discussion Reported acceptability of HPV vaccination amongst parents, teachers and other community members was high in this population. Respondents stressed the need to provide adequate information about the vaccine to parents, that also addresses side effects and infertility concerns. PMID:22732428

  6. Impact of a physician recommendation and parental immunization attitudes on receipt or intention to receive adolescent vaccines.

    PubMed

    Gargano, Lisa M; Herbert, Natasha L; Painter, Julia E; Sales, Jessica M; Morfaw, Christopher; Rask, Kimberly; Murray, Dennis; DiClemente, Ralph J; Hughes, James M

    2013-12-01

    Four vaccines are recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for adolescents. Parental attitudes may play a key role in vaccination uptake in this age group. In 2011, we conducted a cross-sectional survey among parents of adolescents in one county in Georgia to identify parental attitudes toward adolescent vaccination, reasons for vaccine acceptance or refusal, and impact of a physician recommendation for vaccination. Physician recommendation was reported as one of the top reasons for receipt or intent to receive any of the vaccines. Physician recommendation of any of the four vaccines was associated with receipt of Tdap (p<0.001), MCV4 (p<0.001), and HPV (p = 0.03) and intent to receive Tdap (p = 0.05), MCV4 (p = 0.005), and HPV (p = 0.05). Compared with parents who did not intend to have their adolescent vaccinated with any of the vaccines, parents who did intend reported higher perceived susceptibility (3.12 vs. 2.63, p = 0.03) and severity of disease (3.89 vs. 3.70, p = 0.02) and higher perceived benefit of vaccination (8.48 vs. 7.74, p = 0.02). These findings suggest that future vaccination efforts geared toward parents may benefit from addressing the advantages of vaccination and enhancing social norms. Physicians can play a key role by providing information on the benefits of adolescent vaccination. PMID:23883781

  7. Impact of a physician recommendation and parental immunization attitudes on receipt or intention to receive adolescent vaccines

    PubMed Central

    Gargano, Lisa M; Herbert, Natasha L; Painter2, Julia E; Sales, Jessica M; Morfaw3, Christopher; Rask2, Kimberly; Murray4, Dennis; DiClemente2, Ralph; Hughes, James M

    2013-01-01

    Four vaccines are recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for adolescents. Parental attitudes may play a key role in vaccination uptake in this age group. In 2011, we conducted a cross-sectional survey among parents of adolescents in one county in Georgia to identify parental attitudes toward adolescent vaccination, reasons for vaccine acceptance or refusal, and impact of a physician recommendation for vaccination. Physician recommendation was reported as one of the top reasons for receipt or intent to receive any of the vaccines. Physician recommendation of any of the four vaccines was associated with receipt of Tdap (p < 0.001), MCV4 (p < 0.001), and HPV (p = 0.03) and intent to receive Tdap (p = 0.05), MCV4 (p = 0.005), and HPV (p = 0.05). Compared with parents who did not intend to have their adolescent vaccinated with any of the vaccines, parents who did intend reported higher perceived susceptibility (3.12 vs. 2.63, p = 0.03) and severity of disease (3.89 vs. 3.70, p = 0.02) and higher perceived benefit of vaccination (8.48 vs. 7.74, p = 0.02). These findings suggest that future vaccination efforts geared toward parents may benefit from addressing the advantages of vaccination and enhancing social norms. Physicians can play a key role by providing information on the benefits of adolescent vaccination. PMID:23883781

  8. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    PubMed Central

    Obel, J; McKenzie, J; Buenconsejo-Lum, LE; Durand, AM; Ekeroma, A; Souares, Y; Hoy, D; Baravilala, W; Garland, SM; Kjaer, SK; Roth, A

    2015-01-01

    Objective To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific. PMID:25921158

  9. [Adhesion the vaccination against HPV in ASL of L'Aquila].

    PubMed

    Giuliani, A R; De Felice, M; Scatigna, M; Carosi, I; Perrotti, A; Fabiani, L

    2011-01-01

    Sexually transmitted human papillomaviruses (HPVs) are responsible for anogenital infections and tumours. Types 16 and 18 cause 70% of cervical carcinomas, the incidence of which is higher among young women. The aim of this study was to evaluate the propensity of mothers to have their 12-year-old daughters vaccinated against HPV and identify the variables that may influence their agreement, such as their kowledge of HPV and its relationship with cervical cancer. A 17-item questionnaire was anonymously administered to 312 mothers of girls born in 1997 who were invited to undergo vaccination by their local health authority. The results were analysed using the chi-squared test and STATA 9 statistical software. The analysis showed that 69% of the mothers had had their daughters vaccinated, that most of them know about HPV but only 20% clearly understood the relationship between HPV and cancer Acceptance of the vaccination seems to be associated more with a general predisposition to vaccinate than with a knowledge of HPV and its causal relationship with cervical carcinoma. This indicates a need for educational/ information programmes before and during the vaccination cycle. PMID:22026237

  10. Perceptions of Nigerian Women about Human Papilloma Virus, Cervical Cancer, and HPV Vaccine

    PubMed Central

    Akanbi, Olusola Anuoluwapo; Iyanda, Abiodun; Osundare, Folakemi; Opaleye, Oluyinka Oladele

    2015-01-01

    Background. Cervical cancer caused by human papilloma virus (HPV) though preventable has claimed the lives of many women worldwide. This study was embarked upon to evaluate the general knowledge and perceptions of Nigerian women on HPV, cervical cancer, and HPV vaccine. Methods. Structured questionnaires were administered to a cross section of 737 women randomly selected from the general population in two southwestern States of Nigeria. Statistical analysis was done using SPSS computer software version 16. A P value >0.05 was considered statistically significant. Results. One hundred and seventy-six (23.9%) of the respondents had knowledge of HPV; 474 (64.3%) are aware of cervical cancer but only 136 (18.5%) know that HPV causes cervical cancer. 200 (27.1%) are aware that there is an HPV vaccine while 300 (40.7%) had knowledge of Pap smear test. Two hundred and sixty (35.3%) of the respondents know that early detection of HPV can prevent cervical cancer and in spite of this, only 110 (14.9%) have taken the Pap smear test before while 151 (20.5%) are not willing to go for the test at all. Conclusions. There is therefore the need to create proper awareness on the HPV and its possible consequence of cervical carcinoma. PMID:26550522

  11. NIH study finds two doses of HPV vaccine may be as protective as full course

    Cancer.gov

    Two doses of the human papillomavirus (HPV) vaccine Cervarix were as effective as the current standard three-dose regimen after four years of follow-up/NCI-sponsored Costa Rica Vaccine Trial was designed to assess the efficacy of Cervarix in a community-b

  12. Early Lessons Learned from Extramural School Programs That Offer HPV Vaccine

    ERIC Educational Resources Information Center

    Hayes, Kim A.; Entzel, Pamela; Berger, Wendy; Caskey, Rachel N.; Shlay, Judith C.; Stubbs, Brenda W.; Smith, Jennifer S.; Brewer, Noel T.

    2013-01-01

    Background: There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs. Methods: In July to August 2010, 5 programs were identi?ed. Semistructured, in-depth telephone…

  13. Getting Vaccinated against HPV: Attitudes, Intentions and Perceived Barriers of Female Undergraduates

    ERIC Educational Resources Information Center

    Burke, Sloane C.; Vail-Smith, Karen; White, David M.; Baker, Elizabeth; Mitchell, Terri

    2010-01-01

    This study examines college women's intention to receive the Human Papilloma Virus (HPV) vaccine and their perceived barriers to being vaccinated. The study reports findings from an online questionnaire completed by 856 undergraduate women enrolled in a required personal health course at a large (27,000 plus) southeastern university. The majority…

  14. Feasibility of a Catch-Up HPV Vaccination Program among College Students Attending a Large Rural University in the South

    ERIC Educational Resources Information Center

    Richman, Alice R.; Haithcox-Dennis, Melissa J.; Allsbrook, Ashley R.

    2012-01-01

    Our study explored the eligibility and willingness of students to participate in a university-wide catch-up Human papillomavirus (HPV) vaccination program. A total of 1804 electronic surveys (82% response) assessing demographics, HPV knowledge, eligibility, and willingness were gathered. HPV knowledge was moderate, with just over a quarter (26%)…

  15. Current therapeutic vaccination and immunotherapy strategies for HPV-related diseases.

    PubMed

    Skeate, Joseph G; Woodham, Andrew W; Einstein, Mark H; Da Silva, Diane M; Kast, W Martin

    2016-06-01

    Carcinomas of the anogenital tract, in particular cervical cancer, remains one of the most common cancers in women, and represent the most frequent gynecological malignancies and the fourth leading cause of cancer death in women worldwide. Human papillomavirus (HPV)-induced lesions are immunologically distinct in that they express viral antigens, which are necessary to maintain the cancerous phenotype. The causal relationship between HPV infection and anogenital cancer has prompted substantial interest in the development of therapeutic vaccines against high-risk HPV types targeting the viral oncoproteins E6 and E7. This review will focus on the most recent clinical trials for immunotherapies for mucosal HPV-induced lesions as well as emerging therapeutic strategies that have been tested in pre-clinical models for HPV-induced diseases. Progress in peptide- and protein-based vaccines, DNA-based vaccines, viral/bacterial vector-based vaccines, immune checkpoint inhibition, immune response modifiers, and adoptive cell therapy for HPV will be discussed. PMID:26835746

  16. Should I or shouldn't I: decision making, knowledge and behavioral effects of quadrivalent HPV vaccination in men who have sex with men.

    PubMed

    Thomas, Emily A; Goldstone, Stephen E

    2011-01-10

    Prior to FDA licensure in men, a surgical practice (SG) offered the quadrivalent HPV vaccine (qHPV) off-label to men who have sex with men (MSM). We administered a written or telephone survey to MSM to elicit drivers and barriers to vaccination, sexual behavior changes post-vaccination, and knowledge. 191 subjects enrolled: 68 refused qHPV, 71 received qHPV <1 year ago, and 52 received qHPV >1 year ago. History of HPV infection (86%, n=164) and level of HPV and qHPV knowledge were high, with a mean of 10.8 of 13 knowledge questions correct. Ninety-seven percent of participants understood that qHPV does not cure present infection or disease. MSM refused qHPV for reasons including cost and not FDA approved; prevention of future HPV infection was the paramount driver for immunization. Vaccination did not affect sexual behavior. PMID:20950728

  17. Evaluation of the Long-Term Anti-Human Papillomavirus 6 (HPV6), 11, 16, and 18 Immune Responses Generated by the Quadrivalent HPV Vaccine.

    PubMed

    Nygård, Mari; Saah, Alfred; Munk, Christian; Tryggvadottir, Laufey; Enerly, Espen; Hortlund, Maria; Sigurdardottir, Lara G; Vuocolo, Scott; Kjaer, Susanne K; Dillner, Joakim

    2015-08-01

    This quadrivalent human papillomavirus (qHPV) (HPV6, -11, -16, and -18) vaccine long-term follow-up (LTFU) study is an ongoing extension of a pivotal clinical study (FUTURE II) taking place in the Nordic region. The LTFU study was designed to evaluate the effectiveness, immunogenicity, and safety of the qHPV vaccine (Gardasil) for at least 10 years following completion of the base study. The current report presents immunogenicity data from testing samples of the year 5 LTFU visit (approximately 9 years after vaccination). FUTURE II vaccination arm subjects, who consented to being followed in the LTFU, donated serum at regular intervals and in 2012. Anti-HPV6, -11, -16, and -18 antibodies were detected by the competitive Luminex immunoassay (cLIA), and in addition, serum samples from 2012 were analyzed by the total IgG Luminex immunoassay (LIA) (n = 1,598). cLIA geometric mean titers (GMTs) remained between 70% and 93% of their month 48 value depending on HPV type. For all HPV types, the lower bound of the 95% confidence interval (CI) for the year 9 GMTs remained above the serostatus cutoff value. The proportion of subjects who remained seropositive based on the IgG LIA was higher than the proportion based on cLIA, especially for anti-HPV18. As expected, the anti-HPV serum IgG and cLIA responses were strongly correlated for all HPV types. Anti-HPV GMTs and the proportion of vaccinated individuals who are seropositive remain high for up to 9 years of follow-up after vaccination. PMID:26084514

  18. Evaluation of the Long-Term Anti-Human Papillomavirus 6 (HPV6), 11, 16, and 18 Immune Responses Generated by the Quadrivalent HPV Vaccine

    PubMed Central

    Saah, Alfred; Munk, Christian; Tryggvadottir, Laufey; Enerly, Espen; Hortlund, Maria; Sigurdardottir, Lara G.; Vuocolo, Scott; Kjaer, Susanne K.; Dillner, Joakim

    2015-01-01

    This quadrivalent human papillomavirus (qHPV) (HPV6, -11, -16, and -18) vaccine long-term follow-up (LTFU) study is an ongoing extension of a pivotal clinical study (FUTURE II) taking place in the Nordic region. The LTFU study was designed to evaluate the effectiveness, immunogenicity, and safety of the qHPV vaccine (Gardasil) for at least 10 years following completion of the base study. The current report presents immunogenicity data from testing samples of the year 5 LTFU visit (approximately 9 years after vaccination). FUTURE II vaccination arm subjects, who consented to being followed in the LTFU, donated serum at regular intervals and in 2012. Anti-HPV6, -11, -16, and -18 antibodies were detected by the competitive Luminex immunoassay (cLIA), and in addition, serum samples from 2012 were analyzed by the total IgG Luminex immunoassay (LIA) (n = 1,598). cLIA geometric mean titers (GMTs) remained between 70% and 93% of their month 48 value depending on HPV type. For all HPV types, the lower bound of the 95% confidence interval (CI) for the year 9 GMTs remained above the serostatus cutoff value. The proportion of subjects who remained seropositive based on the IgG LIA was higher than the proportion based on cLIA, especially for anti-HPV18. As expected, the anti-HPV serum IgG and cLIA responses were strongly correlated for all HPV types. Anti-HPV GMTs and the proportion of vaccinated individuals who are seropositive remain high for up to 9 years of follow-up after vaccination. PMID:26084514

  19. Immunogenicity of quadrivalent HPV and combined hepatitis A and B vaccine when co-administered or administered one month apart to 9–10 year-old girls according to 0–6 month schedule

    PubMed Central

    Gilca, Vladimir; Sauvageau, Chantal; Boulianne, Nicole; De Serres, Gaston; Couillard, Michel; Krajden, Mel; Ouakki, Manale; Murphy, Donald; Trevisan, Andrea; Dionne, Marc

    2014-01-01

    , the great majority of subjects had antibodies to HPV types included in the vaccine. A two-dose schedule for pre-adolescents might be a reasonable alternative to the currently approved three-dose schedules. PMID:25424952

  20. Impact of Coverage-Dependent Marginal Costs on Optimal HPV Vaccination Strategies

    PubMed Central

    Ryser, Marc D.; McGoff, Kevin; Herzog, David P.; Sivakoff, David J.; Myers, Evan R.

    2015-01-01

    The effectiveness of vaccinating males against the human papillomavirus (HPV) remains a controversial subject. Many existing studies conclude that increasing female coverage is more effective than diverting resources into male vaccination. Recently, several empirical studies on HPV immunization have been published, providing evidence of the fact that marginal vaccination costs increase with coverage. In this study, we use a stochastic agent-based modeling framework to revisit the male vaccination debate in light of these new findings. Within this framework, we assess the impact of coverage-dependent marginal costs of vaccine distribution on optimal immunization strategies against HPV. Focusing on the two scenarios of ongoing and new vaccination programs, we analyze different resource allocation policies and their effects on overall disease burden. Our results suggest that if the costs associated with vaccinating males are relatively close to those associated with vaccinating females, then coverage-dependent, increasing marginal costs may favor vaccination strategies that entail immunization of both genders. In particular, this study emphasizes the necessity for further empirical research on the nature of coverage-dependent vaccination costs. PMID:25979280

  1. Development, theoretical framework, and evaluation of a parent and teacher-delivered intervention on adolescent vaccination.

    PubMed

    Gargano, Lisa M; Herbert, Natasha L; Painter, Julia E; Sales, Jessica M; Vogt, Tara M; Morfaw, Christopher; Jones, LaDawna M; Murray, Dennis; DiClemente, Ralph J; Hughes, James M

    2014-07-01

    The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (tetanus, diphtheria, and acellular pertussis [Tdap]; human papillomavirus [HPV] vaccine; and meningococcal conjugate vaccine [MCV4]) and an annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with nonvaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents are developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle and high school-based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the health belief model and theory of reasoned action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and the literacy needs of parents. We also demonstrated an increase in student knowledge of and positive attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle and high school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention. PMID:24440920

  2. Universal vaccination with the quadrivalent HPV vaccine in Austria: impact on virus circulation, public health and cost-effectiveness analysis.

    PubMed

    Bresse, Xavier; Goergen, Christoph; Prager, Bernhard; Joura, Elmar

    2014-04-01

    The International Agency for Research on Cancer acknowledges that HPV is a human carcinogen affecting both sexes. This study aimed to evaluate the public health impact of universal HPV vaccination in Austria, to assess its cost-effectiveness and to estimate the HPV prevalence reduction over time. Vaccinating 65% of 9-year-old boys and girls in Austria would result in a 70% decrease in HPV infections in both males and females, hereby avoiding 9500 cases of genital warts annually and 431 HPV 16/18-related cancers in males and females. This strategy would be cost effective with base case analysis of €26,701/quality-adjusted life year (QALY) gained for cervical cancer only, €15,820/QALY also including vaginal/vulvar cancers and genital warts, and €10,033/QALY also considering anal, oropharyngeal and penile cancers, with an incremental cost-effectiveness ratio ranging from €2500 to €21,000/QALY in sensitivity analyses. HPV circulation would be controlled hereby preventing subsequent HPV-related cancers. PMID:24450951

  3. Association between mother-child sexual communication and HPV vaccine uptake

    PubMed Central

    Gross, Tyra T.; Laz, Tabassum H.; Rahman, Mahbubur; Berenson, Abbey B.

    2015-01-01

    Objective To examine the association between mother-child communication about sex, sexually transmitted diseases (STDs), and contraception/condoms and HPV vaccine uptake by gender. Methods Women (n=1372) with ≥1 child aged 9-17 years receiving care in reproductive health clinics in Southeast Texas were asked to complete a self-administered questionnaire between September 2011 and October 2013. Results The majority of mothers with ≥1 eligible daughter (n = 886) reported having talked about ‘sex’ (77.7%), ‘STDs’ (76.6%) and ‘contraception’ (73.2%) with their daughter. The respective figures for mothers with ≥1 son (n = 836) were 68.8%, 69.0% and 65.3%. Mothers who discussed sex, STDs, or contraception with their daughters compared to those who did not were more likely to report that their daughter initiated (≥1 dose) HPV vaccination after adjusting for confounders (all p<.05). Similarly, mother-son discussions about STDs or condoms, but not sex, were associated with HPV vaccine initiation for their sons compared to those who did not discuss these topics. These associations were not significant with regard to HPV vaccine completion (3 doses) for neither daughters nor sons. Conclusion Mother-child communication on STDs and contraception/condoms is associated with HPV vaccine initiation, but not completion, among both daughters and sons. PMID:25773469

  4. Protecting our Khmer daughters: Ghosts of the past, uncertain futures, and the HPV vaccine

    PubMed Central

    Burke, Nancy J.; Do, Huyen H.; Talbot, Jocelyn; Sos, Channdara; Ros, Srey; Taylor, Victoria M.

    2014-01-01

    Objectives The FDA approved the first HPV vaccine in 2006. Research into parental decision-making and concerns about HPV vaccination highlight questions about parenting and parents’ role in the crafting of their daughters’ future sexuality. In contrast to much of this literature, we explore narratives from interviews with Cambodian mothers of HPV vaccine age-eligible daughters who experienced genocide and came to the United States as refugees. Design We conducted in-depth, in-person interviews with 25 Cambodian mothers of HPV vaccine-age eligible daughters. Interviews were conducted in Khmer and translated into English for analysis. We followed standard qualitative analysis techniques including iterative data review, multiple coders, and ‘member checking’. Five members of the research team reviewed all transcripts and two members independently coded each transcript for concepts and themes. Results Interview narratives highlight the presence of the past alongside desires for protection from uncertain futures. We turn to Quesada and colleagues’ (2011) concept structural vulnerability to outline the constraints posed by these women’s positionalities as genocide survivors when faced with making decisions in a area with which they have little direct knowledge or background: cervical cancer prevention. Conclusion Our study sheds light on the prioritization of various protective health practices, including but not exclusive to HPV vaccination, for Khmer mothers, as well as the rationalities informing decision-making regarding their daughters’ health. PMID:24905057

  5. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions

    PubMed Central

    TESTI, D.; NARDONE, M.; MELONE, P.; CARDELLI, P.; OTTRIA, L.; ARCURI, C.

    2015-01-01

    SUMMARY The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%–90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before “sexual puberty”. The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer. PMID:27555904

  6. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions.

    PubMed

    Testi, D; Nardone, M; Melone, P; Cardelli, P; Ottria, L; Arcuri, C

    2015-01-01

    The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer. PMID:27555904

  7. Cross-Reactivity, Epitope Spreading, and De Novo Immune Stimulation Are Possible Mechanisms of Cross-Protection of Nonvaccine Human Papillomavirus (HPV) Types in Recipients of HPV Therapeutic Vaccines

    PubMed Central

    Greenfield, William; Moerman-Herzog, Andrea; Coleman, Hannah N.

    2015-01-01

    Numerous versions of human papillomavirus (HPV) therapeutic vaccines designed to treat individuals with established HPV infection, including those with cervical intraepithelial neoplasia (CIN), are in development because approved prophylactic vaccines are not effective once HPV infection is established. As human papillomavirus 16 (HPV-16) is the most commonly detected type worldwide, all versions of HPV therapeutic vaccines contain HPV-16, and some also contain HPV-18. While these two HPV types are responsible for approximately 70% of cervical cancer cases, there are other high-risk HPV types known to cause malignancy. Therefore, it would be of interest to assess whether these HPV therapeutic vaccines may confer cross-protection against other high-risk HPV types. Data available from a few clinical trials that enrolled subjects with CINs regardless of the HPV type(s) present demonstrated clinical responses, as measured by CIN regression, in subjects with both vaccine-matched and nonvaccine HPV types. The currently available evidence demonstrating cross-reactivity, epitope spreading, and de novo immune stimulation as possible mechanisms of cross-protection conferred by investigational HPV therapeutic vaccines is discussed. PMID:25947147

  8. Providers' practice, recommendations and beliefs about HPV vaccination and their adherence to guidelines about the use of HPV testing, 2007 to 2010.

    PubMed

    Berkowitz, Z; Nair, N; Saraiya, M

    2016-06-01

    Human papillomavirus (HPV) vaccines prevent cervical pre-cancer lesion and can potentially reduce abnormal Papanicolaou (Pap) results among vaccinated females. However, current U.S. cervical screening guidelines recommend no change in screening initiation and frequency based on vaccination status. We examined providers' practices and beliefs about HPV vaccination to evaluate their adherence to guidelines. We used 4-year data (2007-2010) from two nationally representative samples totaling 2119 primary-care providers from the Cervical Cancer Screening Supplement to the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS). Providers in each survey were stratified to obstetrician/gynecologist (OB/GYNs) and non-OB/GYNs. Descriptive statistics and chi-square tests were performed to assess differences between providers' types in each survey. Approximately 60% of providers believed that HPV vaccination will result in fewer abnormal Pap tests and fewer referrals to colposcopy and over 92% would not change their cervical cancer screening practices for fully vaccinated females. NAMCS OB/GYNs were more likely (p<0.05) than non-OB/GYNs to rarely/never use the number of sexual partners to determine who gets the HPV vaccine (68.4% vs. 59.1%), more likely to recommend the vaccine to females with history of abnormal Pap (79.6% vs. 68.4%) and to females with a history of HPV positive test result (75.3% vs. 62.8%). Consistent with guidelines, most providers would not change cervical cancer screening practices based on patients' vaccination history. However, some providers used inappropriate tests for making vaccination decisions. Improving HPV vaccine knowledge and recommendations for its use is warranted to implement a successful vaccine program. PMID:26921654

  9. Proof-of-Principle Evaluation of the Efficacy of Fewer Than Three Doses of a Bivalent HPV16/18 Vaccine

    PubMed Central

    Rodriguez, Ana Cecilia; Hildesheim, Allan; Herrero, Rolando; Porras, Carolina; Schiffman, Mark; González, Paula; Solomon, Diane; Jiménez, Silvia; Schiller, John T.; Lowy, Douglas R.; Quint, Wim; Sherman, Mark E.; Schussler, John; Wacholder, Sholom

    2011-01-01

    Background Three-dose regimens for human papillomavirus (HPV) vaccines are expensive and difficult to complete, especially in settings where the need for cervical cancer prevention is greatest. Methods We evaluated the vaccine efficacy of fewer than three doses of the HPV16/18 vaccine Cervarix in our Costa Rica Vaccine Trial. Women were randomly assigned to receive three doses of the HPV16/18 vaccine or to a control vaccine and were followed for incident HPV16 or HPV18 infection that persisted in visits that were 10 or more months apart (median follow-up 4.2 years). After excluding women who had no follow-up or who were HPV16 and HPV18 DNA positive at enrollment, 5967 women received three vaccine doses (2957 HPV vaccine vs 3010 control vaccine), 802 received two doses (422 HPV vs 380 control), and 384 received one dose (196 HPV vs 188 control). Reasons for receiving fewer doses and other pre- and post-randomization characteristics were balanced within each dosage group between women receiving the HPV and control vaccines. Results Incident HPV16 or HPV18 infections that persisted for 1 year were unrelated to dosage of the control vaccine. Vaccine efficacy was 80.9% for three doses of the HPV vaccine (95% confidence interval [CI] = 71.1% to 87.7%; 25 and 133 events in the HPV and control arms, respectively), 84.1% for two doses (95% CI = 50.2% to 96.3%; 3 and 17 events), and 100% for one dose (95% CI = 66.5% to 100%; 0 and 10 events). Conclusion Four years after vaccination of women who appeared to be uninfected, this nonrandomized analysis suggests that two doses of the HPV16/18 vaccine, and maybe even one dose, are as protective as three doses. PMID:21908768

  10. Numerical simulation of a two-sex human papillomavirus (HPV) vaccination model

    NASA Astrophysics Data System (ADS)

    Suryani, I.; Adi-Kusumo, F.

    2014-02-01

    Human Papillomavirus (HPV) is a major cause of cervical cancer, precancerous lesions, cancer and other disease. HPV is the most common sexually transmitted infection. Although HPV virus primarily affects woman but it can also affects man because it cause of cancer of the anus, vulva, vagina, penis and some other cancers. HPV vaccines now used to prevent cervical cancer and genital warts because the vaccine protect against four types of HPV that most commonly cause disease are types 6, 11, 16, and 18. This paper is sequel work of Elbasha (2008). Difference with Elbasha (2008) are give alternative proof global stability, numerical simulation and interpretation. Global stability of the equilibrium on the model of a two-sex HPV vaccination were explored by using Lyapunov. Although we use the same lyapunov function, we use the largest invariant set to proof the global stability. The result show that the global stability of the equilibrium depends on the effective reproduction number (R). If R < 1 then the infection-free equilibrium is asymptotically stable globally. If R > 1 then endemic equilibrium have globally asymptotically stable properties. Then equilibrium proceed with the interpretation of numerical simulation.

  11. When vaccines go viral: an analysis of HPV vaccine coverage on YouTube.

    PubMed

    Briones, Rowena; Nan, Xiaoli; Madden, Kelly; Waks, Leah

    2012-01-01

    This article reports a content analysis of YouTube videos related to the human papillomavirus (HPV) vaccine. In total, 172 YouTube videos were examined with respect to video sources, tones, and viewer responses. Additionally, coverage of specific content was analyzed through the lens of the Health Belief Model (Rosenstock, 1974) and in terms of two content themes (i.e., conspiracy theory and civil liberties). The relations among these aspects of the videos were assessed as well. We found that most of these videos were news clips or consumer-generated content. The majority of the videos were negative in tone, disapproving of the HPV vaccine. In addition, negative videos were liked more by the viewers than positive or ambiguous ones. Accusations of conspiracy theory and infringement of civil liberties were manifested in these videos. The videos also presented mixed information related to the key determinants of health behavior as stipulated in the Health Belief Model. Implications for the findings are discussed. PMID:22029723

  12. Reducing HPV-associated Cancer Globally

    PubMed Central

    Lowy, Douglas R.; Schiller, John T.

    2012-01-01

    Human papillomavirus (HPV)-related cancers are a major worldwide public health concern. Virtually all cervical cancer is HPV-related, with 70% caused by HPV16 and -18. Variable proportions of certain non-cervical cancers (e.g., anal, vulvar, oropharyngeal) are HPV-related; over 90% of the HPV-related ones are related to HPV16, -18. The HPV-related cancers are dominated by cervical cancer in the developing world, where cervical cancer screening is limited. In this setting, widespread uptake of current HPV vaccines by adolescent girls could reduce this cancer's incidence and mortality by approximately two-thirds, with cost-effective screening programs of adult women having the potential to reduce mortality more rapidly. In the industrialized world, non-cervical HPV-related cancers, especially oropharyngeal, are rapidly increasing, and now rival the incidence of cervical cancer, whose rates continue to decline thanks to established cervical screening programs. Therefore, reducing HPV-associated non-cervical cancers with HPV vaccination has greater importance in the industrialized world, especially since there are no approved screening programs for these cancers. Preventing the substantial number of non-cervical HPV cancers in men will require either “herd” immunity through high vaccination rates in females or male vaccination. Current HPV vaccination can complement cervical screening in protecting against cervical cancer and may permit the safe reduction of screening intensity in industrialized countries. Second-generation HPV vaccines (active against a broader array of cervical cancer–related HPV types) could prevent an even higher proportion of cervical precancer and cancer and might permit further reductions in screening intensity. PMID:22219162

  13. Perceived need of a parental decision aid for the HPV vaccine: content and format preferences.

    PubMed

    Lechuga, Julia; Swain, Geoffrey; Weinhardt, Lance S

    2012-03-01

    The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process. PMID:21444922

  14. Patient adherence to three dose completion of the quadrivalent human papillomavirus (HPV) vaccine in a private practice.

    PubMed

    Rubin, Rochelle F; Kuttab, Huda-Marie; Rihani, Rami S; Reutzel, Thomas J

    2012-12-01

    The human papillomavirus quadrivalent (types 6, 11, 16, and 18) recombinant vaccine is effective in preventing cervical, vulvar, vaginal and anal cancer. Maximal protection is achieved with completion of all three recommended doses. A retrospective chart review was performed to (1) assess the current vaccine series completion rates in a private practice multispecialty suburban setting and (2) identify factors associated with failure to complete the vaccine series. Chi-square and independent samples t test were used for data analysis. A total of 4,117 patients out of 10,821 eligible patients received at least one dose of the HPV vaccine between October 1, 2006 and April 30, 2010. Overall, 69.5 % (n = 2,863) of patients who received one dose of the HPV vaccine completed all three doses in a valid time frame, representing 26.5 % of all eligible patients. Patients who completed the series were younger (16.8 vs. 18.2, p < 0.05), less likely to have a sexually transmitted disease diagnosis prior to initiation of the series (57.7 vs. 69.8 %, p < 0.05), and more likely to have visited the pediatrics department compared to family medicine, internal medicine, and OB/GYN departments (75.9, 65.7, 57.0, 60.9 %, respectively, p < 0.05). Deaths, pregnancies, and adverse drug reactions were not identified as independent factors impacting completion rates. The results indicate that adolescents, patients visiting the pediatrics department and those without a prior STD diagnosis completed the vaccination series more frequently than adults managed in family medicine, internal medicine, and OB/GYN departments. PMID:22752532

  15. Does the HPV vaccination programme have implications for cervical screening programmes in the UK?

    PubMed

    Beer, Helen; Hibbitts, Sam; Brophy, Sinead; Rahman, M A; Waller, Jo; Paranjothy, Shantini

    2014-04-01

    In the UK, a national HPV immunisation programme was implemented in 2008 for girls aged 12-13 years. In addition a catch-up programme was implemented for older girls up to 18 years of age from 2009 to 2011, with an uptake rate of 49.4%. Information about future uptake of cervical screening according to vaccination statistics is important in order to understand the impact of the vaccination programme and implications for a national cervical screening programme. We analysed data on a cohort of women who had been offered the HPV vaccine in the catch-up programme and were invited for cervical screening between 2010 and 2012 in Wales (n=30,882), in a record-linked database study, to describe the cervical screening uptake and clinical outcome according to HPV vaccination status. In our cohort, 48.5% (n=14,966) women had had HPV vaccination and 45.9% (n=14,164) women attended for cervical screening. Women who were unvaccinated were less likely to attend cervical screening (adjusted OR 0.58; 95% CI (0.55, 0.61)). Of those who attended for screening, 13.9% of vaccinated women had abnormal cytology reported compared to 16.7% of women who were unvaccinated. Women who lived in areas with high levels of social deprivation were less likely to be vaccinated (Quintile 5 OR 0.48 95% CI (0.45, 0.52)) or attend cervical screening (Quintile 5 OR 0.70; 95% CI (0.65, 0.75)) compared to those who lived in the least deprived areas. These data highlight the need for new strategies to address inequalities in cervical screening uptake and can inform further mathematical modelling work to clarify the impact of the HPV vaccination programme on future cervical cancer incidence. PMID:24530938

  16. Anti-tumor effects of genetic vaccines against HPV major oncogenes

    PubMed Central

    Cordeiro, Marcelo Nazário; Paolini, Francesca; Massa, Silvia; Curzio, Gianfranca; Illiano, Elena; Duarte Silva, Anna Jéssica; Franconi, Rosella; Bissa, Massimiliano; Morghen, Carlo De Giuli; de Freitas, Antonio Carlos; Venuti, Aldo

    2014-01-01

    Expression of HPV E5, E6 and E7 oncogenes are likely to overcome the regulation of cell proliferation and to escape immunological control, allowing uncontrolled growth and providing the potential for malignant transformation. Thus, their three oncogenic products may represent ideal target antigens for immunotherapeutic strategies. In previous attempts, we demonstrated that genetic vaccines against recombinant HPV16 E7 antigen were able to affect the tumor growth in a pre-clinical mouse model. To improve this anti-HPV strategy we developed a novel approach in which we explored the effects of E5-based genetic immunization. We designed novel HPV16 E5 genetic vaccines based on two different gene versions: whole E5 gene and E5Multi. The last one is a long multi epitope gene designed as a harmless E5 version. Both E5 genes were codon optimized for mammalian expression. In addition, we demonstrated that HPV 16 E5 oncogene is expressed in C3 mouse cell line making it an elective model for the study of E5 based vaccine. In this mouse model the immunological and biological activity of the E5 vaccines were assessed in parallel with the activity of anti-E7 and anti-E6 vaccines already reported to be effective in an immunotherapeutic setting. These E7 and E6 vaccines were made with mutated oncogenes, the E7GGG mutant that does not bind pRb and the E6F47R mutant that is less effective in inhibiting p53, respectively. Results confirmed the immunological activity of genetic formulations based on attenuated HPV16 oncogenes and showed that E5-based genetic immunization provided notable anti-tumor effects. PMID:25483514

  17. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    PubMed Central

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-01-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109

  18. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years--United States, 2013.

    PubMed

    Elam-Evans, Laurie D; Yankey, David; Jeyarajah, Jenny; Singleton, James A; Curtis, Robinette C; MacNeil, Jessica; Hariri, Susan

    2014-07-25

    The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, 2 doses of meningococcal conjugate (MenACWY) vaccine, and 3 doses of human papillomavirus (HPV) vaccine.* ACIP also recommends administration of "catch-up"† vaccinations, such as measles, mumps, and rubella (MMR), hepatitis B, and varicella, and, for all persons aged ≥6 months, an annual influenza vaccination. ACIP recommends administration of all age-appropriate vaccines during a single visit. To assess vaccination coverage among adolescents aged 13-17 years, CDC analyzed data from the 2013 National Immunization Survey-Teen (NIS-Teen).§ This report summarizes the results of that analysis, which show that from 2012 to 2013, coverage increased for each of the vaccines routinely recommended for adolescents: from 84.6% to 86.0% for ≥1 Tdap dose; from 74.0% to 77.8% for ≥1 MenACWY dose; from 53.8% to 57.3% for ≥1 HPV dose among females, and from 20.8% to 34.6% for ≥1 HPV dose among males. Coverage varied by state and local jurisdictions and by U.S. Department of Health and Human Services (HHS) region. Healthy People 2020 vaccination targets for adolescents aged 13-15 years were reached in 42 states for ≥1 Tdap dose, 18 for ≥1 MenACWY dose, and 11 for ≥2 varicella doses. No state met the target for ≥3 HPV doses.¶ Use of patient reminder and recall systems, immunization information systems, coverage assessment and feedback to clinicians, clinician reminders, standing orders, and other interventions can help make use of every health care visit to ensure that adolescents are fully protected from vaccine-preventable infections and cancers (5), especially when such interventions are coupled with clinicians' vaccination recommendations. PMID:25055186

  19. Catching Up With the HPV Vaccine: Challenges and Opportunities in Primary Care

    PubMed Central

    Sussman, Andrew L.; Helitzer, Deborah; Bennett, Anzia; Solares, Angélica; Lanoue, Marianna; Getrich, Christina M.

    2015-01-01

    PURPOSE Data confirm that high rates of human papillomavirus (HPV) vaccination have not been achieved despite strong clinician endorsement of the vaccine. We conducted a study of primary care clinicians to assess the broad range of health care delivery, health policy, and attitudinal factors influencing vaccination uptake and opportunities for informed decision making. METHODS We implemented a mixed methods study in RIOS Net, a primary care practice–based research network in New Mexico. We first conducted qualitative, in-depth interviews with primary care clinicians, health policy makers, and immunization experts, and followed up with a confirmatory survey distributed to RIOS Net clinician members. RESULTS Health service delivery challenges emerged as the greatest barrier to HPV vaccination, specifically the lack of capacity to track and distribute reminders to eligible patients. Clinicians also reported variations in counseling approaches attributable to both age and emphasis on the cancer prevention benefits of the vaccine. There was no evidence of sociocultural influences on vaccine decision making, nor did concerns about perceived overprotection emerge. CONCLUSIONS Our findings, based on a long-term program of research, suggest that both patients’ attributes and health system delivery are most influential in HPV vaccination coverage challenges. Interventions targeting innovative communication techniques, as well as health system changes that build on efforts toward coordinated care and utilization of other venues to promote vaccination, will be necessary to address these challenges. PMID:26195681

  20. “Knowledge and attitudes of Spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage”

    PubMed Central

    2014-01-01

    Background HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage. Methods A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters’ participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school. Results 833 mothers (65.1%) accepted participation. All their daughters’ responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05). Conclusion Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the

  1. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France

    PubMed Central

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Remi

    2013-01-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

  2. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France.

    PubMed

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Rémi

    2013-04-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

  3. Design and efficacy of a multilingual, multicultural HPV vaccine education intervention

    PubMed Central

    Valdez, Armando; Stewart, Susan L.; Tanjasiri, Sora Park; Levy, Vivian; Garza, Alvaro

    2016-01-01

    Background The human papillomavirus (HPV) is the precursor and the single, most important risk factor for cervical cancer. It is also the most commonly sexually transmitted infection in the United States. An estimated 20 million persons are currently infected with the virus, with an estimated 6 million new infections occurring annually and 12,000 new cervical cancer cases and 4,000 cervical cancer deaths annually. The human papillomavirus (HPV) vaccine is thus an especially important preventive measure for racial/ethnic groups who bear an unequal burden of cervical cancer mortality. Purpose This study aimed to develop a culturally and linguistically appropriate intervention to educate and empower Latino and Korean Americans to make an informed HPV vaccination decision for their minor children. Methods A parent-focused HPV vaccine education DVD was developed through focus groups and cognitive interviews with Latino and Korean Americans parents of children ages 11-17. A randomized controlled efficacy trial was subsequently conducted with 708 Latino and Korean Americans parents to assess knowledge gains, decisional conflict, decision self-efficacy and informed decision-making resulting from viewing the intervention DVD. Results Differences between treatment and control groups for pre-post changes in knowledge, informed decision-making and decisional conflict were statistically significant among the parents exposed to the education intervention DVD. Conclusion The study demonstrated that a culturally and linguistically appropriate intervention DVD designed to educate parents about the risks and benefits of the HPV vaccine promoted informed decision-making regarding HPV vaccination among at-risk populations. PMID:27540413

  4. Racial/ethnic disparities in HPV vaccine uptake among a sample of college women

    PubMed Central

    Okafor, Chukwuemeka; Hu, Xingdi; Cook, Robert L

    2016-01-01

    Objective To determine the association between racial/ethnic status and uptake and completion of the HPV vaccine series in college women. Methods Participants were recruited from a large University in North Central Florida. Young women between 18 and 26 years of age who were currently enrolled in a college course comprised the study sample. Participants completed an anonymous online survey that assessed sociodemographic characteristics, sexual behaviors, gynecological healthcare utilization and perception of risk to HPV-associated diseases. Multivariable analysis was conducted to determine the relationship between racial/ethnic status and HPV vaccination status. Results Of the 835 with complete data (51.0% white, 16.5% black, 13.8% Hispanic, 8.3% Asian and 9.9% other), 53% had initiated (receipt of at least one dose) the three dose HPV vaccine series. Of those who initiated, 70% indicated that they had completed all three doses. In adjusted analysis, blacks were significantly less likely to report initiation [adjusted prevalence ratio (aPR) = 0.78; 95% confidence interval (CI), 0.63, 0.97] and completion (aPR= 0.64; 95% CI: 0.48, 0.84) of the three dose HPV vaccine as compared to whites. Although completion rates were lower in all other racial/ethnic groups as compared to whites, these rates did not reach statistical significance. Conclusions These findings are consistent with research from other types of settings and demonstrate lower initiation and completion rates of HPV vaccine among black women attending college as compared to their white counterparts. Additional research is needed to understand why black college women have low initiation and completion rates. PMID:26863461

  5. A recommendation to use the diffusion of innovations theory to understand school nurses' role in HPV vaccine uptake.

    PubMed

    Rosen, Brittany; Goodson, Patricia

    Vaccinations represent one of the greatest public health achievements of the past century, but their success largely depends on populations' uptake. Seven years after its approval in 2006 for females, the HPV vaccination rates remain relatively low. Previous literature provides information about research examining U.S. physicians, pediatricians, and other healthcare providers' knowledge, attitudes, and professional practice toward the HPV vaccine. No research has yet investigated U.S. school nurses' role in educating the school community about the vaccine's benefits. Diffusion of Innovations theory is an appropriate perspective for examining school nurses as opinion leaders who can influence the uptake of the HPV vaccine for youth. This theory explains how innovations diffuse throughout a social system, and highlights the construct of opinion leadership. School nurses exhibit the characteristics of opinion leaders; therefore, Diffusion of Innovations can be a useful lens for assessing their role in efforts to promote HPV vaccination for youth. PMID:24366021

  6. Innovative DNA vaccine for human papillomavirus (HPV)-associated head and neck cancer.

    PubMed

    Wu, A; Zeng, Q; Kang, T H; Peng, S; Roosinovich, E; Pai, S I; Hung, C-F

    2011-03-01

    Human papillomavirus (HPV), particularly type 16, has been associated with a subset of head and neck cancers. The viral-encoded oncogenic proteins E6 and E7 represent ideal targets for immunotherapy against HPV-associated head and neck cancers. DNA vaccines have emerged as attractive approaches for immunotherapy due to its simplicity, safety and ease of preparation. Intradermal administration of DNA vaccine by means of gene gun represents an efficient method to deliver DNA directly into dendritic cells for priming antigen-specific T cells. We have previously shown that a DNA vaccine encoding an invariant chain (Ii), in which the class II-associated Ii peptide (CLIP) region has been replaced by a Pan-DR-epitope (PADRE) sequence to form Ii-PADRE, is capable of generating PADRE-specific CD4+ T cells in vaccinated mice. In the current study, we hypothesize that a DNA vaccine encoding Ii-PADRE linked to E6 (Ii-PADRE-E6) will further enhance E6-specific CD8+ T cell immune responses through PADRE-specific CD4+ T-helper cells. We found that mice vaccinated with Ii-PADRE-E6 DNA generated comparable levels of PADRE-specific CD4+ T-cell immune responses, as well as significantly stronger E6-specific CD8+ T-cell immune responses and antitumor effects against the lethal challenge of E6-expressing tumor compared with mice vaccinated with Ii-E6 DNA. Taken together, our data indicate that vaccination with Ii-E6 DNA with PADRE replacing the CLIP region is capable of enhancing the E6-specific CD8+ T-cell immune response generated by the Ii-E6 DNA. Thus, Ii-PADRE-E6 represents a novel DNA vaccine for the treatment of HPV-associated head and neck cancer and other HPV-associated malignancies. PMID:20981112

  7. Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania

    PubMed Central

    Houlihan, Catherine F; Baisley, Kathy; Bravo, Ignacio G; Kapiga, Saidi; de Sanjosé, Silvia; Changalucha, John; Ross, David A; Hayes, Richard J; Watson-Jones, Deborah

    2016-01-01

    Background: No reports exist on genotype-specific human papillomavirus (HPV) acquisition in girls after first sex in sub-Saharan Africa, despite high HPV prevalence and cervical cancer incidence. Methods: We followed 503 HP-unvaccinated girls aged 15-16 years in Mwanza, Tanzania, 3-monthly for 18 months with interviews and self-administered vaginal swabs. Swabs were tested for 13 higHRisk and 24 low-risk HPV genotypes. Incidence, clearance and duration of overall HPV and genotype-specific infections were calculated and associated factors evaluated. Results: A total of 106 participants reported first sex prior to enrolment (N = 29) or during follow-up (N = 77). One was HIV-positive at the final visit. The remaining 105 girls contributed 323 adequate specimens. Incidence of any new HPV genotype was 225/100 person-years (pys), and incidence of vaccine types HPV-6, -11, -16 and -18 were 12, 2, 2 and 7/100 pys, respectively. Reporting sex in the past 3 months and knowing the most recent sexual partner for a longer period before sex were associated with HPV acquisition. Median time from reported sexual debut to first HPVinfection was 5 months, and infection duration was 6 months. Conclusion: This is the first description of HPV acquisition after first sex in sub-Saharan Africa where the incidence of cervical cancer is amongst the highest in the world. HPV incidence was very high after first sex, including some vaccine genotypes, and infection duration was short. This very high HPV incidence may help explain high cervical cancer rates, and supports recommendations that the HPV vaccine should be given to girls before first sex. PMID:26944311

  8. Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

    PubMed Central

    Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

    2013-01-01

    Abstract Objective To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Methods Data were collected from a sample of facilities that participated in five demonstration projects for HPV vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. Findings The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). Conclusion The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services. PMID:23940406

  9. Perceptions of Human Papillomavirus (HPV) infection and acceptability of HPV vaccine among men attending a sexual health clinic differ according to sexual orientation.

    PubMed

    Giuliani, Massimo; Vescio, Maria Fenicia; Donà, Maria Gabriella; Latini, Alessandra; Frasca, Mirko; Colafigli, Manuela; Farinella, Massimo; Rezza, Giovanni; Cristaudo, Antonio

    2016-06-01

    Our aim was to gain a better understanding of the knowledge about Human Papillomavirus (HPV) infection and attitudes toward the HPV vaccine among men at risk for sexually transmitted infections (STI). A self-administered questionnaire was completed by attendees of the largest STI Center in Rome, Italy, from April to June 2013. Determinants of vaccine acceptability were investigated using a Structured Equation Model. A total of 423 males participated in the survey: 296 (70.0%) men who have sex with men (MSM) and 127 (30.0%) men who have sex with women (MSW). Only one half of the participants knew that HPV is the cause of genital warts (56.9% of MSM vs. 49.5% of MSW, p=0.28). Even less were aware that HPV causes cancer in men (37.2% vs. 27.3%, p=0.08). MSW were more likely to indicate HPV as a cause of cervical cancer (80.8% vs. 69.3%, p=0.03) and to have heard about the vaccine (58.3 vs. 43.6%, p=0.01). Moreover, 72.1% of MSM and 70.3% of MSW were willing to be vaccinated. A rise of one-unit in the HPV awareness score increased the OR of vaccine acceptability among MSM by 25% (OR 1.25, 95%CI: 1.05-1.49; p=0.013). Differently, only attitudes had a relevant effect on willingness to be vaccinated among MSW (OR 3.32, 95%CI: 1.53-7.17; p=0.002). Efforts should be made to maximize awareness of HPV, especially as a causative agent of genital warts and male cancers, and to reinforce positive attitudes toward vaccination among men visiting STI centers. PMID:26752151

  10. The biopolitics of reproductive technologies beyond the clinic: localizing HPV vaccines in India.

    PubMed

    Towghi, Fouzieyha

    2013-01-01

    The human papillomavirus (HPV) vaccine research and marketing in India exemplifies the privatization of public sectors and global assemblages of novel actors and public-private partnerships in service delivery and pharmaceutical marketing. Drawing on ethnographic research, in this article I examine how the molecularized conception of cervical cancer and the simultaneous global rise of the HPV vaccine is redefining the meaning of prevention, the role of the state, and blurring the relationship between health care and health research in India. In 2009, two Indian states began "demonstration projects" to vaccinate 30,000 girls. The subsequent deaths of a number of girls exposed inherent problems with the projects. For many health activists, the vaccine has potentially grave consequences for India's public health system. This case demonstrates how biopolitical actors, and the drive for biocapital, can create a public health campaign that might in the end place women's health and the public health system at a greater risk. PMID:23768218

  11. [Research progress regarding the clinical evaluation on recombinant human papillomavirus vaccines].

    PubMed

    He, W G; Zhao, J; Huang, S J; Wu, T

    2016-06-01

    Human papillomavirus (HPV) is the main cause for cervical cancer, anogenital cancers and genital warts. Three HPV vaccines have been licensed abroad. Data from clinical trials showed high efficacy of the HPV vaccines in young women with 90%-100% vaccine-related HPV diseases prevented. Though efficacy of the vaccine appears lower in older women, this population can still benefit from vaccination. Immunobriging trials show that the two-dose schedule in 9-14 years old girls elicits non-inferior immune response than the three-dose one in young adults. In addition, HPV vaccines can reduce the recurrent rates in CIN2+ patients after therapeutic surgery and the vaccines have cross-protection aganist diseases caused by non-vaccine type HPV. Safety data on HPV vaccines are assuring. Thus HPV vaccine should be widely used in adolescent girls and women of appropriate age groups. PMID:27346126

  12. HPV knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the Young Women's Health Study

    PubMed Central

    Wadhera, Priya; Evans, Jennifer L; Stein, Ellen; Gandhi, Monica; Couture, Marie-Claude; Sansothy, Neth; Sichan, Keo; Maher, Lisa; Kaldor, John; Page, Kimberly

    2015-01-01

    Human papillomavirus (HPV) is a common sexually transmitted infection (STI) and the causative agent for cervical cancer, a frequently occurring malignant disease among women in developing countries. We assessed HPV awareness prior to the delivery of a brief information and education intervention, and HPV vaccine provision to female entertainment and sex workers (N=220). At baseline, only 23.6% of women had heard of HPV. Following the educational intervention, 90% answered all the HPV knowledge questions correctly. Of 192 participants attending the first quarterly cohort visit where vaccine was offered, 149 (78%) were eligible for vaccination; HIV-positive (n=32) and pregnant (n=11) women were excluded. Acceptance of vaccine among eligible women was universal, and 79.2% completed the three-dose vaccination series. Women who reported use of amphetamine type stimulants (ATS) had significantly and independently lower odds of vaccine completion (Adjusted OR 0.24; 95% CI 0.08, 0.69). New pregnancies also had an impact on vaccine completion: 5.4% (8/149 5.4%) who started the series had to stop due to new pregnancy. Results demonstrate the effectiveness of a simple education intervention designed to increase HPV knowledge and the feasibility of successful HPV vaccine in a population that is often difficult to engage in preventive health care. PMID:25505042

  13. Do vitamin D levels affect antibody titers produced in response to HPV vaccine?

    PubMed Central

    Zimmerman, Richard K; Lin, Chyongchiou Jeng; Raviotta, Jonathan M; Nowalk, Mary Patricia

    2015-01-01

    In addition to its well-known effects on bone metabolism, vitamin D is an immunomodulating hormone. Serum vitamin D levels in males 18–25 years were measured at baseline, and HPV antibody titers were measured one month following the third quadrivalent HPV vaccine dose. Vitamin D levels were ≥30 ng/ml (normal) in 60 males and <30 ng/ml (low) in 113 males. Reverse cumulative distribution curves and scatter plots showed higher antibody titers with low vitamin D for all vaccine strains (P < 0.05). In linear regression analyses, antibody titers for all HPV strains were significantly higher among those with lower vitamin D levels and among younger participants (P < 0.05). These relationships add to the body of knowledge of the complex role of vitamin D in immunoregulation. PMID:26176493

  14. Correlation between levels of human papillomavirus (HPV)-16 and 18 antibodies in serum and cervicovaginal secretions in girls and women vaccinated with the HPV-16/18 AS04-adjuvanted vaccine.

    PubMed

    Schwarz, Tino F; Kocken, Mariëlle; Petäjä, Tiina; Einstein, Mark H; Spaczynski, Marek; Louwers, Jacqueline A; Pedersen, Court; Levin, Myron; Zahaf, Toufik; Poncelet, Sylviane; Hardt, Karin; Descamps, Dominique; Dubin, Gary

    2010-12-01

    This pooled analysis of data from four Phase III clinical trials was undertaken to assess the correlation between levels of anti-human papillomavirus (HPV)-16/18 antibodies in serum and cervicovaginal secretions (CVS) in girls and women vaccinated with the HPV-16/18 AS04-adjuvanted vaccine. Serum and CVS samples were collected from a subset of women aged 10-65 years (N=350) at pre-specified time-points from 7 to 36 months post-vaccination. Anti-HPV-16/18 antibody levels in serum and CVS were measured by enzyme-linked immunosorbent assay. Pearson correlation coefficients between serum and CVS antibody levels, standardized for total immunoglobulin G, were calculated at each time-point in women with detectable antibodies in both serum and CVS. All subjects had seroconverted at Month 7 and remained seropositive through Month 36 for both antigens. Geometric mean titers of anti-HPV-16/18 antibodies in serum were substantially higher at all time-points than those in a control group of women who had cleared a natural HPV infection in another trial. In women with detectable antibodies in both serum and CVS, good correlation was seen between HPV-16/18 antibody levels at all time-points (Pearson correlation coefficient: 0.84-0.92 for HPV-16 and 0.90-0.91 for HPV-18). The strong correlation between levels of HPV-16/18 antibodies in serum and CVS up to 36 months post-vaccination in girls and women vaccinated with the HPV-16/18 AS04-adjuvanted vaccine supports transudation of serum antibodies as the mechanism by which antibodies are introduced into CVS. These CVS antibodies may play a role in the protective efficacy of this vaccine. PMID:21157180

  15. Association Study between Cervical Lesions and Single or Multiple Vaccine-Target and Non-Vaccine Target Human Papillomavirus (HPV) Types in Women from Northeastern Brazil

    PubMed Central

    Chagas, Bárbara Simas; Comar, Manola; Gurgel, Ana Pavla Almeida Diniz; Paiva, Sérgio; Seraceni, Silva; de Freitas, Antonio Carlos; Crovella, Sergio

    2015-01-01

    We performed an association between high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and single or multiple vaccine-target as well as non-vaccine target Human papillomavirus (HPV) types. Using bead-based HPV genotyping, 594 gynecological samples were genotyped. An association between squamous intraepithelial lesion (SIL) and presence of HPV16, 18, 31, 58 and 56 types were calculated. The risk was estimated by using odds ratio (OR) and 95% of confidence intervals (CI). A total of 370 (62.3%) women were HPV positive. Among these, 157 (42.7%) presented a single HPV infection, and 212 (57.3%) were infected by more than one HPV type. HPV31 was the most prevalent genotype, regardless single and multiple HPV infections. Single infection with HPV31 was associated with LSIL (OR=2.32; 95%CI: 1.01 to 5.32; p=0.04); HPV31 was also associated with LSIL (OR=3.28; 95%CI: 1.74 to 6.19; p= 0.0002) and HSIL (OR=3.82; 95%CI: 2.10 to 6.97; p<0.001) in multiple HPV infections. Risk to harbor cervical lesions was observed in multiple HPV infections with regard to the HPV56 (OR=5.39; 95%CI: 2.44 to 11.90; p<0.001for LSIL; OR=5.37; 95%CI: 2.71 to 10.69; p<0.001) and HPV58 (OR=3.29; 95%CI: 1.34 to 8.09; p=0.0091 for LSIL; OR=3.55; 95%CI: 1.56 to 8.11; p=0.0026) genotypes. In addition, women coinfected with HPV16/31/56 types had 6 and 5-fold increased risk of HSIL (OR=6.46; 95%CI: 1.89 to 22.09; p=0.002) and LSIL (OR=5.22; 95%CI: 1.10 to 24.70; p=0.03), respectively. Multiple HPV infections without HPV16/18 has 2-fold increased risk of HSIL (OR=2.57; 95%CI: 1.41 to 4.70; p=0.002) and LSIL OR=2.03; 95%CI: 1.08 to 3.79; p=0.02). The results of this study suggest that single and multiple vaccine target as well as non-vaccine target HPV types are associated with LSIL and HSIL. These finding should be taken into consideration in the design of HPV vaccination strategies. PMID:26176537

  16. Systematic review of the cost-effectiveness of the vaccination against HPV in Brazil.

    PubMed

    Fonseca, Allex Jardim; de Lima Ferreira, Luiz Carlos

    2014-01-01

    In Brazil, almost 16,000 new cases of cervical cancer (CC), the type of neoplasia that claims the more lives of young women than any other, are expected in 2014. Although the vaccine against HPV has been developed, the application of this strategies to large populations is costly, and its use in Brazil is limited. Studies of the economic implications of new preventive technologies for CC may support rational and evidence-based decisions in public health. A systematic search of articles published between 2000 and 2014 was conducted using MEDLINE, EMBASE, the Cochrane Collaboration of Systematic Reviews, and LILACS. The aim of this search was the identification of original articles that evaluated the cost-effectiveness of vaccination against HPV in Brazil. A total of 6 articles are included in this review, evaluating the addition of a vaccine against HPV in comparison to population screening. Although the vaccine against HPV increases the cost of preventing cervical cancer, this new preventive technology presents favorable cost-effectiveness profiles in the case of Brazil. Failure to utilize the newly available preventative technologies against CC can lead to misguided and perverse consequences in a country in which programs based on the Papanicolaou test have been only partially successful. PMID:25483692

  17. Uptake of Free HPV Vaccination among Young Women: A Comparison of Rural versus Urban Rates

    ERIC Educational Resources Information Center

    Crosby, Richard A.; Casey, Baretta R.; Vanderpool, Robin; Collins, Tom; Moore, Gregory R.

    2011-01-01

    Purpose: To contrast rates of initial HPV vaccine uptake, offered at no cost, between a rural clinic, a rural community college, and an urban college clinic and to identify rural versus urban differences in uptake of free booster doses. Methods: Young rural women attending rural clinics (n = 246), young women attending a rural community college (n…

  18. Systematic review of the cost-effectiveness of the vaccination against HPV in Brazil

    PubMed Central

    Fonseca, Allex Jardim; de Lima Ferreira, Luiz Carlos

    2014-01-01

    In Brazil, almost 16,000 new cases of cervical cancer (CC), the type of neoplasia that claims the more lives of young women than any other, are expected in 2014. Although the vaccine against HPV has been developed, the application of this strategies to large populations is costly, and its use in Brazil is limited. Studies of the economic implications of new preventive technologies for CC may support rational and evidence-based decisions in public health. A systematic search of articles published between 2000 and 2014 was conducted using MEDLINE, EMBASE, the Cochrane Collaboration of Systematic Reviews, and LILACS. The aim of this search was the identification of original articles that evaluated the cost-effectiveness of vaccination against HPV in Brazil. A total of 6 articles are included in this review, evaluating the addition of a vaccine against HPV in comparison to population screening. Although the vaccine against HPV increases the cost of preventing cervical cancer, this new preventive technology presents favorable cost-effectiveness profiles in the case of Brazil. Failure to utilize the newly available preventative technologies against CC can lead to misguided and perverse consequences in a country in which programs based on the Papanicolaou test have been only partially successful. PMID:25483692

  19. Impact of electronic health record (EHR) reminder on human papillomavirus (HPV) vaccine initiation and timely completion

    PubMed Central

    Ruffin, Mack T.; Plegue, Melissa A.; Rockwell, Pamela G.; Young, Alisa P.; Patel, Divya A.; Yeazel, Mark W.

    2016-01-01

    Background Initiation and timely completion of the HPV vaccine in young women is critical. We compared initiation and completion of HPV vaccine among women in two community-based networks with electronic health records: one with a prompt and reminder system (prompted cohort) and one without (unprompted cohort). Methods Female patients aged 9–26 years seen between March 1, 2007 and January 25, 2010 were used as retrospective cohorts. Patient demographics and vaccination dates were extracted from the electronic health record. Results Patients eligible for the vaccine included 6019 from the prompted cohort and 9096 from the unprompted cohort. Mean age at initiation was 17.3 years in prompted cohort and 18.1 years at unprompted cohort with significantly more (p<0.001) patients initiating in the prompted cohort (34.9%) compared to the unprompted cohort (21.5%). African Americans age 9–18 years with three or more visits during the observation period were significantly more likely to initiate in the prompted cohort (p<0.001). Prompted cohort was significantly more (p<0.001) likely to complete the vaccine series timely compared to unprompted cohort. Conclusion More patients age 9–26 years initiated and timely completed the HPV vaccine series in clinics using an electronic health record system with prompts compared to clinics without prompts. PMID:25957365

  20. HEALTH AND ECONOMIC IMPACT OF HPV 16/18 VACCINATION AND CERVICAL CANCER SCREENING IN EASTERN AFRICA

    PubMed Central

    Campos, Nicole G.; Kim, Jane J.; Castle, Philip E.; Ortendahl, Jesse D.; O'Shea, Meredith; Diaz, Mireia; Goldie, Sue J.

    2011-01-01

    Eastern Africa has the world's highest cervical cancer incidence and mortality rates. We used epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, we assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30 we assessed only screening (with HPV DNA testing up to three times per lifetime or VIA at age 35). Assuming no waning immunity, mean reduction in lifetime cancer risk associated with vaccination ranged from 36-45%, and vaccination followed by screening once per lifetime at age 35 with HPV DNA testing ranged from 43-51%. For both younger and older women, the most effective screening strategy was HPV DNA testing three times per lifetime. Provided the cost per vaccinated girl was less than I$10 (I$2 per dose), vaccination had an incremental cost-effectiveness ratio (I$ [international dollars]/year of life saved [YLS]) less than the country-specific per capita GDP, a commonly cited heuristic for “very cost-effective” interventions. If the cost per vaccinated girl was between I$10 (I$2 per dose) and I$25 (I$5 per dose), vaccination followed by HPV DNA testing would save the most lives and would be considered good value for public health dollars. These results should be used to catalyze design and evaluation of HPV vaccine delivery and screening programs, and contribute to a dialogue on financing HPV vaccination in poor countries. PMID:21717458

  1. Female human papillomavirus (HPV) vaccination: global uptake and the impact of attitudes.

    PubMed

    Hopkins, Tom Glass; Wood, Nick

    2013-03-25

    Human papillomavirus (HPV) is the causative agent in cervical cancer and has been implicated in a range of other malignancies. Preventative vaccines are now internationally available and provide high levels of protection from common viral strains. The introduction of a comprehensive vaccination programme (except 'program' in computers) could prevent over 60% of current cervical cancer cases, but this is dependent on such programmes achieving a high level of coverage. In this review, we summarise the current trends in female HPV vaccination coverage throughout the world, and place it in the context of available research on attitudes towards vaccination amongst the public and health professionals. Where countries have the resources for mass vaccination programmes, uptake has varied. School-based opt-out programmes consistently achieve highest coverage, whilst countries and regions without systematic vaccination schemes have low coverage. In all countries, the success of vaccination programmes is dependent on the support of the public and healthcare professionals. Whilst public acceptance is dependent on multiple factors, it has repeatedly been shown that recommendation by a health professional, particularly clinicians, is key to vaccine uptake. Worryingly, it appears that a proportion of clinicians still have significant reservations about promoting vaccination, particularly for younger age groups. A commitment now, to fully educating both the public and clinicians, has the potential to make a dramatic future impact. PMID:23375978

  2. Examining Provincial HPV Vaccination Schemes in Canada: Should We Standardise the Grade of Vaccination or the Number of Doses?

    PubMed Central

    Smith?, Robert J.

    2015-01-01

    Human papillomavirus (HPV) infection is the most common sexually transmitted infection, which is linked to several cancers and genital warts. Depending on the Canadian province, the quadrivalent vaccine is given to girls in grades 4 through 10 with either a two- or three-dose schedule. We use a mathematical model to address the following research questions: (1) Does the grade at which the girls are vaccinated significantly affect the outcome of the program? (2) What coverage rate must the provinces reach in order to reduce the impact of HPV on the Canadian population? (3) What are the implications of vaccinating with two versus three doses? The model suggests the grade of vaccination and the number of doses do not make a significant difference to the outcome of the public vaccination program. The most significant factor is the coverage rate of children and adults. We recommend that provinces vaccinate as early as possible to avoid vaccine failure due to previous infection. We also recommend that the main focus of the program should be on obtaining a large enough coverage rate for children and/or adults in order to achieve the desired outcome with either two or three doses of the vaccine.

  3. Risk Perceptions, Sexual Attitudes, and Sexual Behavior after HPV Vaccination in 11–12 Year-Old Girls

    PubMed Central

    Mullins, Tanya L. Kowalczyk; Widdice, Lea E.; Rosenthal, Susan L.; Zimet, Gregory D.; Kahn, Jessica A.

    2015-01-01

    Objectives Among 11–12 year-old girls who received the human papillomavirus (HPV) vaccine, we explored, over the subsequent 30 months: 1) trajectories of knowledge about HPV/HPV vaccines and vaccine-related risk perceptions; 2) whether knowledge and risk perceptions impacted sexual attitudes and sexual experience; and 3) whether mothers, clinicians, and media influenced girls’ risk perceptions, attitudes, and behavior. Methods Girls and mothers (n=25 dyads) completed separate, semi-structured interviews within 2 days of, and 6, 18, and 30 months after, their first HPV vaccine dose. Knowledge, risk perceptions related to HPV and other sexually transmitted infections (STIs), and attitudes about sexual behaviors were assessed. Sexual experience was assessed at girls’ 30 month interviews. Clinicians completed interviews at baseline. Transcribed interviews were analyzed using framework analysis. Results Girls’ baseline knowledge was poor but often improved with time. Most girls (n=18) developed accurate risk perceptions about HPV but only half (n=12) developed accurate risk perceptions about other STIs by 30 months. The vast majority of girls thought that safer sex was still important, regardless of knowledge, risk perceptions, or sexual experience. Girls whose HPV knowledge was high at baseline or increased over time tended to articulate accurate risk perceptions; those who were able to articulate accurate risk perceptions tended to report not having initiated sexual activity. Girls whose mothers demonstrated higher knowledge and/or communication about HPV vaccination tended to articulate accurate risk perceptions, whereas clinicians and media exposure did not appear to influence risk perceptions. Conclusions Higher knowledge about HPV vaccines among mothers and girls was linked with more accurate risk perceptions among girls. Clinicians may play an important role in providing education about HPV vaccines to mothers and girls. PMID:26116249

  4. Development of a Theory-based, Sociocultural Instrument to Assess Black Maternal Intentions to Vaccinate Their Daughters Aged 9 to 12 Against HPV.

    PubMed

    Cunningham-Erves, Jennifer; Talbott, Laura L; O'Neal, Marcia R; Ivankova, Nataliya V; Wallston, Kenneth A

    2016-09-01

    The human papillomavirus (HPV) vaccine could assist in reducing the cervical cancer disparity existing between Black and White women. Understanding factors influencing Black maternal intentions to vaccinate their daughter is essential in improving vaccination uptake. However, existing instruments do not comprehensively assess factors (e.g., culture) influencing maternal intentions. This paper describes the development of the Human Papillomavirus Vaccination Survey for Black Mothers with Girls Aged 9 to 12 (HPVS-BM), the first instrument to measure knowledge, attitudes, subjective norms, and cultural beliefs relating to Black maternal intentions to vaccinate their daughters aged 9 to 12 years against HPV. The items and scales were refined using content review by experts, as well as cognitive interviews and pilot testing with target audience participants. The final version of the HPVS-BM was administered to 242 Black mothers with adolescent daughters. Internal reliability was determined using Cronbach's alpha. An a priori hypothetical model was developed to determine convergent and discriminant validity. All scales of the HPVS-BM had an acceptable internal reliability of 0.70 or higher. The intention scale of HPVS-BM was significantly correlated (p < .05) with perceived benefits, perceived barriers, and subjective norms, supporting strong convergent validity. Moderate discriminant construct validity was also demonstrated. Exhibiting good psychometrics, this instrument could be used by healthcare researchers and professionals to develop programs to increase HPV vaccination among Black adolescent females aimed at reducing the racial disparities in cervical cancer. Further psychometric testing of this survey tool for understanding factors influencing maternal intentions is warranted. PMID:26081311

  5. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 vaccine and HPV-6/11/16/18 vaccine: follow-up from months 12-24 in a Phase III randomized study of healthy women aged 18-45 years.

    PubMed

    Einstein, Mark H; Baron, Mira; Levin, Myron J; Chatterjee, Archana; Fox, Bradley; Scholar, Sofia; Rosen, Jeffrey; Chakhtoura, Nahida; Meric, Dorothée; Dessy, Francis J; Datta, Sanjoy K; Descamps, Dominique; Dubin, Gary

    2011-12-01

    In this observer-blind study (NCT00423046), women (N=1,106), stratified by age (18-26, 27-35, 36-45 y), were randomized (1:1) to receive the HPV-16/18 vaccine (Cervarix®, GlaxoSmithKline Biologicals, Months 0, 1, 6) or the HPV-6/11/16/18 vaccine (Gardasil® Merck & Co., Inc., Months 0, 2, 6). Month 7 results were previously reported; we now report Month 24 results. In the according-to-protocol cohort for immunogenicity (seronegative and DNA-negative at baseline for HPV type analyzed), seropositivity rates of neutralizing antibodies (nAbs) [pseudovirion-based neutralization assay] were, across all age strata, 100% (HPV-16/18 vaccine) and 97.5-100% (HPV-6/11/16/18 vaccine) for HPV-16, and 99.0-100% (HPV-16/18 vaccine) and 72.3-84.4% (HPV-6/11/16/18 vaccine) for HPV-18. Corresponding geometric mean titers (GMTs) were 2.4-5.8-fold higher for HPV-16 and 7.7-9.4-fold higher for HPV-18 with the HPV-16/18 vaccine versus the HPV-6/11/16/18 vaccine; HPV-16 and HPV-18 GMTs were significantly higher with the HPV-16/18 vaccine than the HPV-6/11/16/18 vaccine (p< 0.0001) in the total vaccinated cohort (received ≥1 vaccine dose, irrespective of baseline sero/DNA-status). Similar results were obtained using enzyme-linked immunosorbent assay (ELISA). Positivity rates and GMTs of antigen-specific IgG antibodies in cervicovaginal secretions (ELISA) were not significantly different between vaccines. At Month 24, CD4⁺ T-cell responses for HPV-16 and HPV-18 were higher with the HPV-16/18 vaccine; memory B-cell response was higher for HPV-18 with the HPV-16/18 vaccine and similar between vaccines for HPV-16. Both vaccines were generally well tolerated. Although an immunological correlate of protection has not been defined, differences in the magnitude of immune response between vaccines may represent determinants of duration of protection. PMID:22048173

  6. A case for immunization of human papillomavirus (HPV) 6/11-infected pregnant women with the quadrivalent HPV vaccine to prevent juvenile-onset laryngeal papilloma.

    PubMed

    Shah, Keerti V

    2014-05-01

    Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a rare disease caused by intrapartum or perinatal transmission of human papillomavirus (HPV) types 6 and 11 from an infected mother to the newborn. Immunization of a pregnant woman who has condyloma or HPV-6/11 infection with the quadrivalent HPV vaccine will result in a high neutralizing antibody response to HPV 6 and HPV 11 in her serum, and these antibodies transferred to the newborn will likely protect the child against the development of JORRP. Because of the low incidence of disease in at-risk children, it may be difficult to test the effectiveness of maternal immunization for prevention of JORRP. PMID:24265442

  7. School nurses' experiences of delivering the UK HPV vaccination programme in its first year

    PubMed Central

    2011-01-01

    Background In the United Kingdom (UK) in September 2008, school nurses began delivering the HPV immunisation programme for girls aged 12 and 13 years old. This study offers insights from school nurses' perspectives and experiences of delivering this new vaccination programme. Methods Thirty in-depth telephone interviews were conducted with school nurses working across the UK between September 2008 and May 2009. This time period covers the first year of the HPV vaccination programme in schools. School nurses were recruited via GP practices, the internet and posters targeted at school nurse practitioners. Results All the school nurses spoke of readying themselves for a deluge of phone calls from concerned parents, but found that in fact few parents telephoned to ask for more information or express their concerns about the HPV vaccine. Several school nurses mentioned a lack of planning by policy makers and stated that at its introduction they felt ill prepared. The impact on school nurses' workload was spoken about at length by all the school nurses. They believed that the programme had vastly increased their workload leading them to cut back on their core activities and the time they could dedicate to offering support to vulnerable pupils. Conclusion Overall the first year of the implementation of the HPV vaccination programme in the UK has exceeded school nurses' expectations and some of its success may be attributed to the school nurses' commitment to the programme. It is also the case that other factors, including positive newsprint media reporting that accompanied the introduction of the HPV vaccination programme may have played a role. Nevertheless, school nurses also believed that the programme had vastly increased their workload leading them to cut back on their core activities and as such they could no longer dedicate time to offer support to vulnerable pupils. This unintentional aspect of the programme may be worthy of further exploration. PMID:21864404

  8. Social marketing to promote HPV vaccination in pre-teenage children: talk about a sexually transmitted infection.

    PubMed

    Cates, Joan R; Coyne-Beasley, Tamera

    2015-01-01

    A significant barrier to the delivery of HPV vaccine is reluctance by both healthcare providers and parents to vaccinate at age 11 or 12, which may be considered a young age. This barrier has been called "vaccine hesitancy" in recent research. In this commentary, we suggest using social marketing strategies to promote HPV vaccination at the recommended preteen ages. We emphasize a critical public health message of a sexually transmitted infection (STI) as preventable and vaccination against HPV as a way to protect against its consequences. The message tackles the issue of vaccine hesitancy head on, by saying that most people are at risk for HPV and there is a way to prevent HPV's serious consequences of cancer. Our approach to this conversation in the clinical setting is also to engage the preteen in a dialog with the parent and provider. We expect our emphasis on the risk of STI infection will not only lead to increased HPV vaccination at preteen ages but also lay important groundwork for clinical adoption of other STI vaccines in development (HIV, HSV, Chlamydia, and Gonorrhea) as well as begin conversations to promote sexual health. PMID:25692313

  9. Social marketing to promote HPV vaccination in pre-teenage children: Talk about a sexually transmitted infection

    PubMed Central

    Cates, Joan R; Coyne-Beasley, Tamera

    2015-01-01

    A significant barrier to the delivery of HPV vaccine is reluctance by both healthcare providers and parents to vaccinate at age 11 or 12, which may be considered a young age. This barrier has been called “vaccine hesitancy” in recent research. In this commentary, we suggest using social marketing strategies to promote HPV vaccination at the recommended preteen ages. We emphasize a critical public health message of a sexually transmitted infection (STI) as preventable and vaccination against HPV as a way to protect against its consequences. The message tackles the issue of vaccine hesitancy head on, by saying that most people are at risk for HPV and there is a way to prevent HPV's serious consequences of cancer. Our approach to this conversation in the clinical setting is also to engage the preteen in a dialog with the parent and provider. We expect our emphasis on the risk of STI infection will not only lead to increased HPV vaccination at preteen ages but also lay important groundwork for clinical adoption of other STI vaccines in development (HIV, HSV, Chlamydia, and Gonorrhea) as well as begin conversations to promote sexual health. PMID:25692313

  10. Factors associated with the persuasiveness of direct-to-consumer advertising on HPV vaccination among young women.

    PubMed

    Manika, Danae; Ball, Jennifer G; Stout, Patricia A

    2014-01-01

    This quantitative study explored young women's response to direct-to-consumer pharmaceutical advertising (DTCA) for a human papillomavirus (HPV) vaccine. In particular, the study examined (a) the association of factors stemming from consumer research with actual and intended behavioral responses to DTCA for HPV and (b) key elements drawn from commonly used health-related theories to determine the strongest associations with behavioral intentions regarding the HPV vaccine. Survey findings showed that vaccinated women indicated that DTCA played a role in their decision to get vaccinated against HPV more so than those who were not vaccinated. Trust in DTCA for an HPV vaccine brand was significantly related to intentions to seek more information about the vaccine. Also, perceived barriers had the only significant association with behavioral intentions when taking into account perceived threat and response efficacy. These results provide practical implications for key industry decision makers and health communication professionals on the design of effective theory-based health communication message content for an HPV vaccine brand with consequent social implications. PMID:24708436

  11. HPV Cancer Prevention

    MedlinePlus

    ... of these cancers can be prevented by HPV vaccine. HPV VACCINE IS RECOMMENDED AT THE SAME TIME AS OTHER ... caused by HPV, and meningitis. V1a1c-ci1n2esyfeoarryooludr:  THMdPaeVpningococcal HPV VACCINE IS BEST AT 11-12 YEARS Preteens have ...

  12. Assessing the effectiveness of a community-based sensitization strategy in creating awareness about HPV, cervical cancer and HPV vaccine among parents in North West Cameroon.

    PubMed

    Wamai, Richard G; Ayissi, Claudine Akono; Oduwo, Geofrey O; Perlman, Stacey; Welty, Edith; Manga, Simon; Ogembo, Javier Gordon

    2012-10-01

    In 2010, the Cameroon Baptist Convention Health Services (CBCHS) received a donation of HPV vaccine (Gardasil®) to immunize girls of ages 9-13 years in the North West Region of Cameroon. We evaluated the effectiveness of the CBCHS campaign program in sensitizing parents/guardians to encourage HPV vaccine uptake, identified factors that influence parents' decisions to vaccinate girls, and examined the uptake of cervical cancer screening among mothers. We conducted a cross-sectional survey in four healthcare facilities run by CBCHS, churches and other social settings. A total of 350 questionnaires were distributed and 317 were used for the analysis. There were high levels of awareness about cervical cancer, HPV and HPV vaccine. 75.5% understood HPV is sexually transmitted and 90.3% were aware of the use of vaccine as a preventive measure. Effectiveness of the vaccine (31.8%) and side effects/safety (18.4%) were the major barriers for parents to vaccinate their daughters. Bivariate analysis further revealed that the level of education (p = 0.0006), income level (p = 0.0044) and perceived risks (p = 0.0044) are additional factors influencing parents' decisions to vaccinate girls. 35.3% of women had sought a cervical cancer screening, significantly higher than the general estimated rate of screening (<10%) in other parts of Cameroon and sub-Saharan Africa. These results support the viability of a community-tailored sensitization strategy to increase awareness among the targeted audience of parents/guardians, who are critical decision-makers for vaccine delivery to children. PMID:22302651

  13. HPV vaccination programs have not been shown to be cost-effective in countries with comprehensive Pap screening and surgery.

    PubMed

    Wilyman, Judy

    2013-01-01

    Pap screening combined with loop electrosurgical excision procedures (LEEP) is almost 100% effective in preventing cervical cancer mortality yet many countries with these procedures have now implemented broad HPV vaccination programs. HPV vaccines have not been demonstrated to be more effective or safer than Pap screening in the prevention of cervical cancer and Pap screening will still be required even in vaccinated women. The HPV vaccine costs Au$450 per person and it does not protect against ~30% of cancer. This investigation analyses the cost-effectiveness of using the HPV vaccine in countries where Pap screening and surgical procedures have already reduced cervical cancer mortality to very low rates. Cost-effectiveness of vaccination programs is being determined by mathematical models which are founded on many assumptions. It is necessary to examine the rigor of these assumptions to be certain of the health benefits that are predicted. In 2002 scientists concluded that HPV 16 and 18 were the central and independent cause of most cervical cancer. This conclusion was based on molecular technology. If HPV 16 and 18 infections are the central and independent cause of most cervical cancer then the incidence of HPV 16 and 18 should vary with the incidence and mortality of cervical cancer worldwide. This correlation does not exist. It is also observed that the majority of HPV 16/18 infections do not lead to cervical cancer. This indicates that other etiological or 'risk' factors are necessary for persistent HPV infection to progress to cancer. The benefits of HPV vaccines have been determined by using pre-cancerous lesions in young women as a surrogate for cervical cancer. This surrogate is found to be inadequate as an end-point for cervical cancer. Clinical trials have only provided speculative benefits for the efficacy of HPV vaccines against cancer and the long-term risks of the vaccine have not been established. Pap screening will still be required in vaccinated

  14. The Multidimensional Nature of Perceived Barriers: Global versus Practical Barriers to HPV Vaccination

    PubMed Central

    Gerend, Mary A.; Shepherd, Melissa A.; Shepherd, Janet E.

    2012-01-01

    Objective Perceived barriers are one of the strongest determinants of health behavior. The current study presents a novel conceptualization of perceived barriers by testing the following hypotheses: (a) perceived barriers are multidimensional and thus should cluster into distinct factors; (b) practical barriers should be salient for individuals intending to engage in a particular health behavior, whereas global barriers should be salient for individuals not intending to enact the behavior; and (c) whereas global barriers should be negatively associated with behavioral intentions, practical barriers should be positively related to intentions. Methods The context for this investigation was young adult women’s perceived barriers to human papillomavirus (HPV) vaccination. Two months after viewing an educational video about HPV vaccination, women (aged 18-26) who had not initiated the series (n = 703) reported their perceived barriers to HPV vaccination and intentions to receive the vaccine. Results Relative to the conventional single factor approach, a five-factor model provided better fit to the data and accounted for a larger proportion of variance in vaccination intentions. The relative salience of different perceived barriers varied as a function of women’s intentions. Participants who were not intending to get vaccinated cited global concerns about vaccine safety and low perceived need for the vaccine. In contrast, participants intending to get vaccinated cited practical concerns (cost, logistical barriers) related to carrying out their intentions. Moreover, whereas global perceived barriers were associated with lower intentions, practical barriers were associated with higher intentions. Conclusions Perceived barriers are multidimensional and vary systematically as a function of people’s behavioral intentions. PMID:22059622

  15. Cervical Cancer Screening in Partly HPV Vaccinated Cohorts – A Cost-Effectiveness Analysis

    PubMed Central

    Naber, Steffie K.; Matthijsse, Suzette M.; Rozemeijer, Kirsten; Penning, Corine; de Kok, Inge M. C. M.; van Ballegooijen, Marjolein

    2016-01-01

    Background Vaccination against the oncogenic human papillomavirus (HPV) types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable) herd effect will be limited at first, but is expected to increase over time. At a certain herd immunity level, tailoring screening to vaccination status may no longer be worth the additional effort. Moreover, uniform screening may be the only viable option. We therefore investigated at what level of herd immunity it is cost-effective to also reduce screening intensity in unvaccinated women. Methods We used the MISCAN-Cervix model to determine the optimal screening strategy for a pre-vaccination population and for vaccinated women (~80% decreased risk), assuming a willingness-to-pay of €50,000 per quality-adjusted life year gained. We considered HPV testing, cytology testing and co-testing and varied the start age of screening, the screening interval and the number of lifetime screens. We then calculated the incremental cost-effectiveness ratio (ICER) of screening unvaccinated women with the strategy optimized to the pre-vaccination population as compared to with the strategy optimized to vaccinated women, assuming different herd immunity levels. Results Primary HPV screening with cytology triage was the optimal strategy, with 8 lifetime screens for the pre-vaccination population and 3 for vaccinated women. The ICER of screening unvaccinated women 8 times instead of 3 was €28,085 in the absence of herd immunity. At around 50% herd immunity, the ICER reached €50,000. Conclusion From a herd immunity level of 50% onwards, screening intensity based on the pre-vaccination risk level becomes cost-ineffective for unvaccinated women. Reducing the screening intensity of uniform screening may then be considered. PMID:26824771

  16. Expression of HPV-16 L1 capsomeres with glutathione-S-transferase as a fusion protein in tobacco plastids: an approach for a capsomere-based HPV vaccine.

    PubMed

    Hassan, Syed Waqas; Waheed, Mohammad Tahir; Müller, Martin; Clarke, Jihong Liu; Shinwari, Zabta Khan; Lössl, Andreas Günter

    2014-01-01

    Human Papillomavirus (HPV) is the main cause of cervical cancer, which is the second most severe cancer of women worldwide, particularly in developing countries. Although vaccines against HPV infection are commercially available, they are neither affordable nor accessible to women in low income countries e.g. Africa. Thus, alternative cost-effective vaccine production approaches need to be developed. This study uses tobacco plants to express pentameric capsomeres of HPV that have been reported to generate elevated immune responses against HPV. A modified HPV-16 L1 (L1_2xCysM) protein has been expressed as a fusion protein with glutathione-S-transferase (GST) in tobacco chloroplasts following biolistic transformation. In total 7 transplastomic lines with healthy phenotypes were generated. Site specific integration of the GST-L1_2xCysM and aadA genes was confirmed by PCR. Southern blot analysis verified homogenous transformation of all transplastomic lines. Antigen capture ELISA with the conformation-specific antibody Ritti01, showed protein expression as well as the retention of immunogenic epitopes of L1 protein. In their morphology, GST-L1 expressing tobacco plants were identical to wild type plants and yielded fertile flowers. Taken together, these data enrich knowledge for future development of cost-effective plant-made vaccines against HPV. PMID:25483463

  17. A proposed ethical framework for vaccine mandates: competing values and the case of HPV.

    PubMed

    Field, Robert I; Caplan, Arthur L

    2008-06-01

    Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective. PMID:18610781

  18. Immunotherapy of HPV-associated cancer: DNA/plant-derived vaccines and new orthotopic mouse models.

    PubMed

    Venuti, Aldo; Curzio, Gianfranca; Mariani, Luciano; Paolini, Francesca

    2015-10-01

    Under the optimistic assumption of high-prophylactic HPV vaccine coverage, a significant reduction of cancer incidence can only be expected after decades. Thus, immune therapeutic strategies are needed for persistently infected individuals who do not benefit from the prophylactic vaccines. However, the therapeutic strategies inducing immunity to the E6 and/or E7 oncoprotein of HPV16 are more effective for curing HPV-expressing tumours in animal models than for treating human cancers. New strategies/technologies have been developed to improve these therapeutic vaccines. Our studies focussed on preparing therapeutic vaccines with low-cost technologies by DNA preparation fused to either plant-virus or plant-toxin genes, such as saporin, and by plant-produced antigens. In particular, plant-derived antigens possess an intrinsic adjuvant activity that makes these preparations especially attractive for future development. Additionally, discrepancy in vaccine effectiveness between animals and humans may be due to non-orthotopic localization of animal models. Orthotopic transplantation leads to tumours giving a more accurate representation of the parent tumour. Since HPV can cause cancer in two main localizations, anogenital and oropharynx area, we developed two orthotopic tumour mouse models in these two sites. Both models are bioluminescent in order to follow up the tumour growth by imaging and are induced by cell injection without the need to intervene surgically. These models were utilized for immunotherapies with genetic or plant-derived therapeutic vaccines. In particular, the head/neck orthotopic model appears to be very promising for studies combining chemo-radio-immune therapy that seems to be very effective in patients. PMID:26138695

  19. Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research

    PubMed Central

    Kasting, Monica L.; Shapiro, Gilla K.; Rosberger, Zeev; Kahn, Jessica A.; Zimet, Gregory D.

    2016-01-01

    ABSTRACT There has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4–0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15–0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06–5.00). These results should be reassuring to parents and health care providers. PMID:26864126

  20. Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research.

    PubMed

    Kasting, Monica L; Shapiro, Gilla K; Rosberger, Zeev; Kahn, Jessica A; Zimet, Gregory D

    2016-06-01

    There has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4-0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15-0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06-5.00). These results should be reassuring to parents and health care providers. PMID:26864126

  1. Epidemiology of HPV genotypes in Uganda and the role of the current preventive vaccines: A systematic review

    PubMed Central

    2011-01-01

    Background Limited data are available on the distribution of human papillomavirus (HPV) genotypes in the general population and in invasive cervical cancer (ICC) in Uganda. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18 responsible for causing about 70% of ICC cases in the world, such information is crucial to predict how vaccination and HPV-based screening will influence prevention of ICC. Methods To review the distribution of HPV infection and prevalent genotypes, electronic databases (e.g. PubMed/MEDLINE and HINARI) were searched for peer reviewed English articles on HPV infection up to November 30, 2010. Eligible studies were selected according to the following criteria: DNA-confirmed cervical or male genital HPV prevalence and genotypes, HPV incidence estimates and HPV seroprevalence among participants. Results Twenty studies were included in the review. Among HIV negative adult women, the prevalence of HR-HPV infections ranged from 10.2% -40.0% compared to 37.0% -100.0% among HIV positive women. Among HIV positive young women aged below 25 years, the prevalence of HR-HPV genotypes ranged from 41.6% -75.0% compared to 23.7% -67.1% among HIV negative women. Multiple infections with non vaccine HR-HPV genotypes were frequent in both HIV positive and HIV negative women. The main risk factors for prevalent HPV infections were age, lifetime number of sexual partners and HIV infection. Incident infections with HR-HPV genotypes were more frequent among adult HIV positive than HIV negative women estimated at 17.3 and 7.0 per 100 person-years, respectively. Similarly, incident HR-HPV among young women aged below 25 years were more frequent among HIV positive (40.0 per 100 person-years) than HIV negative women (20.3 per 100 person-years) women. The main risk factor for incident infection was HIV infection. HPV 16 and 18 were the most common genotypes in ICC with HPV 16/18 contributing up to 73.5% of cases with single infections. Among

  2. Understanding Non-Completion of the Human Papillomavirus Vaccine Series: Parent-Reported Reasons for Why Adolescents Might Not Receive Additional Doses, United States, 2012.

    PubMed

    Clark, Sarah J; Cowan, Anne E; Filipp, Stephanie L; Fisher, Allison M; Stokley, Shannon

    2016-01-01

    Completion rates of the human papillomavirus (HPV) vaccine series among U.S. adolescents are below public health targets. We explored parent-reported reasons for their children's non-completion of the HPV vaccine series using a nationally representative online survey of parents of children aged 9-17 years, fielded in October 2012. Among the 1,653 parents who responded, the proportion reporting that their child would definitely continue with the HPV vaccine series among those who had started the series ranged from 28% to 54%. The most common reason cited by parents for non-completion of the series was their child's fear of needles, followed by lack of awareness about additional doses and safety concerns. These findings demonstrate the need to encourage adoption of strategies addressing needle fears, utilize reminders for parents about subsequent doses, and emphasize recent HPV vaccine safety data in discussions with parents. PMID:27252558

  3. Induction of robust cellular immunity against HPV6 and HPV11 in mice by DNA vaccine encoding for E6/E7 antigen

    PubMed Central

    Shin, Thomas; Pankhong, Panyupa; Yan, Jian; Khan, Amir S.; Sardesai, Niranjan Y.; Weiner, David B.

    2012-01-01

    Due to the strong relationship between the Human Papillomavirus (HPV) “high-risk” subtypes and cervical cancers, most HPV-related studies have been focusing on the “high-risk” HPV subtypes 16 and 18. However, it has been suggested that the “low-risk” subtypes of HPV, HPV6 and HPV11, are the major cause of recurrent respiratory papillomatosis and genital warts. In addition, HPV 6 and 11 are also associated with otolaryngologic malignancies, carcinoma of the lung, tonsil, larynx and low-grade cervical lesions. Therefore, development of HPV therapeutic vaccines targeting on subtypes 6 and 11 E6 or E7 are in great need. In this report, we describe two novel engineered DNA vaccines that encode HPV 6 and 11 consensus E6/E7 fusion proteins (p6E6E7 and p11E6E7) by utilizing a multi-phase strategy. Briefly, after generating consensus sequences, several modifications were performed to increase the expression of both constructs, including codon/RNA optimization, addition of a Kozak sequence and a highly efficient leader sequence. An endoproteolytic cleavage site was also introduced between E6 and E7 protein for proper protein folding and for better CTL processing. The expressions of both constructs were confirmed by western blot analysis and immunofluorescence assay. Vaccination with these DNA vaccines could elicit robust cellular immune responses. The epitope mapping assay was performed to further characterize the cellular immune responses induced by p6E6E7 and p11E6E7. The HPV 6 and 11 E6 or E7-specific immunodominant and subdominant epitopes were verified, respectively. The intracellular cytokine staining revealed that the magnitude of IFN-γ and TNF-α secretion in antigen-specific CD8+ cells was significantly enhanced, indicating that the immune responses elicited by p6E6E7 and p11E6E7 was heavily skewed toward driving CD8+ T cells. Such DNA immunogens are interesting candidates for further studies on HPV 6 and 11-associated diseases. PMID:22336879

  4. Identification of Broad-Genotype HPV L2 Neutralization Site for Pan-HPV Vaccine Development by a Cross-Neutralizing Antibody

    PubMed Central

    Wang, Daning; Li, Zhihai; Xiao, Jieqiong; Wang, Junqi; Zhang, Li; Liu, Yajing; Fan, Fei; Xin, Lu; Wei, Minxi; Kong, Zhibo; Yu, Hai; Gu, Ying; Zhang, Jun; Li, Shaowei; Xia, Ningshao

    2015-01-01

    Human Papillomavirus (HPV), a non-enveloped, double-stranded DNA virus, is responsible for 5% of human cancers. The HPV capsid consists of major and minor structural proteins, L1 and L2. L1 proteins form an icosahedral shell with building blocks of the pentameric capsomere, and one L2 molecule extends outward from the central hole of the capsid. Thus, L2 is concealed within L1 and only becomes exposed when the capsid interacts with host cells. The low antigenic variation of L2 means that this protein could offer a target for the development of a pan-HPV vaccine. Toward this goal, here we describe an anti-L2 monoclonal antibody, 14H6, which broadly neutralizes at least 11 types of HPV, covering types 6, 11, 16, 18, 31, 33, 35, 45, 52, 58 and 59, in pseudovirion—based cell neutralization assay. The mAb 14H6 recognizes a minimal linear epitope located on amino acids 21 to 30 of the L2 protein. Alanine scanning mutagenesis and sequence alignment identified several conserved residues (Cys22, Lys23, Thr27, Cys28 and Pro29) that are involved in the 14H6 binding with L2. The epitope was grafted to several scaffolding proteins, including HPV16 L1 virus-like particles, HBV 149 core antigen and CRM197. The resultant chimeric constructs were expressed in Escherichia coli and purified with high efficiency. Immunization with these pan-HPV vaccine candidates elicited high titers of the L2-specific antibody in mice and conferred robust (3-log) titers of cross-genotype neutralization, including against HPV11, 16, 18, 45, 52, 58 and 59. These findings will help in the development of an L2-based, pan-HPV vaccine. PMID:25905781

  5. Quantifying the broader economic consequences of quadrivalent human papillomavirus (HPV) vaccination in Germany applying a government perspective framework.

    PubMed

    Kotsopoulos, Nikolaos; Connolly, Mark P; Remy, Vanessa

    2015-12-01

    HPV infections can cause substantial burden in females and males as it is associated with several genital cancers, in addition to genital warts. Traditional economic evaluations often focus on quantifying cost-effectiveness, however, it is increasingly recognized that vaccinations may generate broader benefits not captured in cost-effectiveness analysis. Τhe aim of this study was to evaluate the broader economic consequences associated with HPV vaccination in males and females and to conduct a lifetime cost-benefit analysis of investing in universal vaccination in Germany from the perspective of government. Methodologies from generational accounting, human capital and health economics were combined to estimate the broader economic consequences of HPV vaccination including the fiscal impact for the government. A cohort model was developed simulating the medical costs and average lifetime fiscal transfers between the government and 12-year-old immunized and non-immunized males and females. To estimate tax revenue attributed to vaccination-related changes in morbidity and mortality, direct and indirect tax rates were linked to differences in age- and gender-specific earnings. Based on HPV vaccination costs, the base case cost-benefit analysis demonstrated that investing 1 in universal HPV vaccination could yield 1.7 in gross tax revenue over the lifetime of the cohorts. After taking into consideration the governmental transfers, universal HPV vaccination in Germany could result in incremental positive net discounted taxes (i.e. tax revenue-transfers) from 62 million for the German government. The vaccination of males and females with the quadrivalent HPV vaccine is likely to have positive effects on public finances. PMID:26198884

  6. Comparative humoral and cellular immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and HPV-6/11/16/18 vaccine in healthy women aged 18–45 years: Follow-up through Month 48 in a Phase III randomized study

    PubMed Central

    Einstein, Mark H; Levin, Myron J; Chatterjee, Archana; Chakhtoura, Nahida; Takacs, Peter; Catteau, Grégory; Dessy, Francis J; Moris, Philippe; Lin, Lan; Struyf, Frank; Dubin, Gary

    2014-01-01

    We previously reported higher anti-HPV-16 and -18 immune responses induced by HPV-16/18 vaccine compared with HPV-6/11/16/18 vaccine at Month 7 (one month after completion of full vaccination series) in women aged 18–45 y in an observer-blind study NCT00423046; the differences of immune response magnitudes were maintained up to Month 24. Here we report follow-up data through Month 48. At Month 48, in according-to-protocol cohort for immunogenicity (seronegative and DNA-negative for HPV type analyzed at baseline), geometric mean titers of serum neutralizing antibodies were 2.0- to 5.2-fold higher (HPV-16) and 8.6- to 12.8-fold higher (HPV-18) in HPV-16/18 vaccine group than in HPV-6/11/16/18 vaccine group. The majority of women in both vaccine groups remained seropositive for HPV-16. The same trend was observed for HPV-18 in HPV-16/18 vaccine group; however, seropositivity rates in HPV-6/11/16/18 vaccine group decreased considerably, particularly in the older age groups. In the total vaccinated cohort (regardless of baseline serological and HPV-DNA status), anti-HPV-16 and -18 neutralizing antibody levels induced by HPV-16/18 vaccine were higher than those induced by HPV-6/11/16/18 vaccine. CD4+ T-cell response for HPV-16 and HPV-18 was higher in HPV-16/18 vaccine group than in HPV-6/11/16/18 vaccine group. Memory B-cell responses appeared similar between vaccine groups. Both vaccines were generally well tolerated. Overall, the higher immune response observed with the HPV-16/18 vaccine was maintained up to Month 48. A head-to-head study incorporating clinical endpoints would be required to confirm whether the observed differences in immune response between the vaccines influence the duration of protection they provided. PMID:25483700

  7. Intramuscular Therapeutic Vaccination Targeting HPV16 Induces T Cell Responses That Localize in Mucosal Lesions

    PubMed Central

    Jotova, Iveta; Wu, T. C.; Wang, Chenguang; Desmarais, Cindy; Boyer, Jean D.; Tycko, Benjamin; Robins, Harlan S.; Clark, Rachael A.; Trimble, Cornelia L.

    2014-01-01

    About 25% of high-grade cervical intraepithelial neoplasias (CIN2/3) caused by human papillomavirus serotype 16 (HPV16) undergo complete spontaneous regression. However, to date, therapeutic vaccination strategies for HPV disease have yielded limited success when measured by their ability to induce robust peripheral blood T cell responses to vaccine antigen. We report marked immunologic changes in the target lesion microenvironment after intramuscular therapeutic vaccination targeting HPV16 E6/E7 antigens, in subjects with CIN2/3 who had modest detectable responses in circulating T lymphocytes. Histologic and molecular changes, including markedly (average threefold) increased intensity of CD8+ T cell infiltrates in both the stromal and epithelial compartments, suggest an effector response to vaccination. Postvaccination cervical tissue immune infiltrates included organized tertiary lymphoid-like structures in the stroma subjacent to residual intraepithelial lesions and, unlike infiltrates in unvaccinated lesions, showed evidence of proliferation induced by recognition of cognate antigen. At a molecular level, these histologic changes in the stroma were characterized by increased expression of genes associated with immune activation (CXCR3) and effector function (Tbet and IFNβ), and were also associated with an immunologic signature in the overlying dysplastic epithelium. High-throughput T cell receptor sequencing of unmanipulated specimens identified clonal expansions in the tissue that were not readily detectable in peripheral blood. Together, these findings indicate that peripheral therapeutic vaccination to HPV antigens can induce a robust tissue-localized effector immune response, and that analyses of immune responses at sites of antigen are likely to be much more informative than analyses of cells that remain in the circulation. PMID:24477000

  8. Intramuscular therapeutic vaccination targeting HPV16 induces T cell responses that localize in mucosal lesions.

    PubMed

    Maldonado, Leonel; Teague, Jessica E; Morrow, Matthew P; Jotova, Iveta; Wu, T C; Wang, Chenguang; Desmarais, Cindy; Boyer, Jean D; Tycko, Benjamin; Robins, Harlan S; Clark, Rachael A; Trimble, Cornelia L

    2014-01-29

    About 25% of high-grade cervical intraepithelial neoplasias (CIN2/3) caused by human papillomavirus serotype 16 (HPV16) undergo complete spontaneous regression. However, to date, therapeutic vaccination strategies for HPV disease have yielded limited success when measured by their ability to induce robust peripheral blood T cell responses to vaccine antigen. We report marked immunologic changes in the target lesion microenvironment after intramuscular therapeutic vaccination targeting HPV16 E6/E7 antigens, in subjects with CIN2/3 who had modest detectable responses in circulating T lymphocytes. Histologic and molecular changes, including markedly (average threefold) increased intensity of CD8(+) T cell infiltrates in both the stromal and epithelial compartments, suggest an effector response to vaccination. Postvaccination cervical tissue immune infiltrates included organized tertiary lymphoid-like structures in the stroma subjacent to residual intraepithelial lesions and, unlike infiltrates in unvaccinated lesions, showed evidence of proliferation induced by recognition of cognate antigen. At a molecular level, these histologic changes in the stroma were characterized by increased expression of genes associated with immune activation (CXCR3) and effector function (Tbet and IFNβ), and were also associated with an immunologic signature in the overlying dysplastic epithelium. High-throughput T cell receptor sequencing of unmanipulated specimens identified clonal expansions in the tissue that were not readily detectable in peripheral blood. Together, these findings indicate that peripheral therapeutic vaccination to HPV antigens can induce a robust tissue-localized effector immune response, and that analyses of immune responses at sites of antigen are likely to be much more informative than analyses of cells that remain in the circulation. PMID:24477000

  9. Human papillomavirus (HPV) vaccine implementation in low and middle-income countries (LMICs): health system experiences and prospects.

    PubMed

    Wigle, Jannah; Coast, Ernestina; Watson-Jones, Deborah

    2013-08-20

    Prophylactic vaccines for human papillomavirus (HPV) are being introduced in many countries for the prevention of cervical cancer, the second most important cause of cancer-related death in women globally. This is likely to have a significant impact on the future burden of cervical cancer, particularly where screening is non-existent or limited in scale. Previous research on the challenges of vaccinating girls with the HPV vaccine has focused on evidence from developed countries. We conducted a systematic search of the literature in order to describe the barriers and challenges to implementation of HPV vaccine in low- and middle-income countries. We identified literature published post-2006 to September 2012 from five major databases. We validated the findings of the literature review with evidence from qualitative key informant interviews. Three key barriers to HPV vaccine implementation were identified: sociocultural, health systems and political. A linked theme, the sustainability of HPV vaccines programmes in low- and middle-income countries, cuts across these three barriers. Delivering HPV vaccine successfully will require multiple barriers to be addressed. Earlier research in developed countries emphasised sociocultural issues as the most significant barriers for vaccine roll-out. Our evidence suggests that the range of challenges for poorer countries is significantly greater, not least the challenge of reaching girls for three doses in settings where school attendance is low and/or irregular. Financial and political barriers to HPV vaccine roll-out continue to be significant for many poorer countries. Several demonstration and pilot projects have achieved high rates of acceptability and coverage and lessons learned should be documented and shared. PMID:23777956

  10. Human papillomavirus (HPV) vaccine implementation in low and middle-income countries (LMICs): Health system experiences and prospects☆

    PubMed Central

    Wigle, Jannah; Coast, Ernestina; Watson-Jones, Deborah

    2013-01-01

    Prophylactic vaccines for human papillomavirus (HPV) are being introduced in many countries for the prevention of cervical cancer, the second most important cause of cancer-related death in women globally. This is likely to have a significant impact on the future burden of cervical cancer, particularly where screening is non-existent or limited in scale. Previous research on the challenges of vaccinating girls with the HPV vaccine has focused on evidence from developed countries. We conducted a systematic search of the literature in order to describe the barriers and challenges to implementation of HPV vaccine in low- and middle-income countries. We identified literature published post-2006 to September 2012 from five major databases. We validated the findings of the literature review with evidence from qualitative key informant interviews. Three key barriers to HPV vaccine implementation were identified: sociocultural, health systems and political. A linked theme, the sustainability of HPV vaccines programmes in low- and middle-income countries, cuts across these three barriers. Delivering HPV vaccine successfully will require multiple barriers to be addressed. Earlier research in developed countries emphasised sociocultural issues as the most significant barriers for vaccine roll-out. Our evidence suggests that the range of challenges for poorer countries is significantly greater, not least the challenge of reaching girls for three doses in settings where school attendance is low and/or irregular. Financial and political barriers to HPV vaccine roll-out continue to be significant for many poorer countries. Several demonstration and pilot projects have achieved high rates of acceptability and coverage and lessons learned should be documented and shared. PMID:23777956

  11. "Who will take the blame?": understanding the reasons why Romanian mothers decline HPV vaccination for their daughters.

    PubMed

    Craciun, Catrinel; Baban, Adriana

    2012-11-01

    Because Romania has the highest incidence of cervical cancer in Europe, in 2008 a HPV vaccination campaign was introduced targeting 10-11 year old girls. However, only 2.5% of the eligible girls were given parental for vaccination. Campaign failure makes it important to look for possible reasons and investigate mothers' attitudes and perceptions of the HPV vaccine. Three focus groups and 11 interviews were conducted with mothers from urban areas. Data were transcribed verbatim and analysed with thematic analysis. Results show as main reasons for not vaccinating their daughters perceiving the vaccine as risky, the belief that the vaccine represents an experiment that uses their daughters as guinea pigs, the belief that the vaccine embodies a conspiracy theory that aims to reduce the world's population and general mistrust in the ineffective health system. Mothers stated they would need clear, factual information about the HPV vaccine and its link to cervical cancer in order to motivate them to accept it for their daughters. The study offers insight into the beliefs and attitudes towards the vaccine and provides ideas for structuring future health communication campaigns regarding the HPV vaccine. PMID:23017603

  12. The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study

    PubMed Central

    Herweijer, Eva; Feldman, Adina L.; Ploner, Alexander; Arnheim-Dahlström, Lisen; Uhnoo, Ingrid; Netterlid, Eva; Dillner, Joakim; Sparén, Pär; Sundström, Karin

    2015-01-01

    Background Concerns have been raised that HPV-vaccination might affect women’s cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening. Methods A cohort of all women resident in Sweden, born 1977-1987 (N=629,703), and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR) were estimated using Cox regression adjusted for age, education level and income (HRadj). Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately. Results Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897) and 75% in unvaccinated women (N=625,804). The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35) in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13). In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20). Conclusions HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions. PMID:26218492

  13. Minor Consent and Delivery of Adolescent Vaccines

    PubMed Central

    Ford, Carol A.; Skiles, Martha P.; English, Abigail; Cai, Jianwen; Agans, Robert P.; Stokley, Shannon; Markowitz, Lauri; Koumans, Emilia H.

    2016-01-01

    Purpose To explore whether, and to what extent, minor consent influences adolescent vaccine delivery in the United States. Methods A telephone survey was completed by 263 professionals with responsibilities for adolescent health care and/or vaccination in 43 states. Measures included perceived frequency of unaccompanied minor visits and perceived likelihood of vaccine delivery to unaccompanied minors in hypothetical scenarios that varied by adolescent age, vaccine type, visit type, and clinical setting. Results Among the 76 respondents most familiar with private primary care clinics, 47.1% reported perceptions that 17-year-old patients often present without a parent/legal guardian. Among the 104 respondents most familiar with public primary care clinics, 56.7% reported that 17-year-old patients often present alone. In response to hypothetical scenarios, approximately 30% of respondents familiar with private clinics and 50% of respondents familiar with public clinics reported perceptions that unaccompanied 17-year-old adolescents would not receive influenza, Tdap, or human papillomavirus vaccines during routine check-ups because they could not provide consent. Perceived likelihood of unaccompanied minors receiving vaccines when seen for confidential services in primary care, sexually transmitted disease, and Title X/family planning clinics varied significantly by vaccine type and clinical setting. On average, respondents reported that they would support minors having the ability to self-consent for vaccines at age 14. Conclusions The inability of minors to consent for vaccines is likely one barrier to vaccination. Interventions to increase adolescent vaccination should consider strategies that increase the ability of unaccompanied minors, particularly older minors, to receive vaccines within the context of legal, ethical, and professional guidelines. PMID:24074605

  14. Listeria-based HPV-16 E7 vaccines limit autochthonous tumor growth in a transgenic mouse model for HPV-16 transformed tumors

    PubMed Central

    Sewell, Duane A.; Pan, Zhen Kun; Paterson, Yvonne

    2008-01-01

    We have shown that Listeria-based cancer vaccines inhibit the growth of transplanted tumors in a transgenic mouse model of immune tolerance where HPV-16 E7 is expressed in the thyroid gland. In this study we determine whether these vaccines are able to inhibit autochthonous tumor growth in this animal model. Mice treated with Listeria vaccines expressing E7 had significantly smaller thyroid tumors than did mice treated with controls and possessed higher numbers of antigen-specific CD8+ T cells within the spleens, tumors, and peripheral blood. This study shows that Listeria-based vaccines are able to slow autochthonous tumor growth and break immunological tolerance. PMID:18680778

  15. “1-2-3 Pap” Intervention Improves HPV Vaccine Series Completion among Appalachian Women

    PubMed Central

    Vanderpool, Robin C.; Cohen, Elisia; Crosby, Richard A.; Jones, Maudella G.; Bates, Wallace; Casey, Baretta R.; Collins, Tom

    2015-01-01

    Completion of the Human Papillomavirus (HPV) vaccine series is a national priority. This study not only identified correlates of intent to complete the vaccine series and actual series completion, but also tested the efficacy of a DVD intervention to promote series completion. Women’s beliefs that all three doses reduced cancer risk predicted intent and completion. Intention predicted completion, as did the belief that having a friend accompany the woman would promote completion. Beyond these effects, women assigned to the intervention were 2.44 times more likely than women in the control group to complete the series. Thus, in controlled analyses, a theory-grounded DVD intervention successfully promoted HPV series completion in a community setting. This method of intervention has high translational potential. PMID:26560123

  16. Morbidity and mortality of vulvar and vaginal cancers: Impact of 2-, 4-, and 9-valent HPV vaccines.

    PubMed

    Buchanan, Tommy R; Graybill, Whitney S; Pierce, Jennifer Young

    2016-06-01

    Vaginal and vulvar cancers do not account for a large proportion of gynecologic malignancies but their impact is significant. Both vaginal and vulvar lesions have precursors and display levels of dysplasia before progression to invasive disease. Human