HPV vaccination of immunocompromised hosts.

It is well-established that immunocompromised people are at increased risk of HPV-related disease compared with those who are immunocompetent. Prophylactic HPV sub-unit vaccines are safe and immunogenic in immunocompromised people and it is strongly recommended that vaccination occur according to national guidelines. When delivered to immunocompromised populations, HPV vaccines should be given as a 3-dose regimen

Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance.

To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers

Vaccines in Current Culture: The HPV Vaccine Controversy

The use of vaccinations has drastically decreased mortality and morbidity rates related to infectious disease and has become an intrinsic part of modern health care. However, the fear of risks related to vaccines has been partially responsible for the decisions of many parents to delay or avoid vaccinating their children. The human papilloma virus (HPV) vaccine specifically is one of the most controversial vaccines in current culture due to reports of new onset or exacerbation of autoimmune diseases, infertility, and even death following its administration. This review synthesizes information regarding the relevance and safety of the HPV vaccine, as well as its efficacy in preventing cervical cancer and precancerous lesions. There appears to be a need for thorough education regarding concepts of immunity, infection, and vaccine function for those hesitant about receiving vaccines. Particularly regarding the HPV vaccine, practitioners should be familiar with common reasons for vaccine refusal and be prepared to respond with accurate information

Validation of the Vaccination Confidence Scale: A Brief Measure to Identify Parents at Risk for Refusing Adolescent Vaccines

Objective To validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. Methods We analyzed weighted data from 9018 parents who completed the 2010 National Immunization Survey–Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and human papillomavirus vaccines. For each vaccine, separate logistic regression models assessed associations between parents\u27 mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses for the scale\u27s 4-item short form. Results One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific vaccines ranging from 21% for human papillomavirus to 2% for Tdap. Using the full 8-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium (odds ratio, 2.08; 95% confidence interval, 1.75–2.47) or low (odds ratio, 4.61; 95% confidence interval, 3.51–6.05) versus high. For the 4-item short form, scores were also consistently associated with vaccine refusal and vaccination status. Vaccination confidence was inconsistently associated with vaccine delay. Conclusions The Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. The scale\u27s short form appears to offer comparable performance

Uptake of three doses of HPV vaccine by primary school girls in Eldoret, Kenya : a prospective cohort study in a malaria endemic setting

Background: All women are potentially at risk of developing cervical cancer at some point in their life, yet it is avoidable cause of death among women in Sub- Saharan Africa with a world incidence of 530,000 every year. It is the 4th commonest cancer affecting women worldwide with over 260,000 deaths reported in 2012. Low resource settings account for over 75% of the global cervical cancer burden. Uptake of HPV vaccination is limited in the developing world. WHO recommended that 2 doses of HPV vaccine could be given to young girls, based on studies in developed countries. However in Africa high rates of infections like malaria and worms can affect immune responses to vaccines, therefore three doses may still be necessary. The aim of this study was to identify barriers and facilitators associated with uptake of HPV vaccine. Methods: A cross-sectional survey was conducted at Eldoret, Kenya involving 3000 girls aged 9 to 14 years from 40 schools. Parents/guardians gave consent through a questionnaire. Results: Of all 3083 the school girls 93.8% had received childhood vaccines and 63.8% had a second HPV dose, and 39. 1% had a third dose. Administration of second dose and HPV knowledge were both strong predictors of completion of the third dose. Distance to the hospital was a statistically significant risk factor for non-completion (P: 0.01). Conclusions: Distance to vaccination centers requires a more innovative vaccine-delivery strategy and education of parents/guardians on cervical screening to increase attainment of the HPV vaccination

Human Papillomavirus Infection: Prevention, Barriers to Vaccination, and the Need for Education

While there is no known cure for HPV, prophylactic vaccination provides an effective method of primary prevention against HPV-related diseases. However, many females and males never receive the HPV vaccine as recommended. There are multiple barriers to vaccination, and these barriers can be identified as parental, provider, or system level. Understanding these barriers and developing strategies that provide accurate information about HPV, its risks, and the need for vaccination are essential in the form of sustained educational campaigns for parents, young adults, and providers

Understanding Barriers to HPV vaccine uptake in Appalachia

Every year in seven small counties of Ohio seventy-six people lose their lives to a completely preventable Human Papillomavirus-related cancer. These counties are not random, nor are they an anomaly. All seven are considered to be within the Appalachian region of the United States, which, despite holding a little less than one-tenth of the total population, has the highest cancer mortality rates in the country. The term Appalachia describes the counties surrounding the Appalachian mountain range in the eastern United States. Here, rates of Human Papillomavirus (HPV), vaccine uptake are lower than in other areas of the United States. This study seeks to examine, using the 5 A's of Healthcare Access framework (Affordability, Accessibility, Accommodation, Acceptability, and finally Availability) why, despite there being a viable vaccine, rates of uptake remain low using the seven aforementioned counties as a sample. In using a mixed methods approach, the study integrates existing research from major public databases with the direct input of medical professionals gathered via survey. The professionals were asked for their opinion on the impact each of the Five A's of Healthcare Access have on their patients, using data from 2018-19. Through analyzing their answers, as well as related research, the study hopes to provide important information on HPV-vaccine barriers for further programs to use in order to lower the number of preventable deaths.The Ohio State School of Social WorkNo embargoAcademic Major: Social Wor

Human papillomavirus vaccination coverage in Luxembourg : implications of lowering and restricting target age groups

Background: In Luxembourg, a national Human Papillomavirus (HPV) vaccination programme was introduced in 2008, targeting 12-17 year old girls offering a choice of bivalent or quadrivalent vaccine free of charge. In 2015, the programme was changed offering the bivalent vaccine only to 11-13 year old girls. The aim of this study was to evaluate the HPV vaccination coverage, to assess the impact of age target changes and compare vaccination coverage to other European countries. Methods: Anonymous HPV vaccination records consisting of individual vaccine doses obtained free of charge in pharmacies between 2008 and 2016 were extracted from the Luxembourgish Social Security database. Additional aggregate tables by nationality and municipality were analysed. Results: Of the target cohort of 39,610 girls born between 1991 and 2003 residing in Luxembourg, 24,550 (62.0%) subjects obtained at least one dose, 22,082 (55.7%) obtained at least two doses, and 17,197 (43.4%) obtained three doses of HPV vaccine. The mean age at first dose was 13.7 years during 200814 and 12.7 years in 2016 after the age target change. Coverage varied significantly by nationality (p < 0.0001): Portuguese (80%), former Yugoslays (74%), Luxembourgish (54%), Belgian (52%), German (47%), French (39%) and other, nationalities (51%). Coverage varied also by geographical region, with lower rates (<50%) noted in some Northern and Central areas of Luxembourg (range: 38% to 78%). Conclusion: Overall HPV vaccination coverage in Luxembourg is moderate and varied by nationality and region. The policy changes in 2015 did not have a substantial impact except lowering age at initiating vaccination. Options to improve coverage deserve further investigation

Requiring Human Papilloma Virus Vaccination for School Entry

Over 40,000 Americans are diagnosed as having HPV-associated cancer each year, including oropharyngeal cancer for men and cervical cancer for women. These diseases cause significant morbidity and mortality and are largely preventable if people are vaccinated against HPV before they are exposed to the virus. Unfortunately, despite strong evidence of safety and effectiveness of the HPV vaccine, vaccination rates have been disappointingly low – much lower than for the varicella, measles, mumps, rubella, and hepatitis B. The disparity in vaccination rates stem mainly from the fact that HPV vaccination is not universally required for school entry, while the other childhood vaccines are required. In this Viewpoint, we argue that now is the time to mandate HPV vaccination for school entry, and we provide several reasons to support our call to action. First, HPV vaccination is in children’s best interests. Second, while parents should be afforded considerable autonomy in raising their children, law and ethics do not support parents making health-related decisions that are contrary to their child’s best interests. Third, HPV vaccination is a form of social solidarity, and ought to protect ourselves and our neighbors from preventable disease and death. Finally, mandating vaccination will bring greater health equity, since racial minorities and those without health insurance suffer disproportionately from cervical cancer and other HPV-associated diseases. We believe the time for action is long overdue and call on state legislatures to enact HPV vaccination mandates linked to school entry, like with other childhood vaccines

Detection and genotyping of human Papillomavirus in urine samples from unvaccinated male and female adolescents in Italy

The introduction of vaccination against Human Papillomavirus (HPV) in adolescent girls in 2006 has focused virological surveillance on this age group. As few studies have evaluated HPV infections in young populations, further data are needed in order to improve and extend prophylactic policy and to monitor epidemiological changes. The present study aimed at evaluating overall and type-specific HPV prevalence in both female and male adolescents in Italy. HPV DNA detection and genotyping was performed on urine samples collected from 870 unvaccinated adolescents (369 females, 501 males, 11-18 years of age) in five cities in Italy. Following DNA extraction by means of a commercial kit (NucliSENS®-miniMAG®, bioMérieux), the L1 gene fragment was PCR amplified and genotyped by restriction fragment length polymorphism analysis. HPV DNA was detected in 1.5% of all samples, and in 3% and 0.4% of samples from females and males, respectively. In approximately 70% of HPV DNA positive adolescents, the infection was due to a single genotype, with 88.9% of genotypes belonging to the HR-clade. The only two HPV-positive boys (14 and 18 years old) had HPV-70 genotype. Only one of the 11 HPV-infected girls was in the 11-14 age-group. HPV prevalence was 4.2% in girls aged 15-18 years and 60% of infections were due to vaccine types HPV-16 or HPV-6/-11. This is one of the few studies, the first conducted in Italy, on HPV infection in adolescents. Urine testing is the easier way of detecting HPV infection in younger populations. Our data revealed a very low HPV prevalence, and no infections were observed in the 12-year-old vaccine target population. The majority of infections were seen in females aged 15-18 years. Overall, more than 50% and 30% of the potentially persistent HPV infections detected in this group could have been prevented by the quadrivalent and the bivalent vaccines, respectively