24,028 research outputs found

    Associations of health behaviors with human papillomavirus vaccine uptake, completion, and intentions among female undergraduate students

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    This study explored associations between health behaviors and human papillomavirus vaccine receipt/intentions among female undergraduates. Participants (N = 286) completed a survey assessing human papillomavirus vaccine uptake (receiving 1–3 shots vs no shots), completion (receiving 3 shots vs 1–2 shots), and intentions as well as various health behaviors. Human papillomavirus vaccine uptake and completion were associated with receipt of other preventive medical care; completion was associated with having a regular healthcare provider. Among unvaccinated students (n = 115), increased human papillomavirus vaccine intentions were associated with flu shot and human immunodeficiency virus test receipt. Findings suggest promoting human papillomavirus vaccination with other preventive medical care might improve vaccine receipt

    Assessing the Effectiveness of a Quality Improvement Intervention to Decrease Missed Opportunities for Human Papillomavirus Vaccination at a Nurse Managed Health Center

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    Purpose: To decrease the number of missed opportunities for human papillomavirus vaccine eligible patients seeking healthcare in a Nurse Managed Health Center. Background & Significance: Human papillomavirus genital infection has inflicted nearly 79 million Americans. Annually, about 14 million newly infected individuals are identified, with noted predominance in teens and young adults, and of this number approximately 19,200 females and 11,600 males receive a cancer diagnosis as a result of the human papillomavirus infection. The incidence of infections can be reduced with a human papillomavirus vaccine, but only about 63% of females and even fewer males initiate the human papillomavirus vaccine. Methods: A Nurse Managed Health Center assisting the underserved population, in a major southwestern metropolitan city was chosen to implement a Qualified Patient Prompter tool used to screen for human papillomavirus eligibility in all patients seeking healthcare in this Nurse Managed Health Center. A reminder card strategy was used at the end of the accepted human papillomavirus vaccine visit. Results: 334 patient records were reviewed and 135 were eligible to receive the human papillomavirus vaccine; 60 opted to receive it and 75 declined. Conclusion: A 100% of all patients seen were evaluated for human papillomavirus vaccine eligibility. The intervention decreased missed opportunities by 100%. Continued efforts will focus on increasing human papillomavirus vaccine acceptance rates. The Nurse Managed Health Center fully support the continued use of the Qualified Patient Prompter, which was effective within this population

    Impact of human papillomavirus (HPV) 16 and 18 vaccination on prevalent infections and rates of cervical lesions after excisional treatment

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    BackgroundHuman papillomavirus vaccines prevent human papillomavirus infection and cervical precancers. The impact of vaccinating women with a current infection or after treatment for an human papillomavirus-associated lesion is not fully understood.ObjectivesTo determine whether human papillomavirus-16/18 vaccination influences the outcome of infections present at vaccination and the rate of infection and disease after treatment of lesions.Study DesignWe included 1711 women (18−25 years) with carcinogenic human papillomavirus infection and 311 women of similar age who underwent treatment for cervical precancer and who participated in a community-based trial of the AS04-adjuvanted human papillomavirus-16/18 virus-like particle vaccine. Participants were randomized (human papillomavirus or hepatitis A vaccine) and offered 3 vaccinations over 6 months. Follow-up included annual visits (more frequently if clinically indicated), referral to colposcopy of high-grade and persistent low-grade lesions, treatment by loop electrosurgical excisional procedure when clinically indicated, and cytologic and virologic follow-up after treatment. Among women with human papillomavirus infection at the time of vaccination, we considered type-specific viral clearance, and development of cytologic (squamous intraepithelial lesions) and histologic (cervical intraepithelial neoplasia) lesions. Among treated women, we considered single-time and persistent human papillomavirus infection, squamous intraepithelial lesions, and cervical intraepithelial neoplasia 2 or greater. Outcomes associated with infections absent before treatment also were evaluated. Infection-level analyses were performed and vaccine efficacy estimated.ResultsMedian follow-up was 56.7 months (women with human papillomavirus infection) and 27.3 months (treated women). There was no evidence of vaccine efficacy to increase clearance of human papillomavirus infections or decrease incidence of cytologic/histologic abnormalities associated with human papillomavirus types present at enrollment. Vaccine efficacy for human papillomavirus 16/18 clearance and against human papillomavirus 16/18 progression from infection to cervical intraepithelial neoplasia 2 or greater were −5.4% (95% confidence interval −19,10) and 0.3% (95% confidence interval −69,41), respectively. Among treated women, 34.1% had oncogenic infection and 1.6% had cervical intraepithelial neoplasia 2 or greater detected after treatment, respectively, and of these 69.8% and 20.0% were the result of new infections. We observed no significant effect of vaccination on rates of infection/lesions after treatment. Vaccine efficacy estimates for human papillomavirus 16/18 associated persistent infection and cervical intraepithelial neoplasia 2 or greater after treatment were 34.7% (95% confidence interval −131, 82) and −211% (95% confidence interval −2901, 68), respectively. We observed evidence for a partial and nonsignificant protective effect of vaccination against new infections absent before treatment. For incident human papillomavirus 16/18, human papillomavirus 31/33/45, and oncogenic human papillomavirus infections post-treatment, vaccine efficacy estimates were 57.9% (95% confidence interval −43, 88), 72.9% (95% confidence interval 29, 90), and 36.7% (95% confidence interval 1.5, 59), respectively.ConclusionWe find no evidence for a vaccine effect on the fate of detectable human papillomavirus infections. We show that vaccination does not protect against infections/lesions after treatment. Evaluation of vaccine protection against new infections after treatment and resultant lesions warrants further consideration in future studies

    Human papillomavirus-16/18 AS04-adjuvanted cervical cancer vaccine: Immunogenicity and safety in healthy Chinese women from Hong Kong

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    Objective To assess the immunogenicity and safety of human papillomavirus-16/18 AS04-adjuvanted cervical cancer vaccine in Chinese women aged 18 to 35 years enrolled from Hong Kong. Design Double-blind, randomised controlled trial with vaccine and placebo groups. Setting Single-centre study in Hong Kong. Participants Three hundred women enrolled (150 per group) between March 2006 and June 2007. Interventions Subjects received three doses of human papillomavirus-16/18 vaccine or placebo (aluminium hydroxide), administered intramuscularly at 0, 1, and 6 months. Main outcome measures Human papillomavirus-16/18 seroconversion rates and geometric mean titres at month 7 (in human papillomavirus-16/18 recipients); reactogenicity and safety (in all subjects). Results A total of 294 women completed the study (148 in the vaccine group, 146 in placebo group). All initially seronegative subjects in the vaccine group had seroconverted for human papillomavirus-16/18 antibodies by month 7. Anti-human papillomavirus-16 and anti-human papillomavirus-18 antibody geometric mean titres were 10 422 (95% confidence interval, 8730-12 442) EL.U/mL and 4649 (3975-5437) EL.U/mL, respectively. High compliance (99% in both groups) was observed for the three-vaccination course. The frequencies of local injection site reactions were higher in the vaccine than placebo group; pain being the most common symptom in both groups. Regarding solicited symptoms, fatigue and myalgia were the most frequent in both groups. Five serious adverse events (four in vaccine group, one in placebo group) were reported, but all were considered unrelated to the vaccinations. Conclusion The human papillomavirus-16/18 AS04-adjuvanted vaccine was highly immunogenic, safe, and generally well tolerated in Chinese women from Hong Kong.published_or_final_versio

    Using Education to Improve Human Papillomavirus Vaccine Uptake among Adolescents

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    Paper approved May 2019 by the faculty of UMKC in partial fulfillment of the degree of Doctor of Nursing PracticeApproved May 2019 by the faculty of UMKC in partial fulfillment of the requirements for the degree of Doctor of Nursing PracticeThe human papillomavirus vaccine protects adolescents against the human papillomavirus and is recommended for all males and females starting at age 11. The human papillomavirus vaccine is an effective approach to reduce infections and associated cancers however, vaccination uptake continues to lag behind other vaccines common in adolescents. This evidence based proposal aimed to improve human papillomavirus vaccine uptake among adolescents using an education bundle. This project was a quasi-experimental, single group, prospective design which focused on ten adolescents age eleven through fourteen, who scheduled a well child check or sports physical in an urban pediatric clinic. An educational bundle was implemented prior to receiving the human papillomavirus vaccine to improve vaccine uptake. This outcome was evaluated by measuring vaccination uptake among adolescents who received the educational materials compared to baseline data from retrospective chart reviews. Results suggest that the use of the education bundle had a positive impact on HPV vaccine uptake with a 46.7 percent rate of acceptance among the pre-education group, n=16, compared to an 80 percent acceptance rate among the post-education group, n=10. When adolescents consistently accept the human papillomavirus vaccine, the overall prevalence and transmission of the virus are decreased and associated cancers can be prevented in the United States. Through the use of education, healthcare providers can improve the current human papillomavirus vaccine rates and reduce the prevalence of human papillomavirus infections and associated health complications among adolescents

    Human papillomavirus vaccine effectiveness by number of doses: Systematic review of data from national immunization programs.

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    BACKGROUND: Human papillomavirus (HPV) vaccines were first licensed as a three-dose series; a two-dose series is now recommended in some age groups and there is interest in possible one-dose vaccination. METHODS: We conducted a systematic literature review of HPV vaccine effectiveness by number of doses, including assessment of biases and impact of varying buffer periods (time between vaccination and outcome counting). RESULTS: Of 3787 articles identified, 26 full articles were assessed and 14 included in our review. All studies were conducted within the context of recommended three-dose schedules of bivalent (3) or quadrivalent HPV vaccine (11). Two evaluated effectiveness for prevention of HPV prevalence, six anogenital warts, and six abnormal cervical cytology or histology. Many studies found differences between three-, two- and one-dose vaccine recipients, indicating possible differences in HPV exposure prior to vaccination or in risk behavior. Adjusted or stratified analyses were conducted to control for potential confounding. All studies found significant vaccine effectiveness with three doses, 11 with two doses at various intervals, and six with one dose. Most studies showed a relationship (not always statistically significant) between effectiveness and number of doses, with greater decreases in HPV-related outcomes with three, followed by two and one dose(s). Few studies conducted formal comparisons of three vs fewer doses. Three of four studies that examined buffer periods found higher effectiveness and a smaller difference by number of doses with longer periods. CONCLUSION: Most post-licensure studies report highest effectiveness with three doses; some found no statistically significant difference between two and three doses. Additionally, almost half found some effectiveness with one dose. Several biases impact estimates, with most biasing two- and one-dose results away from showing effectiveness. Future effectiveness studies, examining persons vaccinated prior to sexual activity and using methods to reduce potential sources of bias, can help inform vaccination policy

    The effects of perceived risk and responsibility on the acceptance of a Human Papillomavirus vaccine by college men

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    In the summer of 2006 the Food and Drug Administration approved a new vaccine to prevent four types of the Human Papillomavirus believed to cause the majority of genital warts and cervical cancer in women. Since that time the vaccine has experienced considerable uptake among women while it has also been met by some criticism. Current medical research aims to understand if the vaccine, which has been approved only for women, could be used to prevent HPV in men. Little empirical research has been conducted to understand whether or not men would be willing to receive a vaccine for a sexually transmitted infection that poses few serious health risks for them. This research investigates the level of acceptance among a sample of males at a large public university in New Hampshire as well as some of the possible predictors of men\u27s acceptance of a Human Papillomavirus vaccine. Specifically, men\u27s perceived risk for contracting the virus and its possible health consequences and their perceived sense of responsibility for sexual behavior will be examined as predictors of vaccine acceptance

    HPV vaccination of immunocompromised hosts.

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    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

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

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    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

    Knowledge About the Human Papillomavirus Vaccine Among Employees at a Tertiary Cancer Center: Room for Improvement

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    Introduction: The human papillomavirus (HPV) vaccine is recommended by the U.S. Centers for Disease Control and Prevention for routine vaccination of boys and girls to protect against HPV-related cancers and genital warts. To meet the Healthy People 2020 target for HPV vaccination, health care providers must understand the importance of strongly recommending the HPV vaccine to all eligible adolescents. We sought to determine HPV vaccination patterns among employees at a tertiary cancer center and their children and attitudes regarding HPV vaccination among the employees. Methods: All employees at a tertiary cancer center were invited to participate in a cross-sectional survey administered online during July and August 2015. The survey included questions about HPV vaccination of participants and their children, including reasons why vaccine-eligible employees and children had not been vaccinated. Results: Of those eligible, 13% of male and 33% of female employees and 44% of daughters and 24% of sons of employees had completed the vaccine series. The main reasons for not completing the series or not having one’s son completing the series were not knowing that the vaccine was needed and vaccine not recommended by a health care provider. The main reasons for not having one’s daughter complete the series were the two aforementioned reasons and daughter not yet sexually active. Conclusion: Opportunities exist to educate health care workers about the benefits of the HPV vaccine and to increase the number of providers who recommend HPV vaccination to their patients
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