Has Their Son Been Vaccinated? Beliefs About Other Parents Matter for Human Papillomavirus Vaccine

A quadrivalent vaccine against human papillomavirus (HPV; i.e., HPV4) was approved for use in males in 2009 for the prevention of genital warts (Centers for Disease Control & Prevention, 2010). Subsequently, in 2010, the Food and Drug Administration approved HPV4 vaccine for the prevention of anal cancer in both males and females (Food and Drug Administration, 2011). Although the Advisory Committee on Immunization Practices issued a recommendation that HPV4 vaccine should be routinely given to males aged 11–12 years in 2011 (Centers for Disease Control & Prevention, 2011), vaccination rates in young males have been slow to improve (Stokley et al., 2014). As of 2013, only about 35% of males ages 13–17 years had received at least one dose, and only 14% had completed the three-dose vaccine series (Stokley et al.)

Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2014

Vaccines are recommended for adults on the basis of their age, prior vaccinations, health conditions, lifestyle, occupation, and travel. Reasons for current low levels of vaccination coverage for adult vaccines are multifactorial and include limited awareness among the public about vaccines for adults and gaps in incorporation of regular assessments of vaccine needs and vaccination into routine medical care. Updated standards for immunization of adults were approved by the National Vaccine Advisory Committee (NVAC) in September 2013. These standards acknowledge the current low levels of vaccination coverage among adults and the role that all health-care providers, including those who do not offer all recommended adult vaccines in their practices, have in ensuring that their patients are up-to-date on recommended vaccines. NVAC recommends that providers assess vaccination needs for their patients at each visit, recommend needed vaccines, and then, ideally, offer the vaccine or, if the provider does not stock the needed vaccines, refer the patient to a provider who does vaccinate. Vaccinating providers should also ensure that patients and their referring health-care providers have documentation of the vaccination

Impact of 9-Valent Human Papillomavirus Vaccine on HPV Vaccination Coverage of Youths, Ages 9-17, in North Carolina

Background and Research Objectives Human Papillomavirus (HPV) Vaccination •Most common sexually-transmitted infection in the United States •Causes genital warts, and is associated with cervical, vaginal, vulvar, anal, penile, and throat cancers •Routine vaccination at age 11 or 12 years has been recommended by the Advisory Committee on Immunization Practices (ACIP) since 2006 for females and since 2011 for males HPV Vaccination Rates •In 2015, completion of the three-dose series among adolescents ages 13 to 17 was: •42% for girls •28% for boys •HPV vaccination coverage also lags far behind childhood and other adolescent vaccines. HPV Vaccine Types •Quadrivalent HPV vaccine (4vHPV) and 9-valent HPV vaccine (9vHPV) are currently licensed and indicated for use among both females and males in the US to protect against several of the most common HPV types associated with cancer. •Bivalent HPV vaccine (2vHPV) is indicated for females only •9vHPV is the most recent HPV vaccine to enter the market •Food and Drug Administration approval in December 2014 •ACIP recommendation in February 2015 Objectives: •The primary objective was to evaluate the impact of introduction of 9vHPV vaccine on •HPV vaccination uptake (# doses) •Initiation (>1 dose) •Completion (>3 doses) •Compliance (>3 doses within 1 year) •The secondary objective was to describe timing of administration and characteristics of children who received 9vHPV compared to those who received another HPV vaccine (2vHPV or 4vHPV) beginning in July 2015. Methodology: PRIMARY OBJECTIVE Design: Area-level interrupted time series Outcomes: Area-level uptake (doses), initiation, completion, and compliance rates Key explanatory variable: Indicator for the introduction of 9vHPVin NC in July 2015 Analysis •De-trended monthly time series to remove time trend and seasonality •Regression on an indicator variable for ZCTA/months post release of 9vHPV SECONDARY OBJECTIVE Design: Individual-level retrospective cohort Outcome: Indicator variable for receiving 9vHPV (relative to other HPV vaccine type) Key explanatory variables: Youth and area-level demographic characteristics and other area-level market characteristics Analysis •Logistic regression •Separate regressions by sex Data North Carolina Immunization Registry (NCIR) •January 2008 through October 2016 •Youth between the ages of 9 and 17 years in 2016 •Complete vaccination history for this cohort of youth •Excluded youth in the NCIR with missing values for date of the HPV vaccine, HPV vaccine type, sex or ZIP code •Primary objective: aggregated data to ZIP Code Tabulation Areas (ZCTAs) •Secondary objective: restricted sample to doses of HPV vaccine administered during or after July 2015 (introduction of 9vHPV in NC) Discussion Primary objective •Introduction of 9vHPV was not associated with changes in HPV vaccination rates in NC as measured by doses per capita or initiation, completion or compliance rates •Results did not change when we also included ZCTA-level characteristics and allowed for autoregression in the error terms. Secondary objective •Following the introduction of 9vHPV, youth receiving the HPV vaccine were more likely to receive 9vHPV than other HPV vaccine types if they lived in a ZCTA with •a larger age-eligible (i.e., 9 to 17) population, •a health professional shortage area, or •a higher number of annual outpatient visits per capita. •Following the introduction of 9vHPV, youth receiving the HPV vaccine were less likely to receive 9vHPV than other HPV vaccine types if •they were older, •received a publicly-funded dose, or •lived in a ZCTA with a higher percentage of the population with less than a high-school education or •a higher number of religious organizations. Limitations •NCIR does not include complete coverage of privately funded vaccines, vaccines given by pharmacies or to youths who may have moved out of state •Not representative of U.S. or areas of country with different demographics and regional patterns of care •Bias could remain from changes in unobserved confounders concurrent with the introduction of 9vHPV (e.g., changes in outreach policies in the state) Summary •Introduction of 9vHPV was not associated with changes in HPV vaccination rates in NC •Transition from 4vHPVto 9vHPV was quick •Disparities in the diffusion of 9vHPV across areas of N

Correlates of African American Men’s Sexual Schemas

Sexual schemas are cognitive representations of oneself as a sexual being and aid in the processing of sexually relevant information. We examined the relationship between sociosexuality (attitudes about casual sex), masculine ideology (attitudes toward traditional men and male roles), and cultural centrality (strength of identity with racial group) as significant psychosocial and sociocultural predictors in shaping young, heterosexual African American men's sexual schemas. A community sample (n=133) of men in a southeastern city of the United States completed quantitative self-report measures examining their attitudes and behavior related to casual sex, beliefs about masculinity, racial and cultural identity, and self-views of various sexual aspects of themselves. Results indicated that masculine ideology and cultural centrality were both positively related to men's sexual schemas. Cultural centrality explained 12 % of the variance in level of sexual schema, and had the strongest correlation of the predictor variables with sexual schema (r=.36). The need for more attention to the bidirectional relationships between masculinity, racial/cultural identity, and sexual schemas in prevention, intervention, and public health efforts for African American men is discussed

A Qualitative Study of Rural Black Adolescents’ Perspectives on Primary STD Prevention Strategies

Primary STD prevention relies on five key strategies: practicing abstinence, choosing low-risk partners, discussing partners’ sexual history, using condoms consistently and not having multiple partners. Few studies have examined all of these strategies simultaneously, and few have focused on rural black adolescents, whose rates of early sexual initiation and STDs are among the highest in the nation

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

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

Designing Messages to Motivate Parents To Get Their Preteenage Sons Vaccinated Against Human Papillomavirus

Human papillomavirus (HPV) vaccine, licensed for use in 9–26-year-olds, is most effective when given before sexual activity begins. HPV causes genital warts, is associated with several cancers and disproportionately affects racial and ethnic minorities. Parents are typically unaware of male HPV vaccine; messages that might motivate them to get their preteenage sons vaccinated are unexplored

Source of Parental Reports of Child Height and Weight during Phone Interviews and Influence on Obesity Prevalence Estimates among Children Aged 3–17 Years

We compared parental reports of children’s height and weight when the values were estimated vs. parent-measured to determine how these reports influence the estimated prevalence of childhood obesity

Storage of poisonous substances and firearms in homes with young children visitors and older adults

Most unintentional childhood poisonings and firearm injuries occur in residential environments. Therefore, a preventive strategy includes limiting children’s access to poisons and firearms through safe storage. This study examines storage of poisons and firearms among households with older adults, and households where young children reside compared to those where they visit only