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Felsher M, Shumet M, Velicu C, Chen YT, Nowicka K, Marzec M, Skowronek G, Pieniążek I. A systematic literature review of human papillomavirus vaccination strategies in delivery systems within national and regional immunization programs. Hum Vaccin Immunother 2024; 20:2319426. [PMID: 38410931 PMCID: PMC10900274 DOI: 10.1080/21645515.2024.2319426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
The uptake of human papillomavirus (HPV) vaccine remains suboptimal despite being a part of routine vaccination within national immunization program(s). This indicates probable challenges with the implementation of HPV immunization program(s) in various countries. The objective of this systematic literature review (SLR) was to identify implementation strategies for HPV vaccination within national and regional immunization programs worldwide with an aim to provide guidance for countries targeting to increase their HPV vaccine coverage rate (VCR). A comprehensive literature search was conducted across Medline and Embase and included articles published between January 2012 and January 2022. Of the 2,549 articles retrieved, 168 met inclusion criteria and were included in the review. Strategies shown to improve HPV vaccination uptake in the reviewed literature include campaigns to increase community awareness and knowledge of HPV, health care provider trainings, integrating HPV vaccination within school settings, coordinated efforts via multi-sectoral partnerships, and vaccination reminder and recall systems. Findings may help national authorities understand key considerations for HPV vaccination when designing and implementing programs aiming to increase HPV VCR in adolescents.
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Imanishi Y, Kinoshita T, Sakamoto M, Ichimiya M, Mitsunami M, Takahashi T, Shigemi D, Song M, Inaba K. Importance of human papillomavirus vaccination leaflets focusing on the safety profile targeted pediatricians in Japan. Vaccine 2022; 40:5010-5015. [PMID: 35842338 DOI: 10.1016/j.vaccine.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 05/25/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To investigate the association between providing leaflets to support pediatricians in explaining the safety of the human papillomavirus (HPV) vaccine and mother's decision to vaccinate their daughters in Japan. METHODS In this cross-sectional study, we conducted a survey of mothers to evaluate the effect of leaflets that were created to support pediatricians in explaining the safety profile of the HPV vaccine. Mothers who provided consent for vaccination before receiving an explanation were excluded from the study. The primary outcome was the mother's decision to vaccinatetheir daughters with the HPV vaccine after receiving an explanation from pediatricians using our leaflets. RESULTS Among 161 eligible mothers, 101 decided on HPV vaccination (decided group) and 60 did not (decided against group). There was no difference in the maternal background between the 2 groups. The decided group had a significantly more positive impression of the leaflets than the undecided group. In multivariable logistic regression analysis, a detailed explanation for possible adverse events and specific solutions to them was associated with the mother's decision to have their daughters vaccinated (odds ratio 2.35, 95% confidence interval 1.02-5.44), but not the pathology of cervical cancer and the HPV vaccination process. CONCLUSION Leaflets emphasizing an explanation of adverse events may contribute to mothers' decision making for HPV vaccination.
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Affiliation(s)
- Yousuke Imanishi
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan; Minpapi Association, Tokyo, Japan.
| | | | - Masahiko Sakamoto
- Minpapi Association, Tokyo, Japan; Department of Pediatrics, Saku Central Hospital, Nagano, Japan
| | - Megumi Ichimiya
- Minpapi Association, Tokyo, Japan; Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Makiko Mitsunami
- Minpapi Association, Tokyo, Japan; Master of Medical Sciences in Clinical Investigation, Harvard Medical School, Boston, USA
| | - Takayuki Takahashi
- Minpapi Association, Tokyo, Japan; Department of Obstetrics and Gynecology, Keio University, Tokyo, Japan
| | | | - Mihyon Song
- Minpapi Association, Tokyo, Japan; Marunouchi no Mori Ladies Clinic, Tokyo, Japan
| | - Kanako Inaba
- Minpapi Association, Tokyo, Japan; Department of Obstetrics and Gynecology, Kanto Central Hospital, Tokyo, Japan
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Acuti Martellucci C, Morettini M, Brotherton JM, Canfell K, Manzoli L, Flacco ME, Palmer M, Giorgi Rossi P, Martellucci M, Giacomini G, D'Errico MM, Pasqualini F. Impact of a human papillomavirus vaccination programme within organized cervical cancer screening: cohort study. Cancer Epidemiol Biomarkers Prev 2022; 31:588-594. [PMID: 35027435 DOI: 10.1158/1055-9965.epi-21-0895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/22/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We assessed the effectiveness of an HPV vaccination programme in lowering cervical abnormality risk, and conferring herd protection. METHODS Retrospective cohort study using linked screening and vaccination administrative health data of the general population of Ancona Province, Italy. We included all female residents born in 1990-1993, eligible for catch-up HPV vaccination up to age 25y, and adhering to organised screening in 2015-2020 (n=4665). Cervical abnormalities rates were compared between: vaccinated and unvaccinated women, and cohorts with high and low vaccination uptake. Analyses were adjusted for age, country of birth, screening tests number, laboratory, and municipality average income. Main outcomes were ASC-US+ or LSIL+ Pap smears, and CIN1+ or CIN2+ histology. RESULTS Mean screening age was 26.6{plus minus}1.5 years, and 1,118 screened women (24.0%) were vaccinated (mean vaccination age 19.2{plus minus}1.5 years). The diagnosed cervical abnormalities were: 107 LSIL+ (2.3%), 70 CIN1+ (1.5%), and 35 CIN2+ (0.8%). The adjusted odds ratios of LSIL+, CIN1+ and CIN2+ among vaccinated vs unvaccinated women were, respectively: 0.55 (95% confidence interval 0.33-0.91), 0.43 (0.22-0.86), and 0.31 (0.11-0.91). Among the unvaccinated, those in the highest-uptake (45.3%) 1993 cohort, versus the last pre-vaccination 1990 cohort, showed AORs of LSIL+ and CIN1+ of 0.23 (0.10-0.50), and 0.22 (0.07-0.69), respectively. CONCLUSIONS In the first evaluation from Central Italy, catch-up HPV vaccination considerably reduced the risk of all cervical abnormalities diagnosed within organized screening, and conferred an elevated degree of herd protection among unvaccinated women. IMPACT The high protection conferred by HPV vaccination suggests the need to update cervical screening.
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Affiliation(s)
| | | | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, University of Sydney
| | | | | | - Matthew Palmer
- Melbourne School of Population and Global Health, University of Melbourne
| | | | | | - Giusi Giacomini
- Oncologic Screening Unit, Marche Region Health Agency, Area Vasta 2
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Occa A. Who Is Scared of a Needle? An Exploration of Italian Children's Knowledge and Perceptions About the HPV Vaccine. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:990-995. [PMID: 32130673 DOI: 10.1007/s13187-020-01726-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Receiving the HPV vaccine at a young age before being exposed to the virus is essential to improve HPV-related cancer prevention. In many countries in the world, like Italy, the HPV vaccine is offered free of charges to boys and girls aged 12-14. Despite this incentive, the HPV vaccine uptake in Italy remains low. Several interventions and campaigns have been implemented to educate parents and providers. However, children of 12-14 years old have been left out by prevention and education efforts. This study explored middle school children's knowledge and perceptions of the HPV virus and vaccine with the purpose to identify gaps and misperceptions and provide recommendations to develop educational interventions. A total of nine focus groups were conducted, and discussions were analyzed along with 171 anonymous questions collected from the children. Findings included a lack of knowledge of HPV prevention guidelines, negative emotions associated with both the HPV vaccine and vaccines in general, misperceptions between prevention and care, and the desire to receive specific information.
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Affiliation(s)
- Aurora Occa
- Department of Communication, University of Kentucky, 272 Blazer Dining, 343 S. Martin Luther King Blvd, Lexington, KY, 40526-0012, USA.
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Origoni M, Cristoforoni P, Mariani L, Costa S, Preti M, Sandri MT, Preti EP, Ghelardi A, Perino A. [HPV vaccination: not only female adolescents and not only prophylactic. Review and position paper of the Italian HPV Study Group (IHSG)]. ACTA ACUST UNITED AC 2019; 71:442-459. [PMID: 31741364 DOI: 10.23736/s0026-4784.19.04443-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
HPV vaccination has been introduced in clinical practice in recent years and represents the most effective strategy of primary prevention of cervical carcinoma and of female genital preneoplastic conditions. One of the major issues of the subject is represented by vaccination coverage of the target population. Since its introduction, HPV vaccine efficacy has been progressively demonstrated also towards extragenital HPV-correlated conditions and in males too. Moreover, even subjects of older age groups or subjects who already had HPV infections have been demonstrated to received benefits from vaccination, due to improvements of their immunological response. Recently, vaccine efficacy has also been investigated in terms of adjuvant administration after treatments of preneoplastic or benign conditions of the female lower genital tract caused by HPVs; preliminary results indicate an interesting and promising field of application. On this basis, in this article an analysis of the state of the art has been performed, with specific regard to the Italian scenario and with the focus of future perspectives of implementation of the HPV vaccination policy. From the available evidences, the Italian HPV Study Group recommends the extension of systematic HPV vaccination to males too, to adult subjects and also after conservative treatment of genital HPV correlated conditions.
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Affiliation(s)
- Massimo Origoni
- Dipartimento di Ginecologia e Ostetricia, Università Vita Salute San Raffaele, Milano, Italia -
| | | | | | | | - Mario Preti
- Dipartimento di Ginecologia e Ostetricia, Università di Torino, Torino, Italia
| | | | | | | | - Antonio Perino
- Dipartimento di Ginecologia e Ostetricia, Università di Palermo, Palermo, Italia
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Abstract
Active discussions are underway on whether or not the absence or insufficiency of communication is a decisive factor affecting hesitancy with regard to vaccines. Low-quality services such as insufficient communication can lead to an increase in the population postponing vaccinations in countries without deficiencies in vaccine procurement. This study examines the strategies and tasks of health communication in relation to vaccinations. Social networking services (SNSs) are major channels of health communication in responding to infectious diseases. New videos posted on the Internet attract considerable amounts of attention from SNS users and increase traffic to certain Web sites. However, most of these videos are produced and uploaded by nonexperts. Although medical institutions have striven to convey key messages concerning infectious diseases to the public, in the SNS space, contents differing from scientific evidence acknowledged as the established theory have been disseminated as well. Social networking services can also amplify any unnecessary anxiety about infectious diseases. In addition, as false information about vaccines is circulated or conflicting information surfaces, the confusion of the general public is aggravated and the phenomenon of vaccine hesitancy can be intensified. Therefore, it is necessary to improve vaccination acceptance through strategies that integrate new and old media. At the same time, we need to establish customized public health education for the public, vulnerable groups, and experts.
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Venturelli F, Baldacchini F, Campari C, Perilli C, Pascucci MG, Finarelli AC, Moscara L, Rossi PG. Association between mothers' screening uptake and daughters' HPV vaccination: a quasi-experimental study on the effect of an active invitation campaign. BMJ Open 2017; 7:e016189. [PMID: 28951407 PMCID: PMC5722088 DOI: 10.1136/bmjopen-2017-016189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In Emilia-Romagna, the Human Papillomavirus (HPV) vaccination campaign started in 2008 offering free vaccines for 1996 and 1997 cohorts. Systematic active invitation was implemented for the 1997 cohort. Our study aimed at measuring the impact of the active invitation campaign on HPV vaccine coverage and on coverage inequalities in 11-year-old girls. Second, we evaluated the effect of the HPV vaccination campaign on participation in cervical cancer screening by mothers of target girls. METHODS We collected information on vaccination status for girls residing in Reggio Emilia in 2008 and mothers' screening history, before and after the 2008 vaccination campaign. Log-binomial regression models were performed to estimate Relative Risk (RR) and 95% confidence intervals (CIs) of being vaccinated as regarded citizenship, siblings, mothers' education, marital status and screening history, stratified by birth cohort. We also calculated RR of receiving a Pap test after the vaccination campaign as regarded education, daughter's cohort and mothers' decision to have their daughter vaccinated. Interaction between education and cohort in mothers overdue for Pap testing was calculated. RESULTS Vaccination coverage was 46.3% for the uninvited cohort (1046/2260) and 77.9% for the invited cohort (1798/2307). In the uninvited cohort, daughters' vaccination showed association with mothers' education (8 to 11 years of education vs. graduated mothers, RR 1.61 95% CI 1.14-2.28), citizenship (foreigners vs. Italians, RR 0.45 95% CI 0.37-0.56) and screening history (regular vs. non-participant; RR 1.72 95% CI 1.26-2.36). In the invited cohort, only a slight association with screening history persisted (regular vs. non-participant; RR 1.20 95% CI 1.04-1.40). Highly educated under-screened mothers of the invited cohort showed a higher probability of receiving a Pap test after the vaccination campaign period (RR 1.27 95% CI 1.04-1.56) compared with those not invited, CONCLUSION: Active invitation could increase overall HPV immunisation coverage and reduce socio-demographic inequalities and the association with mothers' screening participation.
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Affiliation(s)
- Francesco Venturelli
- Interinstitutional Epidemiology Unit, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS, Meldola, Italy
| | - Cinzia Campari
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Coordination Screening Centre, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Perilli
- Public Health Service, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Maria Grazia Pascucci
- Directorate General for Health and Social Policy - Emilia-Romagna Region, Bologna, Italy
| | - Alba Carola Finarelli
- Directorate General for Health and Social Policy - Emilia-Romagna Region, Bologna, Italy
| | - Luigi Moscara
- Community paediatrics, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Carnovale C, Gentili M, Matacena M, Dimov Di Giusti M, Krnic D, Dolinic B, Kolaric D, Margan Koletic Z, Macolic Sarinic V, Culjak M, Fortino I, Merlino L, Clementi E, Radice S. A retrospective review of paediatric adverse drug reactions reported in Lombardy and Croatia from 2005 to 2013. Expert Opin Drug Saf 2016; 15:35-43. [DOI: 10.1080/14740338.2016.1253678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Carla Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marta Gentili
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marco Matacena
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marina Dimov Di Giusti
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Darko Krnic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Barbara Dolinic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Darija Kolaric
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Zeljana Margan Koletic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Viola Macolic Sarinic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Maja Culjak
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | | | | | - Emilio Clementi
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital ‘Luigi Sacco’, Milan, Italy
| | - Sonia Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
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Biasio LR, Corsello G, Costantino C, Fara GM, Giammanco G, Signorelli C, Vecchio D, Vitale F. Communication about vaccination: A shared responsibility. Hum Vaccin Immunother 2016; 12:2984-2987. [PMID: 27458874 PMCID: PMC5137540 DOI: 10.1080/21645515.2016.1198456] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/01/2016] [Indexed: 11/04/2022] Open
Abstract
Vaccine hesitancy is an important issue to be addressed, due to the risk of decrease of vaccination coverage and consequent control of preventable diseases. While it is not considered a specific determinant, poor or inadequate communication can contribute to vaccine hesitancy and negatively influence vaccination uptake. As a contribution to the ongoing discussion regarding this theme and in the perspective of the implementation of the upcoming national vaccination plan in Italy, the Erice Declaration was drafted by experts in the field of immunization following a 5-day residential, independent workshop regarding communication topics in vaccinology. The aim of the current letter is to present to the broader international audience such a contribution, proposing the identification of the main actions that should be taken into account and prioritized in order to improve communication in the domain of vaccination.
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Affiliation(s)
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother-Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
| | - Claudio Costantino
- Department of Sciences for Health Promotion and Mother-Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
| | - Gaetano M. Fara
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, Rome, Italy
| | - Giuseppe Giammanco
- Department of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Carlo Signorelli
- Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy
| | - Davide Vecchio
- Department of Sciences for Health Promotion and Mother-Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Sciences for Health Promotion and Mother-Child Care “G. D'Alessandro,” University of Palermo, Palermo, Italy
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Chlamydia trachomatis infection and HPV/Chlamydia trachomatis co-infection among HPV-vaccinated young women at the beginning of their sexual activity. Arch Gynecol Obstet 2016; 294:1227-1233. [PMID: 27501926 DOI: 10.1007/s00404-016-4167-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE This study investigated the prevalence of Chlamydia trachomatis infection, co-infection with Human Papillomavirus (HPV) and associated risk factors in a cohort of sexually active young women enrolled in an ongoing trial on HPV vaccination at the European Institute of Oncology (IEO, Milan, Italy). METHODS Cervical samples were collected from 591 girls (median age 18.8 years) at the beginning of their sexual activity. At the time of sample collection, 354 women had not yet been vaccinated, and 237 women had been vaccinated for at least 12 months. All samples were analyzed through a molecular assay for the detection of C. trachomatis infection. Demographic, behavioral risk factors and high-risk HPV (HR-HPV) status were investigated. RESULTS The prevalence of C. trachomatis infection was 4.9 % and HPV/C. trachomatis co-infection rate was 1.5 %. The exact analysis has not underlined statistical significance for the variables considered, except for the infection with HR-HPV (p < 0.001). The prevalence of C. trachomatis infection among women who had not been immunized and those already vaccinated was similar (5.6 vs 3.8 %). However, the rate of HPV/C. trachomatis co-infection was twice as high in unvaccinated women (2 %) compared to vaccinated women (0.8 %). CONCLUSIONS Over 16 % of young women had at least one of the two STIs investigated. The risk of C. trachomatis infection was higher in HR-HPV infected compared to HR-HPV uninfected young women. The rate of co-infection was halved in HPV-vaccinated compared to unvaccinated women. This study underlines that HPV vaccination can confer benefits also in terms of co-infections prevention, leading to a decreased risk of developing cervical malignancies.
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