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Bogka E, Naoum P, Pavi E, Athanasakis K. What Influences Parents on Their Decision to Vaccinate Their Daughters Against HPV? J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00182-7. [PMID: 38367952 DOI: 10.1016/j.jpag.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/28/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
STUDY OBJECTIVE To investigate and compare the attitudes of parents who initiated their daughters' HPV vaccination with parents who did not. METHODS Data were collected through telephone interviews with a close-end questionnaire on parents' knowledge, attitudes towards the vaccine, and the reasons for vaccinating or not their daughters against HPV. The sample was random, stratified by geographic region and urbanization level, national, and representative of the general population of parents of girls aged 11-18 in Greece. Statistical analysis consisted of descriptives, an inferential analysis with hypothesis testing, and a logistic regression model. RESULTS Overall, 996 parents were included in the analysis, 99.0% of which were women. Forty-seven percent of them initiated their daughters' HPV vaccination, with physician recommendation stated as the most important reason for this decision (50.2%). For those who had not initiated their daughters' HPV vaccination (53%), lack of information was the most important reason (25.6%). In the hypothesis testing, parents with unvaccinated daughters agreed more with the statements "I do not have enough information for the HPV vaccine to decide," and "My child is very young to be vaccinated for an STD" (P < .05), but no significant difference found for the statement "It's more possible for a vaccinated girl to begin sexual activities" (P > .05). CONCLUSIONS Lack of information, young age of the daughter, and perceived effectiveness of the vaccine are the most important hesitation factors. Physician recommendation is the most important reason to initiate vaccination.
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Affiliation(s)
- Elissavet Bogka
- Department of Public Health Policy, Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece.
| | - Panagiota Naoum
- Department of Public Health Policy, Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece
| | - Elpida Pavi
- Department of Public Health Policy, Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece
| | - Kostas Athanasakis
- Department of Public Health Policy, Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece
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Ballalai I, Dawson R, Horn M, Smith V, Bekkat-Berkani R, Soumahoro L, Vicic N. Understanding barriers to vaccination against invasive meningococcal disease: a survey of the knowledge gap and potential solutions. Expert Rev Vaccines 2023; 22:457-467. [PMID: 37144283 DOI: 10.1080/14760584.2023.2211163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Invasive meningococcal disease (IMD) is a leading cause of life-threatening bacterial meningitis and septicemia. Evidence points to a knowledge gap among parents, teenagers, and healthcare providers (HCPs) regarding IMD and available vaccines, including those against the highly prevalent serogroup B. AREAS COVERED An online survey was conducted between March 27 and April 12, 2019, to gather insights into the knowledge that parents/guardians have about IMD vaccines. The children were aged 2 months-10 years in Australia, Brazil, Germany, Greece, Italy, and Spain, 5-20 years in the UK, and 16-23 years in the US. The findings were discussed in the context of the available literature and solutions were proposed to minimize the knowledge gap and the barriers to vaccination against IMD. EXPERT OPINION The survey demonstrated that parents have a good understanding of IMD but a limited understanding of the different serogroups and vaccines. The available literature highlighted multiple barriers to IMD vaccine uptake; these may be reduced through education of HCPs, clear recommendations to parents by HCPs, the use of technology, and disease-awareness initiatives that engage parents through physical and digital channels. Further studies are warranted to assess the impact of the COVID-19 pandemic on IMD vaccination.
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Affiliation(s)
| | - Rob Dawson
- Meningitis Research Foundation, Bristol, UK
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Xie H, Zhu HY, Jiang NJ, Yin YN. Awareness of HPV and HPV vaccines, acceptance to vaccination and its influence factors among parents of adolescents 9 to 18 years of age in China: A cross-sectional study. J Pediatr Nurs 2023; 71:73-78. [PMID: 37028228 DOI: 10.1016/j.pedn.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake. METHODS A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed. RESULTS More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV. CONCLUSIONS Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents. PRACTICE IMPLICATIONS Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination.
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Affiliation(s)
- Hong Xie
- Department of Gynecology Nursing, West China Second University Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Han-Yue Zhu
- West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ni-Jie Jiang
- Department of Gynecology Nursing, West China Second University Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Ya-Nan Yin
- Department of Gynecology Nursing, West China Second University Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
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Glenn BA, Crespi CM, Herrmann AK, Nonzee NJ, Rosen DL, Park CL, Johnson G, Chang LC, Singhal R, Taylor VM, Bastani R. Effectiveness and feasibility of three types of parent reminders to increase adolescent human papillomavirus (HPV) vaccination. Prev Med 2023; 169:107448. [PMID: 36773962 DOI: 10.1016/j.ypmed.2023.107448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/17/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Parent reminders have produced modest improvements in human papillomavirus (HPV) vaccination among adolescents. However, little prior research has compared the effectiveness and feasibility of different HPV reminder types in resource-limited settings. We conducted a quasi-experimental study (2016-2017) to evaluate the effectiveness of three parent reminder types (mailed letters, robocalls, text messages) on next-dose HPV vaccine receipt among 12-year-olds in a large Federally Qualified Health Center in Los Angeles County. Six clinics were matched into three pairs: randomly assigning one clinic within each pair to intervention and control. Intervention clinics were randomly assigned to deliver one of the three parent reminder types. We calculated rates of next-dose vaccine receipt and assessed intervention effects using logistic regression models. We calculated the proportion of each type of reminder successfully delivered as a feasibility measure. The study sample comprised 877 12-year-olds due for an HPV vaccine dose (47% female, >85% Latino). At 4-month follow-up, 23% of intervention patients received an HPV vaccine dose compared to only 12% of control patients. Overall, receipt of any reminder increased rates of the next-needed HPV vaccine compared to usual care (p = 0.046). Significant improvements were observed for text reminders (p = 0.036) and boys (p = 0.006). Robocalls were the least feasible reminder type. Text message reminders are feasible and effective for promoting HPV vaccination. Future research is needed to assess the effectiveness and feasibility of reminders compared to other vaccine promotion strategies.
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Affiliation(s)
- Beth A Glenn
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095-6900, USA.
| | - Catherine M Crespi
- UCLA Center for Cancer Prevention and Control Research, Department of Biostatistics, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Dr. South, Los Angeles, CA 90095-6900, USA.
| | - Alison K Herrmann
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095-6900, USA.
| | - Narissa J Nonzee
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095-6900, USA.
| | - Debra L Rosen
- Northeast Valley Health Corporation, San Fernando Health Center, 1600 San Fernando Rd, San Fernando, CA 91340, USA.
| | - Christine L Park
- Northeast Valley Health Corporation, San Fernando Health Center, 1600 San Fernando Rd, San Fernando, CA 91340, USA.
| | - Gina Johnson
- Northeast Valley Health Corporation, San Fernando Health Center, 1600 San Fernando Rd, San Fernando, CA 91340, USA.
| | - L Cindy Chang
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095-6900, USA.
| | - Rita Singhal
- Disease Control Bureau, Los Angeles County Department of Public Health, 2615 S Grand Ave #500, Los Angeles, CA 90007, USA.
| | - Victoria M Taylor
- Department of Health Services, University of Washington School of Public Health and Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA..
| | - Roshan Bastani
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095-6900, USA.
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Babi A, Issa T, Issanov A, Akhanova S, Udalova N, Koktova S, Balykov A, Sattarkyzy Z, Imankulova B, Kamzayeva N, Almawi WY, Aimagambetova G. Knowledge and attitudes of mothers toward HPV vaccination: A cross-sectional study in Kazakhstan. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231172355. [PMID: 37184051 DOI: 10.1177/17455057231172355] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Although recommended for all member states of World Health Organization, there is no national human papillomavirus vaccination program in Kazakhstan. Furthermore, there are no studies in Kazakhstan that evaluate the mothers' perception of human papillomavirus vaccines. OBJECTIVES This study aims to assess the knowledge and attitudes toward human papillomavirus vaccination among mothers in Kazakhstan and the factors associated with their attitudes. DESIGN A cross-sectional study was performed during the period of December 2021-February 2022. The STROBE guideline for cross-sectional studies was applied. METHODS Paper-based structured questionnaires were filled out by 191 mothers, 141 of whom had daughters. The attitude score was assessed as per the Likert-type scale. The Chi-square and Fisher's exact tests, with a significance value of < 0.05 were used to analyze the relationships between the characteristics of mothers and their attitude scores. RESULTS The following factors were significantly associated with mothers' attitudes toward human papillomavirus vaccination: a place of residence, family income, number of children, and refusal of vaccination for themselves (p < 0.005). Of all participants, only 45% of all mothers, 41% of mothers with a female, and 46% of mothers with male children had positive attitudes toward human papillomavirus vaccination. The child's gender was not a significant determinant. Overall, the level of knowledge about human papillomavirus vaccination was found to be low. The median total score is 0 out of 12 for women who have negative and neutral attitudes toward human papillomavirus vaccines. Among women who have positive attitudes toward HPV vaccines, the median score is around 3 points. CONCLUSION Before the implementation of the human papillomavirus vaccination program into the Kazakhstani national vaccination calendar, comprehensive and adequate information and education campaigns are required on the national level for parents and the population in general.
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Affiliation(s)
- Aisha Babi
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Torgyn Issa
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Alpamys Issanov
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Sholpan Akhanova
- Obstetrics and Gynecology Department, "Keruen Medicus" Clinic, Almaty, Kazakhstan
| | - Natalya Udalova
- Obstetrics and Gynecology Department, East-Kazakhstan Regional Hospital, Oskemen, Kazakhstan
| | | | | | - Zhanna Sattarkyzy
- Obstetrics and Gynecology Department, City polyclinic #6, Astana, Kazakhstan
| | - Balkenzhe Imankulova
- Clinical Academic Department of Women's Health, CF University Medical Center, Astana, Kazakhstan
| | - Nazira Kamzayeva
- Clinical Academic Department of Women's Health, CF University Medical Center, Astana, Kazakhstan
| | - Wassim Y Almawi
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Faculty of Sciences, El-Manar University, Tunis, Tunisia
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Lama Y, Qin Y, Nan X, Knott C, Adebamowo C, Ntiri SO, Wang MQ. Human Papillomavirus Vaccine Acceptability and Campaign Message Preferences Among African American Parents: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1691-1701. [PMID: 33934287 PMCID: PMC8088401 DOI: 10.1007/s13187-021-02014-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 05/08/2023]
Abstract
Human papillomavirus (HPV) vaccination can prevent numerous cancers, yet uptake remains low for adolescents. Given disproportionate burden of cancers among African Americans, it is important to identify factors that influence HPV vaccination decisions among African American parents, specifically the role and preferences of vaccine campaign messages. The objectives of this study were to (1) identify the predictors of parents' decisions to get their children vaccinated against HPV, (2) assess parents' evaluation of current HPV vaccination campaign messages, and (3) uncover message strategies or themes parents consider to be effective and motivating to vaccinate their children against HPV. Focus groups were conducted with African American mothers and fathers (n = 18) in person. Several themes emerged regarding HPV vaccine acceptability including the desire to be informed, the unfamiliarity of vaccination, and mistrust toward government, pharmaceutical companies, and healthcare providers. Parental review of existing campaign messages highlighted the importance of clarifying risks and benefits of vaccination, including cancer prevention, and the preference for straightforward language. When brainstorming strategies to craft effective messages, parents highlighted need for the inclusion of diverse groups across race, gender, and age. Additionally, parents recommended clear language on side effects, eligibility, and additional resources for further information. Our findings highlight concerns and potential strategies to promote HPV vaccination tailored to African American parents and their children. Targeted interventions to increase vaccination need to consider the importance of building trust and representation in health promotional materials. Considerations for how messages were shared were also discussed such as physical locations, word of mouth, and social media.
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Affiliation(s)
- Yuki Lama
- Department of Family Science, University of Maryland School of Public Health, 4200 Valley Drive, Bldg. 225, College Park, MD, 20742, USA.
| | - Yan Qin
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Xiaoli Nan
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Cheryl Knott
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Clement Adebamowo
- Institute of Human Virology, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shana O Ntiri
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
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Du EY, Adjei Boakye E, Taylor DB, Kuziez D, Rohde RL, Pannu JS, Simpson MC, Patterson RH, Varvares MA, Osazuwa-Peters N. Medical students' knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer. Hum Vaccin Immunother 2022; 18:2109892. [PMID: 36070503 DOI: 10.1080/21645515.2022.2109892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
On the basis of their training, medical students are considered "the best case scenario" among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC.
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Affiliation(s)
- Eric Y Du
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.,Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Derian B Taylor
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Duaa Kuziez
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rebecca L Rohde
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jaibir S Pannu
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, MO, USA.,Advanced Health Data Research Institute, Saint Louis University, St Louis, MO, USA
| | - Rolvix H Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark A Varvares
- Department of Otolaryngology, Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
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Sypień P, Zielonka TM. Knowledge and Awareness of Polish Parents on Vaccination against Human Papillomavirus. Vaccines (Basel) 2022; 10:vaccines10071156. [PMID: 35891319 PMCID: PMC9322302 DOI: 10.3390/vaccines10071156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 12/21/2022] Open
Abstract
Background: Human papillomavirus (HPV) vaccinations are rare among Polish children, and the reasons are scant. The objective was to evaluate the knowledge, attitude and awareness of parents about HPV vaccination to investigate reasons for low HPV vaccination coverage. Methods: 387 parents of children hospitalized at the Children’s Hospital were asked to participate in an anonymous and voluntary survey study. Three hundred and two surveys were returned. Results: Only 54% of participants have heard about HPV, while 26% know that it is a sexually transmitted disease. According to 71% of responders, vaccines are generally effective, and 63% claim that they are safe. However, only 5% of daughters and 4% of sons are vaccinated against HPV. A total of 25% of parents spoke with their doctor about HPV-related diseases and prevention methods. A higher level of education (p = 0.01), knowledge of sexually transmitted diseases (p < 0.0001), perceiving vaccination as an effective and safe prophylactic method (p < 0.0001), and conversations with a doctor (p < 0.0001) are strong motivators to vaccinate children against HPV. This decision is free of religious beliefs, origin, age, gender and the number of children. Conclusions: Polish parents have a positive attitude towards vaccination. They recognize the limitations of their knowledge and express a desire to further it. Educational activity is an important element of physicians’ work.
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Affiliation(s)
- Piotr Sypień
- Sebastian Petrycy Health Care Facility in Dąbrowa Tarnowska, Szpitalna Street 1, 33-200 Dąbrowa Tarnowska, Poland;
| | - Tadeusz M. Zielonka
- Department of Family Medicine, Medical University of Warsaw, S. Binieckiego Street 6, 02-097 Warsaw, Poland
- Correspondence: ; Tel./Fax: +48-22-116-6232
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Mihretie GN, Liyeh TM, Ayele AD, Belay HG, Yimer TS, Miskr AD. Knowledge and willingness of parents towards child girl HPV vaccination in Debre Tabor Town, Ethiopia: a community-based cross-sectional study. Reprod Health 2022; 19:136. [PMID: 35689288 PMCID: PMC9188100 DOI: 10.1186/s12978-022-01444-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cervical cancer is currently the second-leading cause of cancer death among women in Ethiopia. Vaccination against the human papillomavirus (HPV) is an effective primary prevention strategy for HPV-related illnesses. The knowledge and willingness of parents toward the HPV vaccine are crucial to increasing the uptake of the vaccine. The vaccine's acceptance by children and young adolescents is dependent on parental consent. Therefore, this study aimed to assess knowledge, willingness, and associated factors of the human papillomavirus vaccine among parents of girls aged 9–14 years at Debre Tabor Town. Method A community-based cross-sectional study was conducted among participants from December 10, 2020, to January 15, 2021. A simple random sample technique was used to include 638 participants. A structured face-to-face interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using Epi-Data and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. The Odds Ratio (OR), 95% CI, and p-values less than 0.05 were used to determine the statistical association.
Results Thirty-five percent (35.4%, 95% CI = 31.4%, 38.8%) and 44.8% (95% CI = 40.40%, 48.67%) of participants were knowledgeable about HPV vaccination and willing to get it, respectively. Being government employees (AOR = 5.46, 95% CI = 2.42, 9.34), and having a family history of sexually transmitted diseases (STD) (AOR = 1.76, 95% CI = 1.14, 2.72) were significantly associated with knowledge of the human papilloma virus (HPV) vaccine. Participants’ age (AOR = 1.43, 95% CI = 1.16, 2.87), secondary education and above (AOR = 1.70, 95% CI = 1.05, 2.74), fear of HPV infection (AOR = 2.29, 95% CI = 1.21, 4.32), and having good knowledge of the HPV vaccine (AOR = 3.30, 95% CI = 2.21, 4.93) were significantly associated with willingness to receive the HPV vaccine. Conclusion and recommendation The knowledge and willingness of parents toward the HPV vaccine were low. Then, health officials should boost HPV vaccination promotion through public media. In schools, churches, mosques, and health facilities, health extension workers and health professionals provide information about the HPV vaccine for the parents. Mixed quantitative and qualitative studies are preferable for future research to address “why” issues. Infection with the Human Papillomavirus (HPV) causes nearly 99% of cervical cancer cases and more than 20% of breast, neck, and anogenital cancers. The HPV vaccines protect against high-risk types of HPV (types 16 and 18), which account for approximately 70% of cervical cancers. Global coverage of the HPV vaccine was 39.7%, with high-income countries (68%), middle-income countries (28%), and lower-middle-income countries (2.7%). For different reasons, cervical cancer screening is very poor in Ethiopia (below 2%). Cervical cancer is mostly asymptomatic more than 20 years after infection. Primary prevention (enhancing the HPV vaccine) is the best way to protect women from cervical cancer. Adolescents’ uptake and acceptance of the vaccine depend on parental consent. Assessing parental knowledge and willingness at a community level is very crucial. A simple random sample technique was used to include 638 participants. A structured and pre-tested face-to-face interviewer-administered questionnaire was used to collect the data. The data were entered and analyzed using Epi-Data, and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. Nearly one-third (35.4%) and less than half (44.8%) of participants were knowledgeable and willing to receive the HPV vaccination. The knowledge and willingness of the parents are significantly lower. Being government employees and having a family history of sexually transmitted diseases (STD) were factors affecting the knowledge of parents about the human papillomavirus vaccine. Participants’ age, secondary education and above, fear of HPV infection, and having good knowledge of the HPV vaccine were significantly associated with their willingness to use the HPV vaccine. The knowledge and willingness of the parents are significantly lower. Health officials and stakeholders should scale up HPV vaccine promotion through public media.
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Affiliation(s)
- Gedefaye Nibret Mihretie
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia.
| | - Tewachew Muche Liyeh
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Alemu Degu Ayele
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Habtamu Gebrehana Belay
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Tigist Seid Yimer
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Agernesh Dereje Miskr
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
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10
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Patrick L, Bakeera-Kitaka S, Rujumba J, Malande OO. Encouraging improvement in HPV vaccination coverage among adolescent girls in Kampala, Uganda. PLoS One 2022; 17:e0269655. [PMID: 35679304 PMCID: PMC9182299 DOI: 10.1371/journal.pone.0269655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction WHO recommends vaccination against HPV for girls before sexual debut. Uganda started HPV vaccination in 2008 as pilot programs in 2 districts, followed by national roll out in 2015. Despite the availability of vaccines against human papillomavirus (HPV) in Uganda in the period covered by the study, there was reported low HPV vaccine uptake and completion especially of the second dose in Uganda; with little information available on timely completion of HPV vaccine and the associated factors in Uganda. This study was therefore done to determine the HPV vaccine dose 2 completion and describe the possible factors associated with timely HPV vaccine completion and non-completion among girls of age 9–14 years attending the adolescent clinic at Mulago hospital. Methods A retrospective mixed methods study was conducted in Mulago National Referral hospital adolescent clinic. Data were mainly collected through review of charts and folders for clinic attendance by eligible girls and focus group discussions with eligible girls that completed the 2 doses of HPV vaccine on recommended/scheduled time. Results Out of the 201 girls studied, 87 girls (43.3%) had timely completion of the HPV vaccination. Knowledge about HPV infection and HPV vaccine benefits, positive peer influence and healthcare worker recommendation to get vaccinated at health facility level positively influenced timely completion of HPV vaccine. Among barriers to completion of HPV vaccine identified were: inadequate information about HPV infection and HPV vaccine, concerns about HPV vaccine efficacy and safety, unclear communication with adolescents/caregivers from healthcare workers and -stock out of the HPV vaccine. Conclusion Timely completion of the second dose of HPV vaccine among girls attending the adolescent clinic of Mulago hospital was low (at 43.3%) but higher when compared to earlier published reports. Interventions around improved social mobilization, enhanced outreach and static vaccination approach and education of eligible girls on HPV vaccination can help increase vaccine uptake.
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Affiliation(s)
- Lydia Patrick
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
| | | | - Joseph Rujumba
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
| | - Oliver Ombeva Malande
- Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
- Administration Department, East Africa Centre for Vaccines and Immunization (ECAVI), Kampala, Uganda
- Department of Public Health Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Paediatrics & Child Health, Egerton University, Nakuru, Kenya
- * E-mail:
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11
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Voidăzan TS, Budianu MA, Rozsnyai FF, Kovacs Z, Uzun CC, Neagu N. Assessing the Level of Knowledge, Beliefs and Acceptance of HPV Vaccine: A Cross-Sectional Study in Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116939. [PMID: 35682518 PMCID: PMC9180695 DOI: 10.3390/ijerph19116939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/01/2022] [Accepted: 06/05/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: The infection with Human papilloma virus (HPV) is the most common sexually transmitted infection and it has been associated with cervical cancer (CC) in 99.7% of the cases. In Romania, CC is the second most common, with incidence (22.6%000) and mortality rates (9.6%000) three times higher than any other European country. Our aim was to assess the level of knowledge regarding HPV infection among parents, highschool students, medical students and doctors, with an emphasis on their main source of information—the Internet. (2) Methods: We applied five questionnaires to six categories of respondents: parents of pupils in the 6th–8th grades, medical students, doctors, boys in the 11th–12th grades, girls in the 11th–12th grades and their mothers. (3) Results: We included a total of 3108 respondents. 83.83% of all respondents had known about HPV infection. The level of information about HPV infection and vaccination was either satisfactory, poor or very poor. Their main source of information varied depending on the respondent profile and professional activity. Medical students were informed by doctors and healthcare professionals (53.0%), doctors gathered their information from books, journals and specialized brochures (61.6%). For the other categories of respondents, the Internet was the main source of information. Most respondents answered that doctors and healthcare professionals should provide information on HPV infection and vaccination, but very few of them actually seeked information from their general practitioner. (4) Conclusions: Population adherence to the appropriate preventative programs, as well as relevant information disseminated by the medical staff are key elements towards reducing the risk of HPV-associated cancers. An important role could also be played by schools, where teachers and school doctors could provide relevant information on the general aspects of HPV infection. Additionally, sex education classes and parent-teacher meetings should cover the main characteristics of HPV infection and what preventative measures can be employed against it.
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Affiliation(s)
- Toader Septimiu Voidăzan
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania; (T.S.V.); (N.N.)
| | - Mihaela Alexandra Budianu
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania; (T.S.V.); (N.N.)
- Correspondence: ; Tel.: +40-753628055
| | - Florin Francisc Rozsnyai
- Department of Obstetrics Gynecology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Zsolt Kovacs
- Department of Biochemistry, Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania; (Z.K.); (C.C.U.)
| | - Cosmina Cristina Uzun
- Department of Biochemistry, Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania; (Z.K.); (C.C.U.)
| | - Nicoleta Neagu
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania; (T.S.V.); (N.N.)
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12
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Chowdhury S, Ara R, Roy S, Tanvir SMS, Eva FN, Neela TM, Moonmoon AA, Sifat S, Zamila M, Hawlader MDH. Knowledge, attitude, and practices regarding human papillomavirus and its’ vaccination among the young medical professionals and students of Bangladesh. Clin Exp Vaccine Res 2022; 11:63-71. [PMID: 35223666 PMCID: PMC8844672 DOI: 10.7774/cevr.2022.11.1.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/25/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Sexually transmitted infections are a major worldwide concern, and human papillomavirus (HPV) is one of the significant risk factors. Many populations suffer from various diseases caused by HPV, and the overall death toll due to cervical carcinoma is remarkable. Despite vaccine availability, perception about vaccine safety and efficacy, its’ preventive outcome is still inferior among the health professionals and vaccine providers. So, this study aims to assess the knowledge, attitude, and practice level of HPV and its’ vaccination among doctors, dentists, and medical students. Materials and Methods This cross-sectional survey was carried out between April to August 2021, where 626 participants from all types of medical institutions of Bangladesh were interviewed using a validated and structured questionnaire that consists of four extensive areas; socio-demographic characteristics, HPV knowledge, attitude, and practices regarding vaccination. Results The knowledge and practice standards showed very poor outcomes where 43.29% of the participants showed good knowledge and only 11.82% conveyed good practices. Nevertheless, the attitude towards HPV vaccination was revealed high (75.88%). Female participants showed more positive attitudes than males. Conclusion Physicians and dentists play vital roles in raising public knowledge about HPV and awareness regarding HPV vaccination programs. The provision of medical education on HPV must be prioritized, and current training techniques must be re-evaluated. Thus, by implementing this strategy, improvement in national vaccination policy can be expected.
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Affiliation(s)
| | - Rifat Ara
- Department of Public Health, North South University, Dhaka, Bangladesh
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Simanta Roy
- Department of Public Health, North South University, Dhaka, Bangladesh
| | | | | | | | | | - Shamma Sifat
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Mushfera Zamila
- Department of Public Health, North South University, Dhaka, Bangladesh
- Pharmacovigilance Department, Beacon Pharmaceuticals Limited, Dhaka, Bangladesh
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13
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Njuguna DW, Mahrouseh N, Isowamwen OV, Varga O. Knowledge, Attitude and Practice of Main Stakeholders towards Human Papilloma Virus Infection and Vaccination in Mombasa and Tana-River Counties in Kenya: A Qualitative Study. Vaccines (Basel) 2021; 9:1099. [PMID: 34696206 PMCID: PMC8538985 DOI: 10.3390/vaccines9101099] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 01/17/2023] Open
Abstract
Following a successful Human Papilloma Virus (HPV) vaccination pilot in 2013-2015 in Kitui county, Kenya introduced the HPV vaccine in October 2019 with a goal to immunize approximately 800,000 girls annually against HPV. Our study assessed the knowledge, attitudes, and practice of affected groups towards HPV infection and vaccination in two counties of Kenya. Semi-structured interviews from children aged between nine and thirteen years and key informants comprising of parents, head teachers, community leaders and health workers involved in HPV vaccination in health facilities from Mombasa and Tana-River counties were conducted. Content was analyzed thematically and coded for emerging themes using the QRS Nvivo 12 Plus (QRS International, Doncaster, Australia) software package. From our findings, a significant proportion of participants, especially children, have limited knowledge of the subject. Vaccination of boys was opposed by most participants. Parents and the community members are not in favor of HPV vaccination, as compared to the other groups. A similar pattern of inadequate knowledge and strongly opposed attitudes was observed in Tana-River and Mombasa. Active community involvement in primary prevention strategies may promote the uptake of the vaccine which can be achieved by robust awareness, modifying the negative beliefs about HPV vaccine and encouraging the perceptibility of HPV vaccination.
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Affiliation(s)
- Diana Wangeshi Njuguna
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (D.W.N.); (N.M.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (D.W.N.); (N.M.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | | | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (D.W.N.); (N.M.)
- Office for Supported Research Groups, Eötvös Loránd Research Network, 1052 Budapest, Hungary
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14
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Kong WY, Bustamante G, Pallotto IK, Margolis MA, Carlson R, McRee AL, Gilkey MB. Disparities in Healthcare Providers' Recommendation of HPV Vaccination for U.S. Adolescents: A Systematic Review. Cancer Epidemiol Biomarkers Prev 2021; 30:1981-1992. [PMID: 34426414 DOI: 10.1158/1055-9965.epi-21-0733] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/10/2021] [Accepted: 08/11/2021] [Indexed: 01/19/2023] Open
Abstract
Infrequent provider recommendations continue to be a key barrier to human papillomavirus (HPV) vaccination, including among adolescents at higher risk for future HPV cancers. To inform future interventions, we sought to characterize disparities in health care providers' HPV vaccine recommendation for U.S. adolescents. We systematically reviewed studies published in 2012-2019 that assessed provider HPV vaccine recommendations for adolescents aged 9-17. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 52 eligible studies and used a standardized abstraction form to assess recommendation prevalence by adolescent demographic characteristics. Studies consistently found that fewer parents of boys than girls reported receiving HPV vaccine recommendations (14 studies, range of difference: -11 to -35 percentage points). Studies also found fewer recommendations for adolescents who were younger (2 studies, -3% to -12% points), non-White (3 studies, -5% to -7% points, females only), lower income (3 studies, -1% to -8% points), or uninsured (1 study, -21% points, males only). Studies identified geographic disparities in southern and rural areas. In conclusion, findings from this systematic review identify disparities in HPV vaccine recommendation that may contribute to suboptimal vaccine uptake. Efforts to improve providers' HPV vaccine communication should focus on increasing recommendation consistency, especially for lower-income, non-White, and rural adolescents.
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Affiliation(s)
- Wei Yi Kong
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriela Bustamante
- Medical School, University of Minnesota, Minneapolis, Minnesota.,School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Isabella K Pallotto
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marjorie A Margolis
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca Carlson
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Melissa B Gilkey
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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15
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Richards AS, Qin Y, Daily K, Nan X. African American Parents' Perceived Vaccine Efficacy Moderates the Effect of Message Framing on Psychological Reactance to HPV Vaccine Advocacy. JOURNAL OF HEALTH COMMUNICATION 2021; 26:534-544. [PMID: 34427548 PMCID: PMC8994864 DOI: 10.1080/10810730.2021.1966688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This experiment assessed how the frame of promotional vaccine messages elicited psychological reactance differently for African American parents according to their level of perceived vaccine efficacy. We found that those with low perceived HPV vaccine efficacy experienced more psychological reactance in response to loss-framed messages compared to gain-framed messages, whereas message framing made little difference for those with high perceived HPV vaccine efficacy. In addition, the interaction between frame and perceived HPV vaccine efficacy indirectly affected parents' intentions to vaccinate their child for HPV via reactance. These results support current theorizing about framing effects under defensive message processing specifically as it applies to psychological reactance.
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Affiliation(s)
| | - Yan Qin
- Department of Communication, University of Maryland
| | - Kelly Daily
- Department of Communication, La Salle University
| | - Xiaoli Nan
- Department of Communication, University of Maryland
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16
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Caldwell AC, Madden CA, Thompson DM, Garbe MC, Roberts JR, Jacobson RM, Darden PM. The impact of provider recommendation on human papillomavirus vaccine and other adolescent vaccines. Hum Vaccin Immunother 2021; 17:1059-1067. [PMID: 33074774 DOI: 10.1080/21645515.2020.1817713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
This study explored the association between provider recommendation and adolescent vaccine coverage. We analyzed data from the 2008 to 2018 National Immunization Survey-Teen including coverage with one dose of quadrivalent meningococcal conjugate vaccine (MenACWY), Tetanus-diphtheria-acellular pertussis vaccine (Tdap), and one and three doses of Human papillomavirus (HPV) vaccine. We compared vaccine coverage between those who recalled a provider recommendation and those who did not. Among those who received a provider recommendation for MenACWY, coverage trended from 67.8% (2008) to 88.1% (2013), contrasted to those who did not, trending from 30.9% to 73.1%. Among those with a provider recommendation for Tdap, coverage trended from 47.6% to 89.7%, contrasted to those who did not, trending from 35.6% to 82.2%. Among females with a provider recommendation for HPV vaccine, receipt of initial dose of HPV vaccine trended from 57.5% (2008) to 74.3% (2018), contrasted to those who did not, trending from 18.1% to 49.8%, and among males, trended from 17.2% (2010) to 75.1% (2018) for those with a provider recommendation, compared to 0.5% to 44.7% for those without. In 2013, coverage difference by provider recommendation was 26.0% among females for one dose of HPV vaccine and 21.9% for three doses, and among males was 44.8% and 20.8%, respectively, while it was lower at 15% for MenACWY and 7.6% for Tdap. For each vaccine, coverage was higher with a provider recommendation; the largest difference was noted for HPV vaccine. This finding verifies for providers the importance of their recommendation, especially for the HPV vaccine.
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Affiliation(s)
- Alexandria C Caldwell
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christi A Madden
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David M Thompson
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - M Connor Garbe
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - James R Roberts
- Department of Pediatrics, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Robert M Jacobson
- Mayo Clinic, Department of Pediatric and Adolescent Medicine, Rochester, MN, USA
| | - Paul M Darden
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Huon JF, Grégoire A, Meireles A, Lefebvre M, Péré M, Coutherut J, Biron C, Raffi F, Briend-Godet V. Evaluation of the acceptability in France of the vaccine against papillomavirus (HPV) among middle and high school students and their parents. PLoS One 2020; 15:e0234693. [PMID: 33091021 PMCID: PMC7580947 DOI: 10.1371/journal.pone.0234693] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/13/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The pathogenic and oncogenic roles of papillomavirus (HPV) infections have been documented and shown to occur in women as well as in men. While other countries have already extended their vaccination guidelines to include boys, in 2019 the French National Authority for Health validated implementation of HPV vaccination in the 2020 vaccination schedule. There is, however, a climate of distrust in regard to vaccination in France, and there have been few studies to date regarding the acceptability of HPV vaccination in boys in France. The aim of this study was, therefore, to evaluate the acceptability of extending the recommendations for HPV vaccination in men, among middle and high school students and their parents. METHODS Our study (HPVac) was a prospective, multicenter, departmental, and descriptive survey applied to a sample of male middle and high school students attending schools in the Loire-Atlantique department and their parents. It took place from January 2017 to January 2018. RESULTS We analyzed the information obtained from 127 parent questionnaires and 145 children questionnaires. In terms of acceptability, 36.6% (n = 53) of the children and 37.8% (n = 48) of the parents were in favour of being vaccinated or of having their children vaccinated against HPV (51.7% (n = 75) and 50.4% (n = 64), respectively, were undecided). The perception of a risk stemming from HPV infection was positively associated with acceptability of the HPV vaccine. Being against vaccines in general, being discouraged by their parents, parents thinking that their child is not at risk, and the belief that the vaccine is not mandatory were arguments cited and significantly associated with a willingness to be vaccinated. CONCLUSION This study revealed a lack of information among boys and their parents about HPV and its vaccination. It also clearly showed that taking time to discuss the consequences of an infection and the merits of being vaccinated can help parents overcome their reluctance. The children then generally go along with their parent's choice.
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Affiliation(s)
- Jean-François Huon
- Clinical Pharmacy of the UHC of Nantes, and UMR INSERM 1246 SPHERE Universities of Nantes and Tours, Nantes, France
- * E-mail:
| | - Antoine Grégoire
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
| | - Anita Meireles
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
| | - Maëva Lefebvre
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
- Department of Infectious Diseases, and CIC 1413, INSERM, University Hospital Center of Nantes, Nantes, France
| | - Morgane Péré
- Plateforme de Méthodologie et Biostatistique, Direction de la Recherche, CHU de Nantes, Nantes, France
| | - Julie Coutherut
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
| | - Charlotte Biron
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
- Department of Infectious Diseases, and CIC 1413, INSERM, University Hospital Center of Nantes, Nantes, France
| | - François Raffi
- Department of Infectious Diseases, and CIC 1413, INSERM, University Hospital Center of Nantes, Nantes, France
| | - Valérie Briend-Godet
- Center for the Prevention of Infectious and Transmitted Diseases of the UHC of Nantes, Nantes, France
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CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
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Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
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Jeanne M, Eve S, Pasquier J, Blaizot X, Turck M, Raginel T. [Human papillomaviruses vaccination: Vaccine intentions of parents of children aged 10 to 11s in Normandy schools after an information campaign during the 2015-2016 school year]. Presse Med 2019; 48:e369-e381. [PMID: 31785940 DOI: 10.1016/j.lpm.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In 2015, the vaccine against human Papillomavirus (hPV) was recommended in France for children from 11 to 14 years-old. This study assessed the knowledge of parents from Normandy about this vaccine and measured the impact of an information campaign on their intent to have their children vaccinated. METHODS Parents from Normandy with children in sixth-grade class, aged 10 to 11, during the 2015-2016 school year were included. The secondary schools were selected in collaboration with academic institutions. The intent to have their child vaccinated was measured with a questionnaire distributed to children in April 2016 and collected from May to June 2016 by school nurses. RESULTS Among the 16 selected secondary schools, 1428 questionnaires were distributed and 864 (60.5 %) were collected regardless of the gender of the child. Among the 439 girls, 85.9 % were not vaccinated against hPV. The intent to vaccinate was higher when the parent who responded was the mother (P<0.001). Among the parents who took note of the information booklet, 73.7 % found this information useful. There was a significant association between the knowledge about the vaccine against hPV and the intent to vaccinate (P<0.001). The percentage of vaccinated girls was significantly higher when their parents were informed (10.9 % versus 3.2 %). We noticed a significant rise of the intent to vaccinate children when information booklets were distributed (P<0.001). CONCLUSION The vaccination rate after specific information about vaccination against hPV was significantly higher. The information campaign has thus a significant positive impact.
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Affiliation(s)
- Mathilde Jeanne
- Normandie Université, Unicaen, faculté de médecine, département de médecine générale, 14000 Caen, France
| | - Ségolène Eve
- Normandie Université, Unicaen, faculté de médecine, département de médecine générale, 14000 Caen, France
| | - Julie Pasquier
- Réseau OncoNormandie, 14000 Caen, France; Observatoire régionale de Santé de Basse-Normandie, 14200 Hérouville Saint-Clair, France
| | | | - Mélusine Turck
- CHU de Caen, départment de gynécologie-obstétrique, 14000 Caen, France
| | - Thibaut Raginel
- Normandie Université, Unicaen, faculté de médecine, département de médecine générale, 14000 Caen, France; Normandie université, Unicaen, ANTICIPE, Inserm, 14000 Caen, France.
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20
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Shimabukuro TT, Su JR, Marquez PL, Mba-Jonas A, Arana JE, Cano MV. Safety of the 9-Valent Human Papillomavirus Vaccine. Pediatrics 2019; 144:e20191791. [PMID: 31740500 PMCID: PMC6935554 DOI: 10.1542/peds.2019-1791] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The 9-valent human papillomavirus vaccine (9vHPV) was approved for females and males aged 9 to 26 years in 2014. We analyzed postlicensure surveillance reports to the Vaccine Adverse Event Reporting System (VAERS). METHODS We searched VAERS data for US reports of adverse events (AEs) after 9vHPV from December 2014 through December 2017. We calculated reporting rates and conducted empirical Bayesian data mining to identify disproportional reporting. Physicians reviewed reports for selected prespecified conditions. RESULTS VAERS received 7244 reports after 9vHPV: 31.2% among females, 21.6% among males, and for 47.2%, sex was not reported. Overall, 97.4% of reports were nonserious. Dizziness, syncope, headache, and injection site reactions were most commonly reported; the most commonly reported AEs were similar between females and males. Two reports of death after 9vHPV were verified; no information in autopsy reports or death certificates suggested a causal relationship with vaccination. Approximately 28 million 9vHPV doses were distributed during the study period; crude AE reporting rates were 259 reports per million 9vHPV doses distributed for all reports and 7 per million doses distributed for serious reports. Syncope (a known AE associated with human papillomavirus vaccination) and several types of vaccine administration errors (eg, administered at wrong age) exceeded the statistical threshold for empirical Bayesian data mining findings. CONCLUSIONS No new or unexpected safety concerns or reporting patterns of 9vHPV with clinically important AEs were detected. The safety profile of 9vHPV is consistent with data from prelicensure trials and from postmarketing safety data of its predecessor, the quadrivalent human papillomavirus vaccine.
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Affiliation(s)
- Tom T Shimabukuro
- Division of Healthcare Quality Promotion, Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - John R Su
- Division of Healthcare Quality Promotion, Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Paige L Marquez
- Division of Healthcare Quality Promotion, Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Adamma Mba-Jonas
- Division of Epidemiology, Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Jorge E Arana
- Division of Healthcare Quality Promotion, Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Maria V Cano
- Division of Healthcare Quality Promotion, Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
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21
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Vorsters A, Bonanni P, Maltezou HC, Yarwood J, Brewer NT, Bosch FX, Hanley S, Cameron R, Franco EL, Arbyn M, Muñoz N, Kojouharova M, Pattyn J, Baay M, Karafillakis E, Van Damme P. The role of healthcare providers in HPV vaccination programs - A meeting report. PAPILLOMAVIRUS RESEARCH 2019; 8:100183. [PMID: 31476478 DOI: 10.1016/j.pvr.2019.100183] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 10/26/2022]
Abstract
The Human Papillomavirus (HPV) Prevention and Control Board convened a meeting in Bucharest, Romania (May 2018), to discuss the role of healthcare providers (HCPs) in prevention programs, with a focus on HPV vaccination and cervical cancer screening. International and local experts discussed the role that HCPs can play to increase the uptake of HPV vaccine and screening. Experts recommended: 1) increasing HCP norms of getting vaccinated; 2) training providers to make effective recommendations; 3) making culturally appropriate materials available, in local languages; and 4) centralizing and coordinating education and information material, to direct both HCPs and the general public to the best material available.
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Affiliation(s)
- Alex Vorsters
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium.
| | - Paolo Bonanni
- University of Florence, Health Sciences, Florence, Italy
| | - Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Joanne Yarwood
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - F Xavier Bosch
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Sharon Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ross Cameron
- NHS National Health Services Scotland, Health Protection Scotland, Glasgow, UK
| | | | - Marc Arbyn
- Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Nubia Muñoz
- Emeritus Professor at the Cancer Institute of Colombia, Colombia
| | - Mira Kojouharova
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Jade Pattyn
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium
| | - Marc Baay
- P95, Epidemiology and Pharmacovigilance, Leuven, Belgium
| | - Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium
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22
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Lavelle TA, Messonnier M, Stokley S, Kim D, Ramakrishnan A, Gebremariam A, Simon NJE, Rose AM, Prosser LA. Use of a choice survey to identify adult, adolescent and parent preferences for vaccination in the United States. J Patient Rep Outcomes 2019; 3:51. [PMID: 31359289 PMCID: PMC6663948 DOI: 10.1186/s41687-019-0135-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/19/2019] [Indexed: 01/03/2023] Open
Abstract
Background Adult and adolescent vaccination rates are far below coverage targets in the United States. Our objective was to identify the most influential factors related to vaccine uptake among adults, adolescents, and parents of adolescents (parents) in the United States. Methods We used a fractional factorial design to create a binary choice survey to evaluate preferences for vaccination. The national survey was fielded to a sample of adults, adolescents ages 13–17 years, and parents, using a national probability-based online research panel in November 2015. Respondents were presented with 5 profiles of a hypothetical vaccine and asked in a series of questions whether they would accept each vaccine. We analyzed the binary choice data using logistic regression in STATA v13 (College Station, TX) to calculate the odds that a participant would choose to accept the vaccine. Results We received completed responses from 334 (51%) of 652 adults, 316 (21%) of 1516 adolescents, and 339 (33%) of 1030 parents. Respondents were generally representative of the U.S. population. Vaccine effectiveness was the most influential factor in the choice to vaccinate for all groups. Other most influential factors were primary care provider (PCP) recommendation and the out-of-pocket cost of the vaccine. Other factors such as risk of illness, risk of vaccine side effects, vaccination location, and time for vaccination were not important in the decision to get vaccinated. Conclusions Adults, adolescents, and parents are most sensitive to vaccine effectiveness, PCP recommendation, and out-of-pocket cost for vaccination in their decision to get vaccinated. Strong PCP recommendations that focus on vaccine effectiveness and health care policies that minimize out-of-pocket costs for vaccinations may increase vaccine uptake by adults and adolescents. Electronic supplementary material The online version of this article (10.1186/s41687-019-0135-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
| | - Mark Messonnier
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - David Kim
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | | | - Achamyeleh Gebremariam
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA
| | - Norma-Jean E Simon
- Ann and Robert H. Lurie Children's Hospital, 225 East Chicago Ave, Chicago, IL, 60611, USA
| | - Angela M Rose
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA
| | - Lisa A Prosser
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA.,Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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23
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Nogueira-Rodrigues A. HPV Vaccination in Latin America: Global Challenges and Feasible Solutions. Am Soc Clin Oncol Educ Book 2019; 39:e45-e52. [PMID: 31099692 DOI: 10.1200/edbk_249695] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
HPV vaccine programs in Latin America run the risk of repeating the problems associated with Papanicolaou (Pap) test programs, an efficient, life-saving tool that is unfortunately underutilized for cancer prevention, in low- and middle-income countries. There is a great need for vigilance in the ongoing implementation of the HPV vaccine in Latin America.
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Affiliation(s)
- Angelica Nogueira-Rodrigues
- 1 Federal University of Minas Gerais, Belo Horizonte, Brazil.,2 Brazilian Group of Gynecologic Oncology, EVA, Brazil.,3 Global Cancer Institute, Boston, MA.,4 DOM Oncologia, Minas Gerais, Brazil.,5 LACOG, Latin America Cooperative Oncology Group
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24
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The Acceptability of HPV Vaccines and Perceptions of Vaccination against HPV among Physicians and Nurses in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101700. [PMID: 31091840 PMCID: PMC6572436 DOI: 10.3390/ijerph16101700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/04/2019] [Accepted: 05/10/2019] [Indexed: 12/22/2022]
Abstract
Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections nationwide. Methods: This is the first cross-sectional survey assessing physicians’ and nurses’ knowledge of HPV and recording their attitudes to HPV vaccination in Hong Kong. Survey questions were derived from the Health Belief Model. Results: 1152 clinicians (170 physicians and 982 nurses) aged 21 and 60 participated in this study. A multiple stepwise regression model was used to examine associations between cognitive factors (clinicians’ attitudes) and subjects’ intention to HPV vaccine uptake. Results showed that only 30.2% of physicians and 21.2% nurses found vaccinating for HPV acceptable. Conclusions: Perceived self-efficacy was the only significant background and cognitive variable associated with physicians’ and nurses’ accepting HPV vaccines. Further, when nurses found HPV vaccination acceptable, cues to action was featured as a significant background variable in their choice.
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Shapiro GK, Tatar O, Amsel R, Prue G, Zimet GD, Knauper B, Rosberger Z. Using an integrated conceptual framework to investigate parents' HPV vaccine decision for their daughters and sons. Prev Med 2018; 116:203-210. [PMID: 30267734 DOI: 10.1016/j.ypmed.2018.09.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/13/2018] [Accepted: 09/22/2018] [Indexed: 12/20/2022]
Abstract
Despite being an effective cancer prevention strategy, human papillomavirus (HPV) vaccination in Canada remain suboptimal. This study is the first to concurrently evaluate HPV vaccine knowledge, attitudes, and the decision-making stage of Canadian parents for their school-aged daughters and sons. Data were collected through an online survey from a nationally representative sample of Canadian parents of 9-16 year old children from August to September 2016. Measures included socio-demographics, validated scales to assess HPV vaccine knowledge and attitudes (using the Health Belief Model), and parents' HPV vaccination adoption stage using the Precaution Adoption Process Model (PAPM; six stages: unaware, unengaged, undecided, decided not, decided to, or vaccinated). 3779 parents' survey responses were analyzed (1826 parents of sons and 1953 parents of daughters). There was a significant association between child's gender and PAPM stage of decision-making, with parents of boys more likely to report being in earlier PAPM stages. In multinomial logistic regression analyses parents of daughters (compared to sons), parents of older children, and parents with a health care provider recommendation had decreased odds of being in any earlier PAPM stage as compared to the last PAPM stage (i.e. vaccinated). Parents who were in the 'decided not to vaccinate' stage had significantly greater odds of reporting perceived vaccine harms, lack of confidence, risks, and vaccine conspiracy beliefs. Future research could use these findings to investigate theoretically informed interventions to specifically target subsets of the population with particular attention towards addressing knowledge gaps, perceived barriers, and concerns of parents.
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Affiliation(s)
- Gilla K Shapiro
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, Quebec H3A 1B1, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Quebec H3T 1E4, Canada.
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Quebec H3T 1E4, Canada
| | - Rhonda Amsel
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
| | - Gillian Prue
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom of Great Britain and Northern Ireland
| | - Gregory D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Barbel Knauper
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Quebec H3T 1E4, Canada; Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Quebec H3T 1E4, Canada; Departments of Psychiatry and Oncology, McGill University, 1205 Dr. Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
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26
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Schnaith AM, Evans EM, Vogt C, Tinsay AM, Schmidt TE, Tessier KM, Erickson BK. An innovative medical school curriculum to address human papillomavirus vaccine hesitancy. Vaccine 2018; 36:3830-3835. [PMID: 29778518 DOI: 10.1016/j.vaccine.2018.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/01/2018] [Accepted: 05/02/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vaccination rates against Human Papillomavirus (HPV) in the US remain alarmingly low. Physicians can significantly influence a parent's decision to vaccinate their children. However, medical education often lacks training on specific strategies for communicating with vaccine hesitant parents. METHODS We created an innovative curriculum designed to teach medical students how to address HPV vaccine hesitancy. The curriculum consisted of (1) a presentation on the epidemiology, biology, and disease morbidity associated with HPV, (2) a video that teaches specific communication strategies and (3) role-playing simulations. This curriculum was delivered to medical students at two separate sites. Medical students were surveyed before and after completing the educational curriculum. The surveys assessed student comfort talking to HPV vaccine hesitant parents and their likelihood to recommend the HPV vaccine. RESULTS Pre- and post-intervention surveys were completed by 101 of the 132 participants (77% response rate). After the intervention, student awareness of the benefits of the HPV vaccine increased by a mean of 0.82 points (Likert scale 1-5, p < 0.01) and student comfort talking to vaccine hesitant parents increased by a mean of 1.37 points (p < 0.01). Prior to the intervention, students more strongly recommended the HPV vaccine to females compared to males, but this gender disparity was eliminated after the intervention (p < 0.01). Personal vaccination status was independately associated with a higher likelihood of recommending the HPV vaccine both before and after the intervention. CONCLUSION Our innovative curriculum improved medical student comfort level discussing HPV vaccination with hesitant parents and increased the perceived likelihood of recommending HPV vaccination. The intervention is easy to implement, scalable, and requires minimal resources. Educating future providers on this important topic has the potential to improve vaccination rates nationwide and thus should be considered for all medical students.
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Affiliation(s)
- Abigail M Schnaith
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Erica M Evans
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Caleb Vogt
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Andrea M Tinsay
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Thomas E Schmidt
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Katelyn M Tessier
- Masonic Cancer Center Biostatistics Core, University of Minnesota, 717 Delaware St SE, Minneapolis, MN 55455, United States.
| | - Britt K Erickson
- Department of Obstetrics & Gynecology, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, United States.
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27
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Lacombe-Duncan A, Newman PA, Baiden P. Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: A meta-ethnography of qualitative studies. Vaccine 2018; 36:2545-2558. [PMID: 29625768 DOI: 10.1016/j.vaccine.2018.02.079] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/04/2017] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Genital warts and human papillomavirus (HPV)-associated cancers in men can be substantially reduced through HPV vaccination; yet, globally, HPV vaccine uptake among boys remains low. This meta-ethnography synthesizes qualitative studies to understand, in-depth, HPV vaccine acceptability and decision-making among adolescent boys and/or their parents. METHODS A systematic search identified qualitative studies examining HPV vaccines from the perspectives of boys and/or boys' parents. The Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist was used to assess quality of reporting. Using meta-ethnographic techniques, we conducted a structured and iterative process of data analysis, coded original studies, and then developed descriptive and analytic themes to synthesize the findings. RESULTS Review of 15 eligible studies (n = 3362 parents, n = 39 boys) revealed multilevel factors that influence HPV vaccine acceptability and decision-making among adolescent boys and their parents: (1) individual, e.g., low HPV vaccine knowledge/awareness, (2) interpersonal, e.g., key relationships between parents, sons, and healthcare providers (HCP), (3) community/societal, e.g., parental duty to protect, and (4) systemic, e.g., HPV vaccine messaging. Parents generally accepted adolescent boys' sexuality and the need for vaccination, motivated by wanting to protect their sons from HPV and HPV-associated cancers, and valued HCP-initiated discussion and recommendation. Acceptability was mitigated by low awareness/knowledge of HPV vaccines and low perceived benefits for boys, lack of HCP-initiated discussion, out-of-pocket costs, multiple doses, stigma, and mixed messages about HPV. CONCLUSIONS Multilevel factors influence HPV vaccine acceptability and decision-making among parents and their adolescent sons. Providing clear and unambiguous messages about HPV vaccines-for whom (boys and girls), for what (genital warts and cancers in men), and when (before sexual debut)-through increased HCP-initiated discussion and targeted public health campaigns may support HPV vaccine uptake among boys. Future research should consistently disaggregate findings by sex of child and parent, and explore effective messaging tailored for boys and parents.
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Affiliation(s)
- Ashley Lacombe-Duncan
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada.
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada.
| | - Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper Street, Box 19129, Arlington, Texas, USA.
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28
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Markowitz LE, Gee J, Chesson H, Stokley S. Ten Years of Human Papillomavirus Vaccination in the United States. Acad Pediatr 2018; 18:S3-S10. [PMID: 29502635 DOI: 10.1016/j.acap.2017.09.014] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/06/2017] [Accepted: 09/15/2017] [Indexed: 01/19/2023]
Abstract
Since human papillomavirus (HPV) vaccine was first introduced for females in the United States in 2006, vaccination policy has evolved as additional HPV vaccines were licensed and new data became available. The United States adopted a gender neutral routine HPV immunization policy in 2011, the first country to do so. Vaccination coverage is increasing, although it remains lower than for other vaccines recommended for adolescents. There are various reasons for low coverage, and efforts are ongoing to increase vaccine uptake. The safety profile of HPV vaccine has been well established from 10 years of postlicensure monitoring. Despite low coverage, the early effects of the HPV vaccination program have exceeded expectations.
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Affiliation(s)
- Lauri E Markowitz
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga.
| | - Julianne Gee
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Harrell Chesson
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga
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29
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Lazalde GE, Gilkey MB, Kornides ML, McRee AL. Parent perceptions of dentists' role in HPV vaccination. Vaccine 2018; 36:461-466. [PMID: 29279282 PMCID: PMC5812019 DOI: 10.1016/j.vaccine.2017.12.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Offering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision. METHODS In September 2016, we conducted an online survey using a national sample (n = 1209) of U.S. parents of adolescent children aged 11-17. Adolescents' mean age was 14; 53% were male and 62% were non-Hispanic white. We identified correlates of parents' comfort with dentists as HPV vaccinators using multivariable logistic regression. RESULTS Overall, 23% of parents reported that they would feel comfortable with their child receiving HPV vaccine from a dentist. In multivariable analyses, parents had greater odds of being comfortable if they had higher trust in their child's primary care provider (OR = 1.27, 95% CI: 0.96-1.68) and lower odds if their child was female (OR = 0.65, 95% CI: 0.50-0.86). Convenience (20%) and oral health expertise (20%) were the most commonly cited benefits of dentists administering the vaccine. Wanting their child's regular provider to administer and track vaccinations (61% and 58%, respectively), and lack of insurance coverage (30%) were the most commonly cited concerns. Parents expressed somewhat greater comfort with roles dentists might play in promoting HPV vaccination other than vaccine delivery, such as providing education. CONCLUSIONS Parents in this sample had low comfort with dentists as HPV vaccinators. Findings from this study highlight potential concerns to be addressed before dental practices consider offering HPV vaccination in the future. Further research should assess dentists' perspectives and explore alternative roles for dental providers in HPV prevention efforts.
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Affiliation(s)
- Gabriela E Lazalde
- Division of General Pediatrics and Adolescent Health, University of Minnesota; 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - Melissa B Gilkey
- Department of Health Behavior, University of North Carolina, CB 7440, Chapel Hill, NC 27599, USA.
| | - Melanie L Kornides
- Department of Population Medicine, Harvard Pilgrim Health Care Institute & Harvard Medical School, 401 Park Drive, Suite 401, Boston, MA 02215, USA.
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, University of Minnesota; 717 Delaware St. SE, Minneapolis, MN 55414, USA.
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Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020185. [PMID: 29360785 PMCID: PMC5858260 DOI: 10.3390/ijerph15020185] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/13/2018] [Accepted: 01/15/2018] [Indexed: 12/29/2022]
Abstract
Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013–October 2013, we conducted a mail survey among parents of girls aged 12–15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC) were targeted. Surveys were in English or Spanish. Results: The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking). Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NCs reporting they thought HPV vaccine was unsafe (p < 0.0001) and 43% NIs vs. 21% NCs that it may cause long-term health problems (p < 0.001). Among NCs, 42% reported they did not know their daughter needed more shots (English-speaking, 20%, Spanish-speaking 52%) and 39% reported that “I wasn’t worried about the safety of the HPV vaccine before, but now I am” (English-speaking, 23%, Spanish-speaking, 50%). Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%), more information saying it prevents cancer (70%), and if they knew HPV was spread mainly by sexual contact (61%). Conclusions: Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents’ safety concerns do not appear until initial vaccination.
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Loke AY, Kwan ML, Wong YT, Wong AKY. The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review. J Prim Care Community Health 2017; 8:349-362. [PMID: 29161946 PMCID: PMC5932744 DOI: 10.1177/2150131917742299] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
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Affiliation(s)
- Alice Yuen Loke
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Miu Ling Kwan
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR.,2 Tuen Mun Hospital, Hospital Authority, Hong Kong SAR
| | - Yuen-Ting Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Alice Kar Yan Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
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Klosky JL, Hudson MM, Chen Y, Connelly JA, Wasilewski-Masker K, Sun CL, Francisco L, Gustafson L, Russell KM, Sabbatini G, Flynn JS, York JM, Giuliano AR, Robison LL, Wong FL, Bhatia S, Landier W. Human Papillomavirus Vaccination Rates in Young Cancer Survivors. J Clin Oncol 2017; 35:3582-3590. [PMID: 28837404 PMCID: PMC5662846 DOI: 10.1200/jco.2017.74.1843] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Cancer survivors are at high risk for human papillomavirus (HPV)-related morbidities; we estimated the prevalence of HPV vaccine initiation in cancer survivors versus the US population and examined predictors of noninitiation. Methods Participants included 982 cancer survivors (9 to 26 years of age; 1 to 5 years postcompletion of therapy); we assessed HPV vaccine initiation, sociodemographic and clinical characteristics, and vaccine-specific health beliefs; age-, sex-, and year-matched US population comparisons were from the National Immunization Survey-Teen and the National Health Interview Survey (2012-2015). Results The mean age at the time of the study was 16.3 ± 4.7 years; the mean time off therapy was 2.7 ± 1.2 years; participants were 55% male and 66% non-Hispanic white; 59% had leukemia/lymphoma. Vaccine initiation rates were significantly lower in cancer survivors versus the general population (23.8%; 95% CI, 20.6% to 27.0% v 40.5%; 95% CI, 40.2% to 40.7%; P < .001); survivors were more likely to be HPV vaccine-naïve than general population peers (odds ratio [OR], 1.72; 95% CI, 1.41 to 2.09; P < .001). Initiation in adolescent survivors (ages 13 to 17 years) was 22.0% (95% CI, 17.3% to 26.7%), significantly lower than population peers (42.5%; 95% CI, 42.2% to 42.8%; P < .001). Initiation in young adult survivors and peers (ages 18 to 26 years) was comparably low (25.3%; 95% CI, 20.9% to 29.7% v 24.2%; 95% CI, 23.6% to 24.9%). Predictors of noninitiation included lack of provider recommendation (OR, 10.8; 95% CI, 6.5 to 18.0; P < .001), survivors' perceived lack of insurance coverage for HPV vaccine (OR, 6.6; 95% CI, 3.9 to 11.0; P < .001), male sex (OR, 2.9; 95% CI, 1.7 to 4.8; P < .001), endorsement of vaccine-related barriers (OR, 2.7; 95% CI, 1.6 to 4.6; P < .001), and younger age (9 to 12 years; OR, 3.7; 95% CI, 1.8-7.6; P < .001; comparison, 13 to 17 years). Conclusion HPV vaccine initiation rates in cancer survivors are low. Lack of provider recommendation and barriers to vaccine receipt should be targeted in vaccine promotion efforts.
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Affiliation(s)
- James L Klosky
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Melissa M Hudson
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Yanjun Chen
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - James A Connelly
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Karen Wasilewski-Masker
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Can-Lan Sun
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Liton Francisco
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Laura Gustafson
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Kathryn M Russell
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Gina Sabbatini
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Jessica S Flynn
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Jocelyn M York
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Anna R Giuliano
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Leslie L Robison
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - F Lennie Wong
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Smita Bhatia
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
| | - Wendy Landier
- James L. Klosky, Melissa M. Hudson, Kathryn M. Russell, Gina Sabbatini, Jessica S. Flynn, and Leslie L. Robison, St. Jude Children's Research Hospital, Memphis, TN; Yanjun Chen, Liton Francisco, Jocelyn M. York, Smita Bhatia, and Wendy Landier, University of Alabama-Birmingham, Birmingham, AL; James A. Connelly, University of Michigan, Ann Arbor, MI and Vanderbilt University, Nashville, TN; Karen Wasilewski-Masker, Emory University and Children's Healthcare of Atlanta, Atlanta, GA; Can-Lan Sun, Laura Gustafson, and F. Lennie Wong, City of Hope, Duarte, CA; and Anna R. Giuliano, Moffitt Cancer Center, Tampa, FL
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Shapiro GK, Perez S, Naz A, Tatar O, Guichon JR, Amsel R, Zimet GD, Rosberger Z. Investigating Canadian parents' HPV vaccine knowledge, attitudes and behaviour: a study protocol for a longitudinal national online survey. BMJ Open 2017; 7:e017814. [PMID: 29025844 PMCID: PMC5652458 DOI: 10.1136/bmjopen-2017-017814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/27/2017] [Accepted: 08/01/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV), a sexually transmitted infection, can cause anogenital warts and a number of cancers. To prevent morbidity and mortality, three vaccines have been licensed and are recommended by Canada's National Advisory Committee on Immunisation (for girls since 2007 and boys since 2012). Nevertheless, HPV vaccine coverage in Canada remains suboptimal in many regions. This study will be the first to concurrently examine the correlates of HPV vaccine decision-making in parents of school-aged girls and boys and evaluate changes in parental knowledge, attitudes and behaviours over time. METHODS AND ANALYSIS Using a national, online survey utilising theoretically driven constructs and validated measures, this study will identify HPV vaccine coverage rates and correlates of vaccine decision-making in Canada at two time points (August-September 2016 and June-July 2017). 4606 participants will be recruited to participate in an online survey through a market research and polling firm using email invitations. Data cleaning methods will identify inattentive or unmotivated participants. ETHICS AND DISSEMINATION The study received research ethics board approval from the Research Review Office, Integrated Health and Social Services University Network for West-Central Montreal (CODIM-FLP-16-219). The study will adopt a multimodal approach to disseminate the study's findings to researchers, clinicians, cancer and immunisation organisations and the public in Canada and internationally.
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Affiliation(s)
- Gilla K Shapiro
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Samara Perez
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Anila Naz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rhonda Amsel
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Gregory D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zeev Rosberger
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Department of Oncology, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Luxembourg A, Moeller E. 9-Valent human papillomavirus vaccine: a review of the clinical development program. Expert Rev Vaccines 2017; 16:1119-1139. [PMID: 28956458 DOI: 10.1080/14760584.2017.1383158] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The 9-valent human papillomavirus (9vHPV) vaccine covers the same HPV types (6/11/16/18) as the quadrivalent HPV (qHPV) vaccine and 5 additional cancer-causing types (31/33/45/52/58). Epidemiological studies indicate that the 9vHPV vaccine could prevent approximately 90% of cervical cancers, 70-85% of high-grade cervical dysplasia (precancers), 85-95% of HPV-related vulvar, vaginal, and anal cancers, and 90% of genital warts. Areas covered: Study design features and key findings from the 9vHPV vaccine clinical development program are reviewed. In particular, 9vHPV vaccine efficacy was established in a Phase III study in young women age 16-26 years. Efficacy results in young women were extrapolated to pre- and young adolescent girls and boys and young men by immunological bridging (i.e., demonstration of non-inferior immunogenicity in these groups versus young women). Expert commentary: The development of the 9vHPV vaccine is the outcome of 20 years of continuous clinical research. Broad vaccination programs could help substantially decrease the incidence of HPV-related disease.
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Desiante F, Russo C, Giorgino A, Caputi G, Battista T, Cipriani R, Conversano M. Universal proposal strategies of anti-HPV vaccination for adolescents: comparative analysis between school-based and clinic immunization programs. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2017; 58:E225-E230. [PMID: 29123369 PMCID: PMC5668932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION A promising approach to increase teenager's adherence to immunization against HPV is the administration of vaccinations within the school facilities. The Local Health Unit of Taranto experienced two different vaccine strategy proposals in the twelve-year-olds: the first one was the usual active call strategy in the outpatient clinic, while the second one provided the involvement of the schools in the area. The aim of the study is to evaluate the results of the proposed vaccination strategies in both sexes and in towns of different sizes in order to identify an effective path for achieving vaccine coverage improvement. METHODS To estimate the number of anti-HPV vaccine doses administered in adolescents of the 2003 cohort, we used the computerized vaccination system data of the Apulia Region. Then, once analyzed, the data for anti-HPV vaccine were broken down by gender, vaccine strategy and size of the town of residence. Analyses performed by using STATA SE 14. RESULTS The multiple logistic regression points out that, females (OR = 3.2; p < 0.01), living in small towns (OR = 1.3; p < 0.01) and school vaccination strategy (OR = 2; p < 0.01) increase the likelihood of completing the anti-HPV vaccine cycle in adolescents. The comparative assessment of anti-HPV coverage strategies, suggests that school vaccination has resulted in significantly better outcomes than outpatient clinic one, for all the groups considered (overall 72.3% vs 55.6%). CONCLUSIONS The involvement of school institutes can define a winning organizational model to get a wider adolescent's adherence to immunization programs, especially in bigger towns. The school vaccination strategy could improve anti-HPV vaccine adherence also in males, who perceives a lower HPV-related diseases risk than females.
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Affiliation(s)
- F. Desiante
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy;,Correspondence: Francesco Desiante, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, piazza Giulio Cesare 11, 70124 Bari, Italy - E-mail:
| | - C. Russo
- Italian Society of Hygiene, Preventive Medicine and Public Health (SItI), Vaccine Strategies Apulian Working Group
| | - A. Giorgino
- Department of Public Health, Taranto Local Health Unit, Italy
| | - G. Caputi
- Department of Public Health, Taranto Local Health Unit, Italy
| | - T. Battista
- Department of Public Health, Taranto Local Health Unit, Italy
| | - R. Cipriani
- Department of Public Health, Taranto Local Health Unit, Italy
| | - M. Conversano
- Department of Public Health, Taranto Local Health Unit, Italy
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McBride KR, Singh S. Predictors of Adults' Knowledge and Awareness of HPV, HPV-Associated Cancers, and the HPV Vaccine: Implications for Health Education. HEALTH EDUCATION & BEHAVIOR 2017; 45:68-76. [PMID: 28595454 DOI: 10.1177/1090198117709318] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified sociodemographic characteristics associated with HPV knowledge at the population level. Data from adult men ( n = 1,197) and women ( n = 1,906) who participated in the National Cancer Institute's 2014 Health Information National Trends Survey were analyzed. Multivariable regression was used to identify predictors of four HPV knowledge categories: (1) general knowledge, (2) cervical cancer knowledge, (3) "other" cancer knowledge (i.e., anal, oral, penile), and (4) vaccine knowledge. Significant gender differences in awareness and knowledge of HPV and the HPV vaccine were revealed. Most participants (>70%) knew that HPV could cause cervical cancer, but fewer (14.9% to 31.5%) knew of the association between HPV and "other" cancers. Women were more likely to report that a health care provider recommended vaccination. Significant predictors of general HPV and HPV vaccine knowledge included gender, education, income, race, and other sociodemographic characteristics. Age and income predicted cervical cancer knowledge. Knowledge of "other" HPV-associated cancers was predicted by having a child under 18 years in the household and relationship status. HPV knowledge appears to be socially patterned. Low HPV knowledge among men and some racial minorities suggests a need for further intervention. Health education should emphasize risks of noncervical HPV-associated cancers. Patient-provider communication that includes education, counseling, and clear recommendations favoring vaccination may improve uptake.
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Daley EM, Vamos CA, Thompson EL, Zimet GD, Rosberger Z, Merrell L, Kline NS. The feminization of HPV: How science, politics, economics and gender norms shaped U.S. HPV vaccine implementation. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 3:142-148. [PMID: 28720448 PMCID: PMC5883212 DOI: 10.1016/j.pvr.2017.04.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/10/2017] [Accepted: 04/19/2017] [Indexed: 12/14/2022]
Abstract
Human papillomavirus (HPV) can cause a number of anogenital cancers (i.e., cervical, penile, anal, vaginal, vulvar) and genital warts. A decade ago, the HPV vaccine was approved, and has been shown to be a public health achievement that can reduce the morbidity and mortality for HPV-associated diseases. Yet, the mistaken over-identification of HPV as a female-specific disease has resulted in the feminization of HPV and HPV vaccines. In this critical review, we trace the evolution of the intersection of science, politics, economics and gender norms during the original HPV vaccine approval, marketing era, and implementation. Given the focus on cervical cancer screening, women were identified as bearing the burden of HPV infection and its related illnesses, and the group responsible for prevention. We also describe the consequences of the feminization of HPV, which has resulted primarily in reduced protection from HPV-related illnesses for males. We propose a multilevel approach to normalizing HPV vaccines as an important aspect of overall health for both genders. This process must engage multiple stakeholders, including providers, parents, patients, professional organizations, public health agencies, policymakers, researchers, and community-based organizations.
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Affiliation(s)
- Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Gregory D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital & Departments of Oncology, Psychiatry and Psychology, McGill University, Montreal, QC, Canada.
| | - Laura Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA.
| | - Nolan S Kline
- Department of Anthropology, Rollins College, Winter Park, FL, USA.
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Nogueira-Rodrigues A, Bukowski A, Paulino E, St Louis J, Barrichello A, Sternberg C, Gifoni MAC, Luciani S, Goss PE. An alert to Latin America: Current human papillomavirus vaccination trends highlight key barriers to successful implementation. Cancer 2017; 123:2193-2199. [PMID: 28440878 DOI: 10.1002/cncr.30647] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Angelica Nogueira-Rodrigues
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Federal University of Minas Gerais, Belo Horizonte, Brazil.,Brazilian Group of Gynecologic Oncology, EVA, Brazil
| | - Alexandra Bukowski
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Eduardo Paulino
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Brazilian Group of Gynecologic Oncology, EVA, Brazil.,Brazilian National Cancer Institute, Rio de Janeiro, Brazil.,Integrated Oncology Clinics Group, Rio de Janeiro, Brazil
| | - Jessica St Louis
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Cinthya Sternberg
- Brazilian Society of Clinical Oncology, Belo Horizonte, Minas Gerais, Brazil.,Post-Graduate Program of Anatomic Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Markus A C Gifoni
- Brazilian Society of Clinical Oncology, Belo Horizonte, Minas Gerais, Brazil
| | | | - Paul E Goss
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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39
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Eve S, Pham AD, Blaizot X, Turck M, Raginel T. [Human papillomaviruses vaccination: Parental awareness and acceptance of the vaccine for children in Lower Normandy schools and informative campaign during the 2015-2016 school year]. Rev Epidemiol Sante Publique 2017; 65:255-263. [PMID: 28410863 DOI: 10.1016/j.respe.2017.01.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 11/04/2016] [Accepted: 01/18/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The vaccine against human papillomavirus (HPV) can be administered starting at the age of 9 years. Parents thus play a major role in the choice of vaccination. The objective of this study was to investigate parental awareness about anti-HPV vaccination in Lower Normandy and to measure their vaccinal intentions before an informative campaign. METHODS The study population included parents of children aged 10-11 years enrolled in school (2015-2016) in Lower Normandy, France. The initial study was observational and descriptive. With the agreement of the academic directors, 16 middle schools were selected. A questionnaire was delivered to the school children and collected in September 2015 by the school nurses. RESULTS Within the selected middle schools, 1427 questionnaires were delivered. School nurses collected 1168 questionnaires (81.9%) among which 1155 could be analyzed because they contained answers (80.9%). Out of 575 girls aged 10-11 years, 523 (91.0%) were not vaccinated against HPV. Among parents of non-vaccinated schoolgirls who answered, 48.4% did not know if they intended to have their children vaccinated (251 of 519 questionnaires). There was a significant association between the socio-professional status of the parents who answered and their intention to vaccinate their daughters against HPV (P=0.03). Parents were significantly more likely to immunize their children when they previously knew about the vaccine (P<0.001) and when they had good knowledge about the vaccine (P<0.05). Parents who previously had their daughters vaccinated were also significantly more likely to have their sons vaccinated against HPV (P<0.001). CONCLUSION The significant association between knowledge about the vaccine and intentions to have their children vaccinated allows us to predict the effectiveness of information campaigns on vaccination rates.
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Affiliation(s)
- S Eve
- Département de médecine générale, Normandie université, faculté de médecine, 2, rue des Rochambelles, 14032 Caen cedex 5, France.
| | - A-D Pham
- Department of Biostatistics and Clinical Research, CHU de Caen, 14000 Caen, France
| | - X Blaizot
- Réseau OncoBasseNormandie, 3, place de l'Europe, 14200 Hérouville-Saint-Clair, France
| | - M Turck
- Département de gynécologie-obstétrique, CHU de Caen, 14000 Caen, France
| | - T Raginel
- Département de médecine générale, Normandie université, faculté de médecine, 2, rue des Rochambelles, 14032 Caen cedex 5, France; U1086 Inserm-UCBN « Cancers & Préventions », Normandie université, 14000 Caen, France
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40
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Gottvall M, Stenhammar C, Grandahl M. Parents' views of including young boys in the Swedish national school-based HPV vaccination programme: a qualitative study. BMJ Open 2017; 7:e014255. [PMID: 28246143 PMCID: PMC5337740 DOI: 10.1136/bmjopen-2016-014255] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys. DESIGN Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis. SETTING 11 strategically chosen municipalities in central Sweden. PARTICIPANTS Parents (n=42) who were offered HPV vaccination for their 11-12 years old daughter in the national school-based vaccination programme. RESULTS The key themes were: equality from a public health perspective and perception of risk for disease. Parents expressed low knowledge and awareness about the health benefits of male HPV vaccination, and they perceived low risk for boys to get HPV. Some parents could not see any reason for vaccinating boys. However, many parents preferred gender-neutral vaccination, and some of the parents who had not accepted HPV vaccination for their daughter expressed that they would be willing to accept vaccination for their son, if it was offered. It was evident that there was both trust and distrust in authorities' decision to only vaccinate girls. Parents expressed a preference for increased sexual and reproductive health promotion such as more information about condom use. Some parents shared that it was more important to vaccinate girls than boys since they believed girls face a higher risk of deadly diseases associated with HPV, but some also believed girls might be more vulnerable to side effects of the vaccine. CONCLUSIONS A vaccine offered only to girls may cause parents to be hesitant to vaccinate, while also including boys in the national vaccination programme might improve parents' trust in the vaccine. More information about the health benefits of HPV vaccination for males is necessary to increase HPV vaccination among boys. This may eventually lead to increased HPV vaccine coverage among both girls and boys.
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Affiliation(s)
- Maria Gottvall
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Red Cross University College, Huddinge, Sweden
| | - Christina Stenhammar
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Grandahl
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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41
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Fontenot HB, Fantasia HC, Vetters R, Zimet GD. Increasing HPV vaccination and eliminating barriers: Recommendations from young men who have sex with men. Vaccine 2016; 34:6209-6216. [PMID: 27838067 DOI: 10.1016/j.vaccine.2016.10.075] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/20/2016] [Accepted: 10/28/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is a disparity in HPV vaccination rates in particular among young men who have sex with men (YMSM) and until very recently there has been a dearth of research examining factors related to HPV vaccination for YMSM. The purpose of this study was to elicit YMSM's beliefs about HPV and the HPV vaccine as well as describe perceived barriers and facilitators of vaccine initiation and completion. METHODS A qualitative, descriptive study that utilized a focus group design was conducted among an urban and racially diverse sample of YMSM. Questionnaire data were analyzed using descriptive statistics, and focus group data were analyzed using content analysis. FINDINGS 34 YMSM with a mean age of 20.8years participated. The sample was diverse, with the largest proportion of youth identifying as Black (35.4%). Over 90% reported having an annual exam each year, 61.8% reported obtaining a flu vaccine during the past year, and 58.8% reported initiating the HPV vaccine 3-dose series. Themes identified included low HPV knowledge and awareness, positive vaccine beliefs, perceived stigmas, and HPV vaccine facilitators. Participants identified 3 ways health providers/ researchers could facilitate vaccination: creative use of mobile technology, bundling vaccination with other health services, and increasing HPV and HPV vaccine awareness. CONCLUSIONS Our findings point to some clear avenues to pursue in research and practice to improve HPV vaccination rates among YMSM, including increased use of mobile health strategies, making HPV vaccination a co-occurring part of other health-related services (e.g., HIV testing), and providing information on the relevance of HPV and HPV vaccination to YMSM.
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Affiliation(s)
- Holly B Fontenot
- Boston College, W.F. Connell School of Nursing, Chestnut Hill, MA 02467, United States; The Fenway Institute, 1340 Boylston St., Boston, MA 02215, United States; Fenway Health/Sidney Borum Jr. Health Center, 75 Kneeland St., Boston, MA 02111, United States.
| | - Heidi C Fantasia
- University of Massachusetts Lowell, College of Health Sciences, School of Nursing, 113 Wilder Street, Lowell, MA 01854, United States.
| | - Ralph Vetters
- Fenway Health/Sidney Borum Jr. Health Center, 75 Kneeland St., Boston, MA 02111, United States.
| | - Gregory D Zimet
- Indiana University School of Medicine, Department of Pediatrics, Section of Adolescent Medicine, 410 West 10th St., Indianapolis, IN 46202, United States.
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