1
|
Stefanos R, Lewis RM, Querec TD, Gargano JW, Unger ER, Markowitz LE. High impact of quadrivalent human papillomavirus vaccine across racial/ethnic groups: National Health and Nutrition Examination Survey, 2003-2006 and 2015-2018. Hum Vaccin Immunother 2024; 20:2308378. [PMID: 38372273 PMCID: PMC10877980 DOI: 10.1080/21645515.2024.2308378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Human papillomavirus (HPV) causes cervical as well as other cancers. Racial and ethnic disparities in cervical cancer incidence and mortality in the United States are well documented. HPV vaccination has been recommended in the United States since 2006 and is expected to prevent HPV-attributable cancers in all racial/ethnic groups. Quadrivalent HPV vaccine-type (HPV6/11/16/18) and nonvaccine-type cervicovaginal HPV prevalences were estimated from National Health and Nutrition Examination Surveys in 2015-2018 (vaccine era) and 2003-2006 (prevaccine era) data. Prevalence ratios comparing 2015-2018 to 2003-2006 were calculated among sexually experienced Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Mexican American (MA) females aged 14-24 years. Quadrivalent HPV vaccine-type prevalence declined 82% (CI: 60%-92%) among NHW, 86% (CI: 64%-95%) among NHB, and 100% among MA females, forecasting future reductions in cervical cancer across racial/ethnic groups.
Collapse
Affiliation(s)
- Ruth Stefanos
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rayleen M. Lewis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Troy D. Querec
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julia W. Gargano
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
2
|
Lynette Ejezie C, Cuccaro P, Savas LS, Shegog R. Regional differences in provider recommendation of HPV vaccines among 13-to-17 year old adolescents from 2019 to 2021. Vaccine 2024:S0264-410X(24)00581-4. [PMID: 38796327 DOI: 10.1016/j.vaccine.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE The prevalence of recommendation of human papillomavirus (HPV) vaccination by health care providers has improved over the last decade. However, research to determine whether the COVID-19 pandemic affected the progress in recommendation among adolescents across the U.S. regions has been limited. Therefore, the present study was conducted to determine if region was associated with provider recommendation of HPV vaccines in 2019-2021 and whether changes in recommendations varied by region. METHOD Using a cross-sectional design to examine National Immunization Survey-Teen (2019-2021) data, logistic regression and moderation analyses were performed to model region variation in HPV vaccine recommendations (n = 50,739 respondents). RESULTS The odds of recommendation were higher in the Midwest (aOR, 1.17 [95% CI, 1.06-1.29]), and Northeast (aOR, 1.38 [95% CI, 1.23-1.56]) regions than in the South region. Also, the odds of provider recommendation were higher in 2020 (aOR,1.16 [95% CI, 1.03-1.30]) than in 2019. Other variables-sex, age, race/ethnicity, health insurance status, and poverty status-were associated with recommendation of HPV vaccination. CONCLUSION Although the improvement in recommendation from 2019 to 2020 is an important public health gain, recommendation in the South still lags behind that in other regions. More efforts are needed to improve HPV vaccination recommendations in this region.
Collapse
Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX 77030, USA
| |
Collapse
|
3
|
Piscatelli N, Claus J, George D, Schlecht NF, Seserman M, Alvarado A, Sullivan M, Frustino J. Retrospective study of a pilot program focused on educating dental patients on human papillomavirus and vaccination in a hospital setting. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38741337 DOI: 10.1111/scd.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) is an epidemic currently affecting 80 million people in the United States. The HPV virus can be passed from one person to another via sexual intercourse, oral sex, open mouth kissing and skin-to-skin contact. In some cases, the infection is not eliminated by the immune system and can cause cancer of the head and neck, cervix, anus, and genitals. There has been a rise in oropharyngeal cancer (OPC) associated with HPV, which can be missed on conventional dental screening examinations. Dentists should engage in promoting HPV vaccination as a primary measure for OPC prevention. The goal of this HPV pilot program was to educate and offer same day HPV vaccination to dental patients by using a multidisciplinary approach in a hospital setting. METHODS Patients 18 through 26 years of age who presented to the Erie County Medical Center's dental clinic were approached and educated on HPV. Eligible patients received a direct recommendation for the HPV vaccine. Those interested in same day vaccination were referred to the division of infectious diseases' YOU Center for Wellness. A retrospective chart review was completed for patients who were HPV educated from March 5, 2020, through December 15, 2021. Charts were evaluated for age, sex, race, ethnicity, reason for visit, HPV vaccine referral, and HPV vaccine administration. RESULTS 326 patients were included in the chart review. The prominent sex, race, and ethnicity were male, Black or African American, and non-Hispanic origin. The median age was 23. Most patients presented to the dental clinic for an emergency visit and were not previously vaccinated against HPV. 110 patients were unvaccinated, and 44 patients were referred to the division of infectious disease for same day vaccination. Of these 44, 24 patients initiated the vaccination process. Five patients received all three doses, three patients received two doses, and 16 patients received one dose. CONCLUSION This pilot program successfully vaccinated 24 patients with at least a single dose of the HPV vaccine. This multidisciplinary model can be implemented in other health care settings.
Collapse
Affiliation(s)
- Nicole Piscatelli
- Division of Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, New York, USA
| | - Jonathan Claus
- Department of Infectious Disease, Division of Infectious Disease, Erie County Medical Center, Buffalo, New York, USA
| | - Devin George
- Division of Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, New York, USA
| | - Nicolas F Schlecht
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Michael Seserman
- State Partnerships, Community Impact at the American Cancer Society, Buffalo, New York, USA
| | | | - Maureen Sullivan
- Division of Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, New York, USA
| | - Jennifer Frustino
- Division of Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, New York, USA
| |
Collapse
|
4
|
Kong WY, Oh NL, Kennedy KL, Carlson RB, Liu A, Ozawa S, Brewer NT, Gilkey MB. Identifying Healthcare Professionals With Lower Human Papillomavirus (HPV) Vaccine Recommendation Quality: A Systematic Review. J Adolesc Health 2024; 74:868-877. [PMID: 38231146 PMCID: PMC11031337 DOI: 10.1016/j.jadohealth.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Strengthening healthcare professionals' (HCPs) communication is an evidence-based approach to increasing human papillomavirus (HPV) vaccine uptake among adolescents. To better target future interventions, we sought to synthesize evidence on HCP subgroups who most need to improve their HPV vaccine recommendation quality. METHODS We searched five databases for quantitative studies published from 2012 to 2022 on HPV vaccine recommendation quality, including recommendation consistency and strength, for United States adolescents. Two coders independently abstracted data from each eligible study, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We summarized variation in recommendation quality by clinical and HCP characteristics. RESULTS The 28 eligible studies indicated that relatively low proportions of HCPs used higher-quality recommendation practices (median: 61% across 30 measures) and that recommendation quality varied across HCP subgroups. The most consistent findings were that more pediatric HCPs used higher-quality recommendations than family medicine HCPs (8 of 11 studies, 2-60 percentage point difference) and that HPV-related knowledge was associated with higher recommendation quality (four of seven studies). Most studies observed no differences in recommendation quality by clinical role (e.g., provider vs. nurse) or HCP demographics (e.g., gender, age, race/ethnicity). DISCUSSION Studies suggest a substantial need to improve HCPs' recommendation quality, with opportunities for targeting future interventions.
Collapse
Affiliation(s)
- Wei Yi Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Nul Loren Oh
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn L Kennedy
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca B Carlson
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy Liu
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Noel T Brewer
- Department of Health Behavior, 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
| | - Melissa B Gilkey
- Department of Health Behavior, 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
| |
Collapse
|
5
|
Trott S, Lei F, Jay Christian W, Mao X, Lehmkuhl B, Kejner A. Geographic variation of HPV-associated cancer incidence in Kentucky using spatial scan statistics. Cancer Causes Control 2024; 35:817-824. [PMID: 38212533 DOI: 10.1007/s10552-023-01835-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Populations with high cancer risk that are targeted for screening, education, and vaccination have been shown to increase rates of screening, which ultimately may improve timing of diagnosis and overall outcome for certain cancers. Spatial scan analysis provides a visual representation of areas with higher rates of disease. Limited research has used this methodology to assess HPV-associated cancers. Using, spatial scan statistics, our goal was to identify regions within Kentucky having significantly higher rates of HPV-associated tumors. These regions can be targeted for public health efforts in the form of education, vaccination, screening, and physician recruitment. METHODS The Kentucky Cancer Registry data from 1995 to 2016 and spatial scan statistics were used to identify county-level clusters with high-incidence of HPV-associated cancers after adjustment for age and sex. Anatomic sites included in this analysis were oropharynx, cervix, anus, penis, and vulva. RESULTS There was one high-rate cluster of oropharyngeal cancer, which was observed in the Louisville metropolitan region (Relative Risk [RR] = 1.24, p < 0.001). One high-rate cluster of anal and penile cancer incidence in men was identified that partially overlapped with the oropharyngeal cluster. There were five clusters of higher cervical, vulvar, and anal cancer incidence in females, one of which overlapped with the oropharyngeal cluster. CONCLUSION Overlapping clusters of HPV-associated cancers were identified at the county-level and included both urban and rural counties of Kentucky. Findings can assist in the design of public health interventions to increase screenings, promote vaccination, and recruit physicians in these regions to improve prevention, diagnosis, and early treatment of HPV-associated cancers.
Collapse
Affiliation(s)
- Skylar Trott
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Feitong Lei
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - W Jay Christian
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Xihua Mao
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Ben Lehmkuhl
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Alexandra Kejner
- Department of Otolaryngology, Medical University of South Carolina, Charleston, SC, USA.
| |
Collapse
|
6
|
Cagle-Colon KJ, Voigt P, Boyd L. HPV Vaccination Practices Among Medical Trainees in Pediatrics, Obstetrics and Gynecology, and Family Medicine. J Low Genit Tract Dis 2024:00128360-990000000-00108. [PMID: 38661333 DOI: 10.1097/lgt.0000000000000807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The human papillomavirus (HPV) vaccine has been proven effective in preventing HPV-related cancer. However, vaccination uptake in the United States remains unacceptably low. The aim of this study is to determine whether residents' HPV vaccination status, demographics, or residency training setting are predictive of vaccination prescribing practices. METHODS This was an anonymous, IRB-approved, opt-in survey of OBGYN, Family Medicine, and Pediatric residents. Using the National Residency Match Program Web site, surveys were sent to program directors requesting their residents' participation. Demographics, practice settings, HPV vaccination status, reasons for being inappropriately vaccinated, and resident vaccination-prescribing practices were analyzed. RESULTS A total of 853 residents participated. A total of 56.7% of respondents were fully vaccinated against HPV. The most common reasons for being unvaccinated were as follows: age (51.7%, n = 122), monogamous (30.9%, n = 73), do not believe it works (22.5%, n = 53), and affordability/insurance did not cover (14.4%, n = 34). Residents working in an urban setting were more likely to be vaccinated than those in suburban (odds ratio [OR] = 1.93, 95% confidence interval [CI], 1.364-3.229, p < .001) or rural (OR = 2.08, 95% CI 1.461-3.359, p 0.01) settings. Males were less likely than females (OR = 0.90, 95% CI 0.702-0.997, p < .001) to be vaccinated. Single residents were more likely to be vaccinated than married (OR = 2.56, 95% CI 2.444-2.704, p < .001) or divorced (OR = 2.15, 95% CI 1.822-3.264, p 0.21) residents. Vaccinated residents were more likely to recommend HPV vaccination to their patients than those who were unvaccinated (OR = 1.83, 95% CI 1.321-2.548, p .004). CONCLUSIONS A significant portion of Family Medicine, Pediatrics, and OBGYN residents have not received appropriate vaccination against HPV. Vaccination is highest among residents who identify as female, single, or working in urban settings. Vaccinated residents were also found to be almost 2 times as likely to recommend vaccination to their patients. As such, our data suggest that targeted provider education is needed to increase vaccination rates for both trainees and their patients.
Collapse
Affiliation(s)
- Kayla J Cagle-Colon
- Department of Obstetrics and Gynecology, Cherokee Nation Health Services, 19600 E Ross St, Tahlequah, OK
| | - Paxton Voigt
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY USA
| | - Leslie Boyd
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY USA
| |
Collapse
|
7
|
Portocarrero-Bonifaz A, Syed S, Kassel M, McKenzie GW, Shah VM, Forry BM, Gaskins JT, Sowards KT, Avula TB, Masters A, Silva SR. Dosimetric and toxicity comparison between Syed-Neblett and Fletcher-Suit-Delclos Tandem and Ovoid applicators in high dose rate cervix cancer brachytherapy. Brachytherapy 2024:S1538-4721(24)00045-X. [PMID: 38643046 DOI: 10.1016/j.brachy.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/21/2024] [Accepted: 03/06/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE To compare patient and tumor characteristics, dosimetry, and toxicities between interstitial Syed-Neblett and intracavitary Fletcher-Suit-Delclos Tandem and Ovoid (T&O) applicators in high dose rate (HDR) cervical cancer brachytherapy. METHODS A retrospective analysis was performed for cervical cancer patients treated with 3D-based HDR brachytherapy from 2011 to 2023 at a single institution. Dosimetric parameters for high-risk clinical target volume and organs at risk were obtained. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. RESULTS A total of 115 and 58 patients underwent Syed and T&O brachytherapy, respectively. Patients treated with Syed brachytherapy were more likely to have larger tumors and FIGO stage III or IV disease. The median D2cc values to the bladder, small bowel, and sigmoid colon were significantly lower for Syed brachytherapy. Patients treated with Syed brachytherapy were significantly more likely to be free of acute gastrointestinal (44% vs. 21%, p = 0.003), genitourinary (58% vs. 36%, p = 0.01), and vaginal toxicities (60% vs. 33%, p = 0.001) within 6 months following treatment compared to patients treated with T&O applicators. In contrast, Syed brachytherapy patients were more likely to experience late gastrointestinal (68% vs. 49%, p = 0.082), genitourinary (51% vs. 35%, p = 0.196), and vaginal toxicities (70% vs. 57%, p = 0.264). CONCLUSIONS Syed-Neblett and T&O applicators are suitable for HDR brachytherapy for cervical cancer in distinct patient populations. Acute toxicities are more prevalent with T&O applicators, while patients treated with Syed-Neblett applicators are more likely to develop late toxicities.
Collapse
Affiliation(s)
- Andres Portocarrero-Bonifaz
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY; Physics Department, Pontificia Universidad Catolica del Peru, Lima, Peru.
| | - Salman Syed
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Maxwell Kassel
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Grant W McKenzie
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Vishwa M Shah
- Department of Gynecologic Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Bryce M Forry
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Jeremy T Gaskins
- Department of Bioinformatics & Biostatistics, University of Louisville School of Public Health and Information Sciences, Louisville, KY
| | - Keith T Sowards
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Thulasi Babitha Avula
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Adrianna Masters
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - Scott R Silva
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| |
Collapse
|
8
|
Luisi M, Geana MV, Pei J. Pandemic antecedents - Exploring predictivity and relationships between COVID-19 vaccine uptake and influenza, shingles, and HPV vaccination. Vaccine 2024; 42:2455-2462. [PMID: 38461049 DOI: 10.1016/j.vaccine.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/16/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND A wealth of extant research focuses on identifying barriers to, and predictors of, COVID-19 vaccination. In addition to treating COVID-19 vaccination and related experiences as antecedents, this study analyzes the relationships between COVID-19 vaccination experiences and intent to receive the flu, shingles, and HPV vaccines. METHOD Analyses were performed on the responses from U.S. survey panel of 1,024 participants (n = 1,024), 530 (51.8 %) who received at least a dose of the COVID-19 vaccine and 494 (48.2 %) who had not. Descriptive and inferential statistics identify participant demographic characteristics, prior vaccination behavior, vaccination intentions, risk behavior assessment, vaccination attitudes and beliefs, and the predictivity of COVID-19 vaccination, when treated as an antecedent. RESULTS Receiving a first dose of the COVID-19 vaccine interacted with receiving a past influenza vaccine, predicting the future intention to receive a COVID-19 vaccine or booster. Vaccine hesitancy in parents is significantly related to vaccination behaviors for themselves and their children. Analyses also showed differences between the vaccinated group (VG) and the unvaccinated group (UVG) on hesitancy, beliefs, and attitudes toward the COVID-19 vaccine. CONCLUSION Experience with COVID-19 vaccination and the relationship of those experiences with other vaccinations provide useful insight on leveraging vaccine uptake. Healthcare professionals should improve the COVID-19 vaccination experience and use vaccination appointments to promote other vaccinations. Research should continue to compare vaccination experiences and how they may persuade or dissuade vaccination intent for other vaccinations.
Collapse
Affiliation(s)
- Monique Luisi
- School of Journalism, University of Missouri, 178 Gannett Hall, Columbia, MO 65211, USA.
| | - Mugur V Geana
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, 1000 Sunnyside Ave., Suite 2001, Lawrence, KS 66045, USA.
| | - Jun Pei
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, 1000 Sunnyside Ave., Suite 2001, Lawrence, KS 66045, USA.
| |
Collapse
|
9
|
Patel JC, Cole M, Rubis AB, Burzalff K, Cruz V, Edge K, Kudish K, Liko J, Pena S, Thomas ES, Skoff TH, McNamara LA. Differences in Pertussis Incidence by Race and Ethnicity in the United States, 2010-2017. Open Forum Infect Dis 2024; 11:ofae177. [PMID: 38665172 PMCID: PMC11045015 DOI: 10.1093/ofid/ofae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Background An increased pertussis burden has been demonstrated among Hispanic or Latino and American Indian or Alaska Native (AI/AN) infants. However, data on potential disparities among other age and racial groups are limited. Methods We analyzed pertussis cases reported through Enhanced Pertussis Surveillance from 2010 to 2017. Pertussis and severe pertussis incidence were calculated by race (White, Black or African American, AI/AN, and Asian or Pacific Islanders), ethnicity (Hispanic or Latino and non-Hispanic or non-Latino), and age. Results Compared with White persons, overall incidence was lower among Black or African American (incidence rate ratio [IRR], .57; 95% confidence interval [CI], .53-.61), AI/AN (IRR, 0.65; 95% CI, .58-.72), and Asian or Pacific Islander persons (IRR, 0.39; 95% CI, .35-.43). Overall incidence of pertussis was higher (1.5-fold; 95% CI, 1.37-1.60) among Hispanic or Latino compared with non-Hispanic or non-Latino adults, potentially related to household size or lower pertussis vaccine uptake among adult Hispanic or Latino cases. Severe pertussis incidence was similar among Black or African American and AI/AN persons compared with White persons. Among infants, severe pertussis incidence was 1.4-fold higher (95% CI, 1.03-1.82) among Black or African American infants than among White infants, and 2.1-fold higher (95% CI, 1.67-2.57) among Hispanic or Latino infants than non-Hispanic or non-Latino infants. Conclusions The contrast between lower reported incidence but similar or higher severe pertussis incidence among Black or African American and AI/AN persons compared with White persons warrants further investigation and may reflect underdiagnosis or underreporting of mild disease.
Collapse
Affiliation(s)
- Jaymin C Patel
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matthew Cole
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy B Rubis
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kari Burzalff
- Department of Health, New York State Department of Health, Albany, New York, USA
| | - Victor Cruz
- Department of Health, Minnesota Department of Health, St Paul, Minnesota, USA
| | - Karen Edge
- Colorado Disease Control and Environmental Epidemiology Division, Department of Public Health and Environment, Denver, Colorado, USA
| | - Kathy Kudish
- Department of Health, Connecticut Department of Public Health, Hartford, Connecticut, USA
| | - Juventila Liko
- Health Authority, Oregon Health Authority, Portland, Oregon, USA
| | - Sandra Pena
- Department of Health, New Mexico Department of Health, Santa Fe, New Mexico, USA
| | - Ebony S Thomas
- Department of Health, Georgia Department of Public Health, Atlanta, Georgia, USA
| | - Tami H Skoff
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lucy A McNamara
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
10
|
Larson S, McAnany B, Ladd I, Gogoi R. What do cervical cancer patients know, how do they learn, and who do they tell? A pilot study. J Eval Clin Pract 2024. [PMID: 38498396 DOI: 10.1111/jep.13964] [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: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND This study explored what patients identified with cervical cancer know about the link between human papillomavirus (HPV) and cervical cancer and where they learned this information. Patients share a great deal of information with family, friends and colleagues and we were interested in the accuracy and sources of information they are sharing. METHODS Patients identified through the EHR of a health system who had a history of cervical cancer were invited to participate in a brief survey of their experience. The sample represents an opportunity sample of patients who responded. RESULTS Generally, these patients, drawn from the Geisinger Health System in central Pennsylvania, were older (mean 57.5 years), White, and about half had annual household income of $35 K. Among all respondents about 17% had not heard of HPV, 21% did not know about an HPV vaccine, and about 38% did not know about the link between HPV and cervical cancer. Most frequently patients reported obtaining their information about HPV from television advertisements. About half received information from their oncologist. Patients reported having conversations with families about their own cancer, the cause of their cancer and HPV vaccination. It is important to note that these conversations were supported by information from many sources. CONCLUSIONS Patients may serve as a conduit for information about their condition and may be informal 'educators' in the community. It is important to make certain that these opportunities are informed by information obtained from trusted and accurate sources.
Collapse
Affiliation(s)
- Sharon Larson
- College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Center for Population Health Research at the Lankenau, Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Brian McAnany
- Center for Population Health Research at the Lankenau, Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA
| | | | - Radhika Gogoi
- Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA
| |
Collapse
|
11
|
Xiong S, Humble S, Barnette A, Brandt H, Thompson V, Klesges LM, Silver MI. Associations of geographic-based socioeconomic factors and HPV vaccination among male and female children in five US states. BMC Public Health 2024; 24:702. [PMID: 38443823 PMCID: PMC10916280 DOI: 10.1186/s12889-024-18206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/24/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND We assessed whether five geographic-based socioeconomic factors (medically underserved area (MUA); healthcare provider shortage area (HPSA); persistent poverty; persistent child poverty; and social vulnerability index (SVI)) were associated with the odds of HPV vaccination initiation, series completion, and parental vaccine hesitancy, and whether the observed relationships varied by gender of the child. METHODS An online panel service, administered through Qualtrics®, was used to recruit parents of adolescents 9-17 years of age to complete a one-time survey in 2021. Coverage of the panel included five US states: Arkansas, Mississippi, Missouri, Tennessee, and Southern Illinois. Generalized estimating equation (GEE) models were used to assess population-level associations between five geographic-based socioeconomic factors (MUA; HPSA; persistent poverty; persistent child poverty; and SVI) and three HPV vaccination outcomes (initiation, series completion, and hesitancy). All GEE models were adjusted for age of child and clustering at the state level. RESULTS Analyses were conducted using responses from 926 parents about their oldest child in the target age range (9-17 years). The analytic sample consisted of 471 male children and 438 female children across the five states. In adjusted GEE models, persistent child poverty and HPSA were negatively associated with HPV vaccination initiation and series completion among female children, respectively. Among male children, high social vulnerability was negatively associated with HPV vaccine series completion. Additionally, persistent poverty and high social vulnerability were negatively associated with HPV vaccine hesitancy in male children. CONCLUSIONS The results of this cross-sectional study suggest that geographic-based socioeconomic factors, particularly, HPSA, persistent poverty, and SVI, should be considered when implementing efforts to increase HPV vaccine coverage for adolescents. The approaches to targeting these geographic factors should also be evaluated in future studies to determine if they need to be tailored for male and female children.
Collapse
Affiliation(s)
- Serena Xiong
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 166, 55414, Minneapolis, MN, USA.
| | - Sarah Humble
- Department of Surgery, Washington University School of Medicine, 600 S Taylor Avenue, 63110, St. Louis, MO, USA
| | - Alan Barnette
- Saint Francis Medical Center, 211 St. Francis Drive, 63703, Cape Girardeau, MO, USA
| | - Heather Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, 38105-3678, Memphis, TN, USA
| | - Vetta Thompson
- Barnes-Jewish Hospital, Alvin J. Siteman Cancer Center, Washington University School of Medicine, 63110, St. Louis, MO, USA
- Department of Medicine and Pediatrics, Washington University School of Medicine, Washington University in St. Louis, 63110, St. Louis, MO, USA
| | - Lisa M Klesges
- Department of Surgery, Washington University School of Medicine, 600 S Taylor Avenue, 63110, St. Louis, MO, USA
| | - Michelle I Silver
- Department of Surgery, Washington University School of Medicine, 600 S Taylor Avenue, 63110, St. Louis, MO, USA
| |
Collapse
|
12
|
Cataldi JR, Suresh K, Brewer SE, Perreira C, Nederveld A, Skenadore A, Furniss A, Williams C, Severson R, Dempsey AF, O'Leary ST. Boot Camp Translation using Community-Engaged messaging for adolescent Vaccination: A Cluster-Randomized trial. Vaccine 2024; 42:1078-1086. [PMID: 38253469 DOI: 10.1016/j.vaccine.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Routine vaccination coverage for adolescents living in the rural US is lower than adolescents living in urban areas. We sought to measure the effect of Boot Camp Translation (BCT), a community-based participatory intervention, on rural adolescent vaccination coverage. METHODS A cluster randomized controlled trial was performed September 2018-November 2021 involving 16 rural Colorado counties. Intervention county community members engaged in BCT to develop interventions to improve adolescent vaccination locally. Adolescent vaccination coverage was measured using the Colorado Immunization Information System. RESULTS For 11-12-year-olds, HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage was lower post- versus pre-intervention in the control and intervention groups. For 11-12-year-olds in the intervention group, there was no significant difference post- versus pre-intervention in the odds of HPV vaccine initiation (adjusted ratio of odds ratios [aROR] = 0.93, 95 %: 0.85-1.02, p = 0.10) or up-to-date HPV vaccination (aROR: 1.10, 95 % CI: 0.98-1.23, p = 0.11) compared with the control group. Among 11-12-year-olds, the decrease in the proportion vaccinated with MenACWY and Tdap in the intervention group was significantly greater than the control group. Among 13-17-year-olds, there were significant increases in HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage from pre- to post-intervention for both groups, with no significant differences between groups. CONCLUSION 11-12-year-old vaccination coverage decreased slightly from pre- to post-intervention while 13-17-year-old vaccination coverage increased. We saw no effect from the BCT intervention. Our findings about the effectiveness of BCT for improving vaccine uptake may not be generalizable because the study coincided with the COVID-19 pandemic. CLINICAL TRIAL REGISTRY This study was registered with ClinicalTrials.gov, NCT03955757.
Collapse
Affiliation(s)
- Jessica R Cataldi
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Krithika Suresh
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Sarah E Brewer
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cathryn Perreira
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Andrea Nederveld
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Amanda Skenadore
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anna Furniss
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Charnetta Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Rachel Severson
- Colorado Department of Public Health and Environment, Denver, CO, United States
| | - Amanda F Dempsey
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Sean T O'Leary
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| |
Collapse
|
13
|
Puente AA, Ortega-Rivera OA, Wirth DM, Pokorski JK, Steinmetz NF. Melt Processing Virus-Like Particle-Based Vaccine Candidates into Biodegradable Polymer Implants. Methods Mol Biol 2024; 2720:221-245. [PMID: 37775669 DOI: 10.1007/978-1-0716-3469-1_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Melt processing is an emerging production method to efficiently encapsulate proteins into polymeric devices for sustained release. In the context of vaccines, melt processing is well-suited to develop vaccine delivery devices that are stable outside the cold chain and can generate protective immunity from a single dose. We have demonstrated the compatibility of bacteriophage Qβ virus-like particles (VLPs) with hot-melt extrusion (HME) and have leveraged this technology to develop a single-dose vaccine candidate for vaccination against human papillomavirus (HPV). Here, we detail the methods for chemically conjugating an HPV peptide epitope from the L2 minor capsid protein to Qβ VLPs to generate HPV-Qβ particles. We outline techniques used to characterize HPV-Qβ particles, and we elaborate on the process to encapsulate HPV-Qβ into biodegradable poly(lactic-co-glycolic acid) (PLGA) implants and discuss methods for the materials characterization of the HPV-Qβ/polymer melts. The methods described could be adapted to other disease targets, i.e., by conjugation of a different peptide epitope, or transferred to other VLP systems suited for conjugation, immune response, or stability during processing. Such VLPs are ideally suited for use in HME, a mature, scalable, continuous, and solvent-free process which can be adapted to mold devices, therefore allowing the processing of the melts into various geometries, such as subcutaneous implants, or self-administrable microneedle patches.
Collapse
Affiliation(s)
- Armando A Puente
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Oscar A Ortega-Rivera
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, USA
- Center for Nano-ImmunoEngineering, University of California San Diego, La Jolla, CA, USA
| | - David M Wirth
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, USA
| | - Jonathan K Pokorski
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, USA
- Center for Nano-ImmunoEngineering, University of California San Diego, La Jolla, CA, USA
- Institute for Materials Design and Delivery, University of California San Diego, La Jolla, CA, USA
| | - Nicole F Steinmetz
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA.
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, USA.
- Center for Nano-ImmunoEngineering, University of California San Diego, La Jolla, CA, USA.
- Institute for Materials Design and Delivery, University of California San Diego, La Jolla, CA, USA.
- Department of Radiology, University of California San Diego, La Jolla, CA, USA.
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
| |
Collapse
|
14
|
Herrera-Restrepo O, Zhou Z, Krishnan A, Conley WJ, Oladele E, Multani JK, Tuly R, Shi L, Chen CC, Preiss S, Clements DE. Awareness, attitudes, and practices on meningococcal serogroup B vaccination in the United States among parents of older adolescents and among young adults. Curr Med Res Opin 2024; 40:125-140. [PMID: 38032143 DOI: 10.1080/03007995.2023.2285366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Meningococcal serogroup B (MenB) vaccination is recommended by the Advisory Committee on Immunization Practices (ACIP) for adolescents and young adults 16-23-years-old under shared clinical decision-making (SCDM). However, MenB vaccination coverage in this population remains low in the United States (US). We investigated the awareness, attitudes, and practices regarding MenB disease and vaccination among parents of 16-18-year-old older adolescents and among 19-23-year-old young adults. METHODS An online survey was conducted in September-October 2022 among parents of older adolescents and among young adults recruited from a US-based patient panel. RESULTS There were 606 total participants, including parents of MenB-vaccinated (n = 151) and non-vaccinated (n = 154) adolescents, and also MenB-vaccinated (n = 150) and non-vaccinated (n = 151) young adults. Non-vaccinated cohorts reported low awareness of MenB disease (58.3-67.5%) and vaccination (49.7-61.0%), though awareness was higher among non-vaccinated parents. However, all cohorts reported high interest in learning more about MenB disease and vaccination. Vaccinated cohorts relied on primary care providers (PCPs) to initiate MenB vaccination conversation and had a low awareness of SCDM at 35.1-45.3%, though those aware of SCDM were more likely to participate in decision-making. Barriers to MenB vaccination included lack of PCP recommendation, vaccine side effects, and uncertainty about vaccination need. CONCLUSIONS There are gaps in awareness of MenB disease, vaccination, and SCDM among parents and patients in the US, resulting in missed opportunities for discussing and administering MenB vaccination. Targeted education on MenB and vaccination recommendations may increase these opportunities and improve MenB vaccination awareness and initiation.
Collapse
Affiliation(s)
| | - Zifan Zhou
- Health Economics and Outcomes Research | Real-World Evidence Solutions, IQVIA, Inc, Falls Church, VA, USA
| | | | - Wanda J Conley
- North American Medical Affairs, GSK, Philadelphia, PA, USA
| | - Eni Oladele
- North American Medical Affairs, GSK, Philadelphia, PA, USA
| | - Jasjit K Multani
- Health Economics and Outcomes Research | Real-World Evidence Solutions, IQVIA, Inc, Falls Church, VA, USA
| | - Rifat Tuly
- Health Economics and Outcomes Research, IQVIA, Inc, Los Angeles, CA, USA
| | | | | | | | | |
Collapse
|
15
|
Ejezie CL, Shegog R, Durand C, Cuccaro P, Savas LS. A Multivariate Probit Regression of the Uptake of Adolescent Vaccines Among Racial/Ethnic Minority Adolescents Before and During the COVID-19 Pandemic. J Adolesc Health 2024; 74:28-35. [PMID: 37804299 DOI: 10.1016/j.jadohealth.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/09/2023] [Accepted: 08/04/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE The uptake of adolescent vaccines has improved over the years. However, research of the effects of the COVID-19 pandemic on this uptake among racial/ethnic minority adolescents has been limited. This study was conducted to compare the probability of uptake of the human papillomavirus (HPV); tetanus, diphtheria, and acellular pertussis (Tdap); and quadrivalent meningococcal conjugate (MenACWY) vaccines among racial/ethnic minority adolescents ages 13-17 years in 2019, 2020, and 2021. METHODS Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), multivariate probit regression was used to model variation in uptake of these three adolescent vaccines (n = 38,128). The outcome measures were HPV, Tdap, and MenACWY vaccine uptake. RESULTS The probability of uptake of HPV vaccine was higher in 2020 (Coef = 0.09 [95% confidence interval (CI), 0.03-0.16]) and 2021 (Coef = 0.07 [95% CI, 0.00-0.15]) than in 2019. The probability of uptake of MenACWY vaccine was higher in 2020 (Coef = 0.08 [95% CI, 0.02-0.15]) than in 2019. The probability of uptake of recommended vaccines varied among racial/ethnic minorities with non-Hispanic Black adolescents exhibiting higher probability of uptake of HPV vaccine (Coef = 0.10 [95% CI, 0.01-0.19]) than Tdap vaccine. U.S. Census region and insurance status were associated with the uptake of all recommended vaccines. DISCUSSION Progress in the uptake of these recommended vaccines may not have been interrupted by the COVID-19 pandemic. Also, disparities in uptake of the recommended vaccines still exist despite increased uptake during the pandemic. Future research should examine the disparities as well as examine regional differences in the uptake of these three adolescent vaccines.
Collapse
Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| |
Collapse
|
16
|
Packnett ER, Zimmerman NM, Novy P, Morgan LC, Chime N, Ghaswalla P. Meningococcal serogroup B vaccination series initiation in the United States: A real-world claims data analysis. Hum Vaccin Immunother 2023; 19:2165382. [PMID: 36715008 PMCID: PMC9980443 DOI: 10.1080/21645515.2023.2165382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
In the United States (US), meningococcal serogroup B (MenB) vaccination has been recommended for 16-23-year-olds (preferably 16-18 years) based on shared clinical decision-making since 2015. MenB vaccine coverage (≥1 dose) by age 17 years has been reported, but initiation at older ages and by insurance type is unknown. In this retrospective cohort study, MarketScan claims data were analyzed to assess MenB vaccine series initiation (i.e. receipt of a first dose) during 2017-2020 among US commercially insured and Medicaid-covered individuals aged 16-18 and 19-23 years. Kaplan-Meier curves were generated to estimate series initiation at various times from index (latest of 1/1/2017 or 16th/19th birthday, depending on the cohort). Multivariable analyses were conducted to identify factors associated with series initiation. Among 1,450,354 Commercial and 1,140,977 Medicaid 16-18-year-olds, MenB vaccine series initiation rates within 3 years of each person's first eligibility were estimated to be 33% and 20%, respectively; among 1,857,628 Commercial and 747,483 Medicaid 19-23-year-olds, 3% and 1%, respectively. Factors identified to be significantly associated with increased likelihood of initiating a MenB vaccine series included co-administration of meningococcal serogroups ACWY (MenACWY) vaccine, younger age, female sex, nonwhite race (Medicaid only), New England or Middle Atlantic location (Commercial only), urban residence, and previous influenza vaccination. MenB vaccine series initiation among the studied US adolescents and young adults was low. There is a need for continued efforts to better understand barriers to the uptake of vaccines that are recommended based on shared clinical decision-making.
Collapse
Affiliation(s)
| | | | | | - Laura C Morgan
- Merative (formerly IBM Watson Health), Cambridge, MA, USA
| | | | | |
Collapse
|
17
|
McNeil CJ, Barr B, Munawar I, DeWitt ME, Myers JS, Shetty AK. Assessing Barriers to Human Papillomavirus (HPV) Vaccination in At-Risk Rural Communities of Western North Carolina, United States. Vaccines (Basel) 2023; 11:1785. [PMID: 38140189 PMCID: PMC10747883 DOI: 10.3390/vaccines11121785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Human papillomavirus (HPV) vaccination among adolescents in rural, western North Carolina (NC) remains suboptimal. Data are needed to understand the barriers to HPV vaccination in these communities. We conducted a cross-sectional pilot study of parental attitudes and provider practices regarding HPV vaccination in rural western NC counties with lower HPV vaccination rates. Eight health department clinics were enrolled in the study. Further, 29 provider and 32 parent surveys were analyzed along with environmental scans. Median provider comfort regarding knowledge of HPV-associated diseases was 85% (IQR = 75-95), on a scale of 0-100% (100% representing complete comfort). Median parental comfort level regarding knowledge of HPV-associated diseases and the HPV vaccine was 75% (IQR = 50-89) and 75% (IQR = 49-96), respectively. Less than 25% of parents rated the HPV vaccine as 'extremely effective' against genital (16.7%) and anal cancers (17.9%). Parents were more likely to rate the vaccine as 'extremely effective' to 'very effective' if their child was female. There was no significant difference between parental- and provider-reported comfort with knowledge about HPV-associated diseases (p = 0.0725) and the HPV vaccine (p = 0.167). This study identified multiple opportunities to increase HPV vaccine coverage among unvaccinated adolescents at parental, provider, and clinic levels. Health education of rural NC residents and providers in public health settings may identify future interventions to increase HPV vaccine uptake.
Collapse
Affiliation(s)
- Candice J. McNeil
- Office of Global Health, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (B.B.); (A.K.S.)
- Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (I.M.); (M.E.D.)
| | - Breona Barr
- Office of Global Health, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (B.B.); (A.K.S.)
- Department of Family Medicine, West Virginia University, Ranson, WV 26506, USA
| | - Iqra Munawar
- Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (I.M.); (M.E.D.)
| | - Michael E. DeWitt
- Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (I.M.); (M.E.D.)
- Department of Biology, Wake Forest University, Winston-Salem, NC 27109, USA
| | - Jenny Snow Myers
- Immunization Branch, Division of Public Health, Carolina Department of Health and Human Services, Raleigh, NC 27609, USA;
| | - Avinash K. Shetty
- Office of Global Health, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (B.B.); (A.K.S.)
- Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (I.M.); (M.E.D.)
| |
Collapse
|
18
|
Lin MG, Zhu A, Read PW, Garneau J, McLaughlin C. Novel HPV Associated Oropharyngeal Squamous Cell Carcinoma Surveillance DNA Assay Cost Analysis. Laryngoscope 2023; 133:3006-3012. [PMID: 37070629 DOI: 10.1002/lary.30701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/15/2023] [Accepted: 03/30/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVES We aim to propose a modified surveillance strategy using a novel blood assay that detects plasma circulating tumor-specific HPV DNA with reported 100% NPV and 94% PPV as the main method of detection to understand the cost implications of potentially avoiding routine imaging and surveillance visits at our institution. METHODS We performed a retrospective chart review focusing on recurrences in p16+ patients with OPSCC and defined two surveillance strategies: "Strategy A", follow-up visits with flexible laryngoscopy (FL) plus regular imaging studies; "Strategy B", follow-up visits with FL plus regular NavDx assays and imaging used at the discretion of the physician(s) in cases of high clinical suspicion. RESULTS Of the p16+ OPSCC patients (n = 214), 23 had confirmed recurrence (11%). Standard work-flow model determined 72 imaging studies and 2198 physical examinations with FL were needed to detect one recurrence. Potential individual patient cost reduction during surveillance was 42%. CONCLUSION Implementing NavDx for HPV + OPSCC surveillance would benefit patients by reducing costs and unnecessary diagnostic testing. LEVEL OF EVIDENCE Step/Level 3 Laryngoscope, 133:3006-3012, 2023.
Collapse
Affiliation(s)
- Michael G Lin
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Alexander Zhu
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA
| | - Paul W Read
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA
| | - Jonathan Garneau
- Department of Otolaryngology, University of Virginia, Charlottesville, Virginia, USA
| | - Christopher McLaughlin
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
19
|
Biehl R, Efre A. Improving human papilloma virus vaccination rates among adolescents. J Am Assoc Nurse Pract 2023; 35:642-645. [PMID: 37192408 DOI: 10.1097/jxx.0000000000000893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 04/20/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The human papilloma virus (HPV) is the leading cause of cervical cancer worldwide and is responsible for genital warts and five other types of cancers. The HPV vaccine was introduced in 2006 and demonstrated to be safe and more effective than expected, yet adolescent rates of immunization in the United States remain low. LOCAL PROBLEM Adolescent HPV vaccine rates were below the national average, and effective vaccine recommendation strategies were not used at an urban pediatric primary care office in southern Florida. METHODS The percentage of HPV vaccine rates in this primary care office were measured among adolescents ages 13-17 years using data obtained from Florida's state vaccine registry before implementation of the intervention, after the intervention, and monthly over a 90-day period. INTERVENTIONS Interventions aimed to improve vaccine rates included implementing an HPV protocol consisting of education on providing a strong bundled recommendation, appointing a vaccine champion, implementing standing vaccine orders, and educational materials. RESULTS The vaccine rates among adolescents increased by 11% for the initial dose, 7% for the second dose, and 6% for the vaccine completion rate. Chi-square test demonstrated statistical significance, for the initial vaccine. CONCLUSION A nurse practitioner-led application of an evidenced-based HPV vaccine protocol positively affected the care of adolescents in this primary care setting.
Collapse
Affiliation(s)
- Renee Biehl
- College of Nursing, University of South Florida, Tampa, Florida
| | | |
Collapse
|
20
|
Kessler R, Auwaerter P. Strategies to improve human papillomavirus (HPV) vaccination rates among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2192-2199. [PMID: 34469255 DOI: 10.1080/07448481.2021.1965146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/26/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
Improve (HPV) vaccination rates in a college-aged population using a strategic toolkit for student health services. Eighteen to twenty-six year-olds enrolled at Johns Hopkins University who utilized the Student Health & Wellness Center (JHU SHWC) during the study period. The toolkit comprised of a) continuing medical education (CME) presentation on strategies to improve HPV vaccination, b) campus-wide visual messaging regarding HPV prevalence, genital warts, cancer, and vaccine availability, and c) an electronic medical record (EMR) form prompting discussion about the HPV vaccine during visits. HPV vaccination rates at JHU SHWC improved from historical baseline 290/2,372 students/year (12.2%) to 515/2,479 students/year (20.8%), [risk ratio (RR) 1.70 (95% CI, 1.47-1.96), p < 0.001]. Additional changes included significant increases in vaccination rate per visit and vaccination rate by gender, especially among male students. Methods and resources from this toolkit could be successfully adapted and deployed by college health centers.
Collapse
Affiliation(s)
- Roanna Kessler
- Johns Hopkins Student Health & Wellness Center, Johns Hopkins University - Homewood Campus, Baltimore, Maryland, USA
| | - Paul Auwaerter
- Department of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
21
|
Ejezie CL, Cuccaro P, Durand C, Savas L, Shegog R. Parent-reported provider recommendation of HPV vaccination among minority adolescents before and during the COVID-19 pandemic: Findings from the National Immunization Survey-Teen, 2019-2021. Prev Med Rep 2023; 35:102286. [PMID: 37361924 PMCID: PMC10282928 DOI: 10.1016/j.pmedr.2023.102286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Provider recommendation of human papillomavirus (HPV) vaccination among adolescents has steadily improved over the years, however, limited research has been conducted to examine if the COVID-19 pandemic disrupted this positive trend in parent-reported provider recommendation among minority adolescents. Therefore, we conducted the present study to determine if there is an association between the pandemic and parent-reported provider recommendation of HPV vaccine among non-Hispanic black and Hispanic adolescents. We also examined whether any changes in parent-reported provider recommendation in the years 2019, 2020, and 2021 differed by race or ethnicity. Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), a moderation analysis and logistic regression analysis were performed to model race-specific variation in parent-reported provider recommendation (n = 50,739). We found that Hispanic parents had lower odds (aOR = 0.80 [0.71, 0.91]) of reporting receiving a recommendation compared to non-Hispanic white parents. We also found that the odds of parent-reported provider recommendation were higher in 2020 (aOR = 1.15 [1.03-1.29]) than in 2019. Other variables-age, region, sex, health insurance status, and poverty status-were all associated with parent-reported provider recommendation. These findings demonstrated that the pandemic may not have triggered any race-related gap in the recommendation of HPV vaccines, however, more pandemic-resilient public health efforts are needed to improve parent and provider communication regarding HPV vaccination of adolescents.
Collapse
Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
- Department of Radiation Oncology, The University of MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Lara Savas
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| |
Collapse
|
22
|
Ejezie CL, Savas LS, Durand C, Shegog R, Cuccaro P. The prevalence of human papillomavirus vaccination among racial and ethnic minority adolescents during the COVID-19 pandemic. JNCI Cancer Spectr 2023; 7:pkad065. [PMID: 37651597 PMCID: PMC10521629 DOI: 10.1093/jncics/pkad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination among adolescents has steadily improved over the past several years. However, research conducted to determine whether the COVID-19 pandemic disrupted this positive trend in HPV vaccine initiation among racial and ethnic minority adolescents is limited. Therefore, this study was conducted to determine if the COVID-19 pandemic and the resulting changes in the US health-care sector affected the increasing HPV vaccine initiation among non-Hispanic Black and Hispanic adolescents aged 13-17 years. METHODS Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), logistic regression and moderation analysis were used to model race-specific variations in HPV vaccine initiation (n = 49 031). Two-sided P values of up to .05 were considered statistically significant. RESULTS Hispanic (adjusted odds ratio [AOR] = 1.35, 95% confidence interval [CI] = 1.16 to 1.57) and non-Hispanic Black (AOR = 1.29, 95% CI = 1.10 to 1.51) adolescents had higher odds of HPV vaccine initiation than did non-Hispanic White adolescents. Additionally, the odds of HPV vaccine initiation were higher in 2021 (AOR = 1.22, 95% CI = 1.08 to 1.38) than in 2019. Other variables-age, region, sex, insurance status, and poverty status-were also associated with HPV vaccine initiation. CONCLUSION These findings demonstrate that during the COVID-19 pandemic, racial and ethnic minorities had higher odds of receiving the HPV vaccine. Therefore, more research of the impact of the pandemic on HPV vaccine initiation among non-Hispanic White and racial and ethnic minority adolescents is needed.
Collapse
Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| |
Collapse
|
23
|
Osaghae I, Chandra M, Talluri R, Shete S. Individual, systemic and state factors associated with provider recommendation of HPV vaccination: Findings from NIS-Teen, 2020. Hum Vaccin Immunother 2023; 19:2239678. [PMID: 37550623 PMCID: PMC10408691 DOI: 10.1080/21645515.2023.2239678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 08/09/2023] Open
Abstract
The most important determinant of HPV vaccination uptake is healthcare provider recommendation, yet not all eligible patients receive HPV vaccination recommendations. We used data from the 2020 National Immunization Survey-Teen to determine individual, systemic, and state factors associated with provider recommendation of HPV vaccination. A total of 18,534 teens were included, with 81.4% receiving provider recommendations for HPV vaccination. HPV vaccination recommendation was higher among females compared to males (AOR: 1.57; 95% CI: 1.27-1.93), teens who received a well-child exam at 11 or 12 years compared to those who did not (AOR: 2.10; 95% CI: 1.61-2.74), and teens whose mothers had college, some college or at least a high school education compared to those with less than high school education. In addition to individual factors, provider recommendation of HPV vaccination was higher in hospitals (AOR: 1.51; 95% CI: 1.00-2.29) and STD/school/teen clinics (AOR: 2.47; 95% CI: 1.05-5.78) compared to public facilities. However, the odds of provider recommendation were lower when none of the teen's providers ordered vaccines from the state compared to when all teen providers ordered vaccines from the state (AOR: 0.69; 95% CI: 0.52-0.93). Moreover, the state's mean prevalence of provider recommendations of HPV vaccination was 7.2% lower (Coefficient: -0.072; 95% CI: -0.107 - -0.036) in states with high religious ideology compared to those with low religious ideology. Interventions to increase provider recommendation of HPV vaccination should take a multiprong and comprehensive approach that addresses religious and systemic barriers to HPV vaccination recommendation.
Collapse
Affiliation(s)
- Ikponmwosa Osaghae
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monalisa Chandra
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajesh Talluri
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
24
|
Schwartz BI, Maccani M, Bansal S, Gannon M. Parental perceptions of the HPV vaccine for prevention of anogenital and oropharyngeal cancers. Vaccine X 2023; 14:100298. [PMID: 37113741 PMCID: PMC10126902 DOI: 10.1016/j.jvacx.2023.100298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Background and Objectives Human papillomavirus (HPV) is implicated in the development of both anogenital and oropharyngeal cancers. Although HPV vaccination prevents the majority of anogenital and head and neck cancers (HNC), vaccination rates remain low, especially among males. Known barriers to vaccination are knowledge gaps and vaccine acceptability. The objective of this study is to explore parental knowledge, perceptions, and decision-making processes about HPV and HPV vaccination for both anogenital and HNC. Methods This qualitative study recruited parents of children and adolescents aged 8-18 to participate in semi-structured telephone interviews. Data were analyzed using thematic analyses, informed by an inductive approach. Results A total of 31 parents participated in the study. Six themes emerged: 1) knowledge about HPV vaccines, 2) perceptions and attitudes toward cancers, 3) role of child's sex in HPV vaccination, 4) decision-making processes around HPV vaccination, 5) communication with health care providers about HPV vaccines, and 6) influence of social networks. There were significant knowledge gaps about the vaccine's indications and effects, especially for males and HNC prevention. Parents had concerns related to risks of the HPV vaccine. They cited pediatricians as important sources of information about vaccination and critical to their decision-making. Conclusions This study identified many parental knowledge gaps related to HPV vaccination, with information about males, HNC prevention, and risks particularly lacking. As parents identified pediatricians as the most important sources of information regarding HPV vaccination, this should empower pediatricians to educate families about this important preventive health measure, with a focus on addressing concerns about vaccine risks.
Collapse
Affiliation(s)
- Beth I. Schwartz
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
- Division of Adolescent Medicine and Pediatric Gynecology, Nemours Children’s Health, Wilmington, DE, USA
- Corresponding author at: Department of Obstetrics and Gynecology, Thomas Jefferson University, 833 Chestnut St., 1 Floor, Philadelphia, PA 19107, USA.
| | - Merissa Maccani
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Shalini Bansal
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Meghan Gannon
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
25
|
Lee HY, Daniel CL, Wang K, McLendon L, Coyne-Beasley T. HPV Vaccination among College Students in the South: The Role of HPV Knowledge on Vaccine Initiation and Completion. Asian Pac J Cancer Prev 2023; 24:2149-2156. [PMID: 37378947 PMCID: PMC10505885 DOI: 10.31557/apjcp.2023.24.6.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine factors related to HPV vaccination initiation and completion, especially the role of health knowledge, among college students in a southern state. METHODS College students ages 17-45 (n=1,708) were analyzed in this study. Primary outcomes were HPV vaccine series initiation and completion; binary logistic regressions were performed to identify associated factors. RESULTS Among total participants, students who were aware that HPV could be transmitted even without symptoms were less likely to initiate HPV vaccination. However, among students who have initiated the vaccine series, those who were aware that HPV could be transmitted without symptoms and that men should receive the HPV vaccine were more likely to complete the vaccine series. Other significant variables included age, gender, race, and international student status. CONCLUSION Future studies are needed to investigate students' concerns regarding initiating HPV vaccination and how to effectively motivate students to initiate and complete the HPV vaccine series.
Collapse
Affiliation(s)
- Hee Y. Lee
- School of Social Work, Associate Dean for Research, Endowed Academic Chair on Social Work and Health, The University of Alabama, Tuscaloosa, AL 35487, United States.
| | - Casey L. Daniel
- USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, United States.
| | - Kun Wang
- Department of Social Work, Binghamton University, Binghamton, NY, 13905, United States.
| | - Lane McLendon
- USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, United States.
| | - Tamera Coyne-Beasley
- USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, United States.
| |
Collapse
|
26
|
Tomić SD, Ćorić A, Tomić S, Mujičić E, Malenković J, Šljivo A, Malenković G. Cervical Cancer Prevention Knowledge (Cckp-64) among Female Students in Novi Sad, Serbia during COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11101400. [PMID: 37239686 DOI: 10.3390/healthcare11101400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic using the Cervical Cancer Knowledge Prevention-64 (CCKP-64) tool. The study sample consisted of 402 predominantly 20-22-year-old female students from either social or technical science faculties in urban environments. Results revealed that out of the 402 female students involved in the study, most had a good general knowledge of primary prevention of cervical cancer, with a correct answer rate ranging from 29.9 to 80.6%. On the contrary, only 63.4% of female students have heard about the vaccine against cervical cancer; 52.0% know that the vaccine exists in Serbia; and 31.8% know where to get vaccinated. Only a small proportion of students (9.7%) have encountered cervical cancer among their relatives/friends and think that the disease could affect them in the future (25.4%). Older students (>26 years) generally (p < 0.05) had better knowledge regarding distressing symptoms of cervical cancer, cytological examination and secondary prevention; however, it was also noted that a significant percentage of this age group reported not having received vaccinations (53.0%, p = 0.001). This study underscores the need for increased awareness and education about the HPV vaccine and secondary prevention among young women in Serbia. Future research should investigate knowledge and attitudes toward cervical cancer prevention in diverse populations to develop effective interventions and strategies. These findings have implications for public health policies in Serbia to promote cervical cancer prevention among young women.
Collapse
Affiliation(s)
- Sanja D Tomić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Andrijana Ćorić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Slobodan Tomić
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Ermina Mujičić
- Clinical Center, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | | | - Armin Šljivo
- Clinical Center, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Goran Malenković
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| |
Collapse
|
27
|
Olusanya OA, Tomar A, Thomas J, Alonge K, Wigfall LT. Application of the theoretical domains framework to identify factors influencing catch-up HPV vaccinations among male college students in the United States: A review of evidence and recommendations. Vaccine 2023; 41:3564-3576. [PMID: 37164820 DOI: 10.1016/j.vaccine.2023.04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Genital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15-25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low. METHODS Accordingly, our study utilized a comprehensive - Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18-26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes. RESULTS Overall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: 'knowledge' (82% of included studies), 'environmental context and resources' (53%), 'beliefs about consequences' (53%), 'unrealistic optimism' (50%) and 'pessimism' (6%), 'emotion' (50%), 'social influences' (50%), 'beliefs about capabilities' (41%), 'intention' (24%), 'reinforcement' (18%), 'social professional role and identity'(12%), and 'behavioral regulation' (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers' recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines. DISCUSSION Our study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.
Collapse
Affiliation(s)
- Olufunto A Olusanya
- University of Tennessee Health Science Center (UTHSC), UTHSC-Oak Ridge National Laboratory Center for Biomedical Informatics, Department of Pediatrics, Le Bonheur Research Center, 50 N Dunlap, Memphis, TN 38103, United States.
| | - Aditi Tomar
- Department of Health and Kinesiology, Texas A&M University, 107 Gilchrist Building (Reception Area), Mail Stop 4243, College Station, TX 77842-4243, United States.
| | - Jonathan Thomas
- Department of Public Health Studies, Texas A&M School of Public Health, 212 Adriance Lab Rd, College Station, TX 77843, United States.
| | - Kemi Alonge
- Marshfield Clinic Health System, Marshfield, WI 54449, United States.
| | - Lisa T Wigfall
- MD Anderson Cancer Center, Cancer Prevention Research Training Program, The University of Texas MD Anderson Cancer Center, 1150 Pressler Street, Cancer Prevention Research Building (CPB7.3556), Houston, TX 77030, United States.
| |
Collapse
|
28
|
Shukla A, Chintapalli A, Ahmed MKAB, Welch K, Villa A. Assessing the Effectiveness of Web-Based Modules on Human Papillomavirus Among Dental and Dental Hygiene Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:485-496. [PMID: 35296971 PMCID: PMC8926887 DOI: 10.1007/s13187-022-02144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 05/20/2023]
Abstract
Literature suggests that deficiencies among dental professional students in both knowledge and awareness of human papillomavirus (HPV) and its association with oropharyngeal cancers (OPC), as well as its risk factors implicating the prevalence of HPV, may be due to the lack of HPV-related education during professional schooling. The aim of this study was to assess the effectiveness of an online learning tool to educate dental and dental hygiene students about HPV and its association with OPC, rapidly evolving disease patterns, and dental professionals' role in HPV-associated OPC prevention efforts. A three-section online learning module was developed to improve dental professionals' comfort levels with, and knowledge of, HPV. The participants were recruited to participate in surveys before and after the intervention. Descriptive statistics and chi-square analysis were computed to study the effectiveness of the modules in improving the knowledge of students about this topic. Pre-intervention survey participants totaled 142, and 107 participants answered the post-intervention survey. The majority of the study participants had some baseline understanding of HPV prior to accessing the modules. After reviewing the modules, there was a statistically significant increase in the proportion of respondents who identified OPC (p = 0.01), vaginal cancer (0.02), vulvar cancer (0.04), and penile cancer (0.01) as associated with HPV. A gap in the understanding of HPV vaccine-eligible groups was noted in almost half of the participants; while most participants could correctly identify that boys and girls aged 9-12 years were eligible to get the vaccine, the gap in knowledge in this regard was related to "25-year-old with an abnormal pap result." Due to the evolving nature of this topic, there is a need to find new and effective methods of disseminating HPV-related information among the existing and future dental workforce.
Collapse
Affiliation(s)
- Anubhuti Shukla
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St, Indianapolis, IN, 46202, USA.
| | | | | | | | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
29
|
Hughes KC, Herring TA, Song JN, Gately RV, Przybyl LM, Ogilvie RP, Simon K, Bhuyan PK, Kyrgiou M, Seeger JD. Cervical High-Grade Squamous Intraepithelial Lesion Burden and Standard of Care Treatment Effectiveness and Safety in the United States, 2008-2018: The EACH-WOMAN Project. J Low Genit Tract Dis 2023; 27:105-112. [PMID: 36815642 DOI: 10.1097/lgt.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Management of cervical high-grade squamous intraepithelial lesions (HSILs), the immediate precursor of cervical cancer, consists largely of surgical treatment for women at higher risk for progression to cancer. The authors' objective was to describe the occurrence of cervical HSIL in the United States and various outcomes for women who received surgical treatment. METHODS From a US commercial health insurer, a cohort of adult women with cervical HSIL diagnoses receiving surgical treatment within 3 months of diagnosis between January 2008 and September 2018 was identified. This cohort was followed for several outcomes, including cervical HSIL recurrence, human papillomavirus clearance, preterm birth, infection, and bleeding. RESULTS The incidence rate of cervical HSIL declined from 2.34 (95% CI = 2.30-2.39) cases per 1,000 person-years in 2008 to 1.39 (95% CI = 1.35-1.43) cases per 1,000 person-years in 2014, remaining near that level through 2018. Among 65,527 women with cervical HSIL, 47,067 (72%) received surgical treatment within 3 months of diagnosis. Among the women receiving surgical treatment, cervical HSIL recurred in 6% of surgically treated women, whereas 45% of surgically treated women underwent subsequent virological testing that indicated human papillomavirus clearance. Preterm birth was observed in 5.9% by 5 years follow-up and bleeding and infection each at 2.2% by 7 days follow-up. CONCLUSIONS From 2008 through 2018, the incidence of diagnosed cervical HSIL decreased for several years before stabilizing. Surgical treatment of HSIL may be beneficial in removing the precancerous lesion, but cervical HSIL may recur, and the surgery is associated with complications including preterm birth, infection, and bleeding.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Keiko Simon
- Inovio Pharmaceuticals, Inc, Plymouth Meeting, PA
| | | | | | | |
Collapse
|
30
|
Smajlovic A, Toth CD. Quality Improvement Project to Increase Human Papillomavirus Two-Dose Vaccine Series Completion by 13 Years in Pediatric Primary Care Clinics. J Adolesc Health 2023; 72:958-963. [PMID: 36925411 DOI: 10.1016/j.jadohealth.2023.01.011] [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: 06/18/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The human papillomavirus (HPV) causes genitourinary and oropharyngeal cancers. The HPV vaccine is safe and effective in preventing those diseases; however, vaccine series completion rates remain low in the United States. Our quality improvement (QI) project aimed to increase HPV-vaccination series completion rates to 70% from 2017 to 2020 for the 13-year patient population in an extensive academic pediatric primary care network that serves predominantly minority and Medicaid-insured children in Columbus, OH. METHODS The outcome measure was the percentage of 13-years Nationwide Children's Hospital Primary Care Network patients who completed the two-dose vaccine series by their 13th birthday. Four QI implemented interventions were utilized. Electronic medical records alert informed providers when the HPV vaccines are due. We studied monthly data for the network and for individual clinics using statistical process control, displaying data on a control chart. We followed two process measures, captured opportunity rate, and the number of HPV vaccines given. RESULTS We substantially increased HPV-vaccination series completion rates overall in the 13-year teen population from 27% to 65%, and three clinics reached the 70% goal for at least one quarter. Latino children had the highest completion rate of 80% and White children had the lowest completion rate at 64%. DISCUSSION Our QI project used four measures to improve HPV-vaccination series completion rates in the 13-year patient population that serves minority and low-income teens predominantly. Further QI studies are needed to improve HPV vaccine completion rates in teens.
Collapse
Affiliation(s)
- Amina Smajlovic
- Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio; Division of Primary Care Pediatrics, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
| | - Christina D Toth
- Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio
| |
Collapse
|
31
|
AlMahasis SO, Fox B, Ha D, Qian J, Wang CH, Westrick SC. Pharmacy-based immunization in rural USA during the COVID-19 pandemic: A survey of community pharmacists from five southeastern states. Vaccine 2023; 41:2503-2513. [PMID: 36898932 PMCID: PMC9988709 DOI: 10.1016/j.vaccine.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Immunization rates for seasonal and non-seasonal vaccines dropped during the COVID-19 pandemic. Little is known about the extent to which community pharmacies in the USA continued to serve as immunization sites during the pandemic. This study compared 1) the types and perceived changes in non-COVID-19 vaccine doses administered at rural community pharmacies in 2020 (during the pandemic) to 2019 (pre-pandemic) and 2) the delivery of non-COVID-19 immunization services in 2020 to 2019. METHODS A mixed-mode (paper/electronic) survey of a convenience sample of 385 community pharmacies operating in rural settings and have administered ≥1 vaccine in 2019 and 2020 was distributed in May-August 2021. Survey development was informed by relevant literature, pre-tested with three individuals, and pilot-tested with 20 pharmacists. Non-response bias was assessed, and survey responses were analyzed using descriptive and bivariate statistics. RESULTS Of the 385 community pharmacies, 86 qualified pharmacies completed the survey (Response Rate = 23.8%). The percentage of pharmacies offering a given vaccine in 2019 and 2020 were similar; with one exception, a higher percentage of pharmacies reported having MMR administered for adults in the pharmacy in 2020 (McNemar's test; p-value = 0.0253). For each given vaccine, the majority of respondents did not perceive a change in the number of doses administered in 2020 compared to 2019. Further, the majority reported no difference in how they delivered immunization services during and pre-pandemic. However, a small percentage of respondents (6.0-22.0%) adapted their services by adopting several measures to ensure the safety and continuity of immunizations during the pandemic. CONCLUSION Findings highlight the importance of community pharmacies as immunization sites during the pandemic. Community pharmacies continued immunization delivery at community pharmacies during the pandemic with almost no noticeable change to types and doses of vaccines compared to pre-pandemic nor the process of vaccine delivery.
Collapse
Affiliation(s)
- Sura O AlMahasis
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA; Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Brent Fox
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - David Ha
- Stanford Health Care, Stanford, CA, USA; Stanford University, Stanford, CA, USA
| | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Chih-Hsuan Wang
- Department of Educational Research, Measurement, and Assessment, Auburn University, Auburn, AL, USA
| | - Salisa C Westrick
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA.
| |
Collapse
|
32
|
Warren BR, Gillette-Walch H, Adler J, Arias R, Klausner JD, Ashing KT, Villa A. Assessment of human papillomavirus vaccination rates of adolescents in California, 2018-2019. Prev Med Rep 2023; 32:102144. [PMID: 36852308 PMCID: PMC9958035 DOI: 10.1016/j.pmedr.2023.102144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/20/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Accurate documentation of state-level human papillomavirus (HPV) vaccination is required for public health planning and to inform corrective actions. To examine the representativeness of the California Immunization Registry, we compared the National Immunization Survey (NIS)-Teen, commercial HMOs in California, Medi-Cal, and California Immunization Registry data for HPV vaccine series completion. Our objectives were to evaluate the vaccine registries, compare and report their completeness, and make recommendations on how to improve and use these studies. Vaccination values were extrapolated for all adolescents aged 13 to 17 years from 2018 to 2019 from NIS-Teen, adolescents aged 13 years from 2018 to 2019 reported in the California Immunization Registry, and adolescents aged 13 years for 2018 for commercial HMOs and Medi-Cal. HPV series completion among 13-year-olds in 2018 for commercial HMOs was 50 %, Medi-Cal was 45 %, and the California Immunization Registry was 28 %, with NIS-Teen rates for 13 to 17-year-olds at 50 % in 2018 and 54 % in 2019. Both rural and urban geographic regions were found to have low completion rates of the HPV series, with trends ranging from 13 % to 45 %. The California Immunization Registry's lower HPV vaccine series completion among 13-year-olds compared to the other reporting sources is most likely due differences in reporting and data collection. Importantly, this data will serve as a comparator for future, similar studies of various sources of HPV vaccination rates following the passing of Bill-1797, which will mandate immunization reporting starting in January 2023.
Collapse
Affiliation(s)
- Brooke R. Warren
- School of Medicine, University of California, San Francisco. San Francisco, CA, United States
| | | | - Jaime Adler
- Academy Health. Washington, DC, United States
| | - Raquel Arias
- American Cancer Society. Burbank, CA, United States
| | - Jeffrey D. Klausner
- Division of Disease Prevention, Policy and Global Health, Department of Preventive Medicine, University of Southern California Keck School of Medicine. Los Angeles, CA, United States
| | - Kimlin T. Ashing
- Division of Health Equity, City of Hope Comprehensive Cancer Center. Duarte, CA, United States
| | - Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute. Miami, FL, United States,Herbert Wertheim College of Medicine, Florida International University. Miami, FL, United States,Corresponding author at: 8900 N. Kendall Drive Miami, FL 33176, United States.
| |
Collapse
|
33
|
Pei J, Shu T, Wu C, Li M, Xu M, Jiang M, Zhu C. Impact of human papillomavirus vaccine on cervical cancer epidemic: Evidence from the surveillance, epidemiology, and end results program. Front Public Health 2023; 10:998174. [PMID: 36684904 PMCID: PMC9859059 DOI: 10.3389/fpubh.2022.998174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/11/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Since 2006, the human papillomavirus (HPV) vaccine has been recommended for females aged 9-26 years in the United States. Aiming to evaluate the early effect of the HPV vaccine on cervical cancer, this study assessed the incidence of cervical cancer by age and histology before and after the introduction of HPV vaccination. Methods Data on cervical cancer incidence from 1975-2019 were extracted from the Surveillance, Epidemiology, and End Results Program. Joinpoint regression was used to determine temporal trends over time. Future cervical cancer incidence (2015-2039) was projected using Bayesian age-period-cohort analysis. Age-period-cohort (APC) models were created to evaluate age, period, and cohort effects. Results For overall cervical cancer and cervical squamous cell carcinoma (SCC), incidence rate showed decreasing trends (-0.7%, and -1.0% annually, respectively), whereas cervical adenocarcinoma (AC) incidence continuously increased (2.6% annually). The incidence trends for AC were stable in the 20-24 and 25-29-year age groups, whereas there was an increasing trend in older age groups. Similarly, the projected trend for AC in females aged 20-30 years exhibited a decline, whereas an increase was predicted in the 31-40-year age group, especially in the 35-44 year age group. The birth cohort and period effects in SCC and AC were extracted from APC models. Discussion During the period of 1975-2019, the incidence of cervical AC remained almost unchanged in the age groups receiving HPV vaccines while increased in the age groups not receiving HPV vaccines. The birth cohort effects of SCC and AC of the cervix provided evidence supporting the effectiveness of the HPV vaccine in preventing cervical cancer.
Collapse
Affiliation(s)
- Jiao Pei
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Shu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- The Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chenyao Wu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mandi Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Minghan Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
34
|
Salcedo MP, Gowen R, Rodriguez AM, Fisher-Hoch S, Daheri M, Guerra L, Toscano PA, Gasca M, Morales J, Reyna-Rodriguez FE, Cavazos B, Marin E, Perez C, Guerra M, Milbourne A, Varon ML, Reininger B, Fernandez ME, Ogburn T, Castle PE, McCormick J, Baker E, Hawk E, Schmeler KM. Addressing high cervical cancer rates in the Rio Grande Valley along the Texas-Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring. Perspect Public Health 2023; 143:22-28. [PMID: 34130548 DOI: 10.1177/1757913921994610] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIMS Cervical cancer incidence and mortality rates are approximately 55% higher in the Rio Grande Valley (RGV) along the Texas-Mexico border compared with the average rates in the US. Our aim was to improve cervical cancer prevention efforts in the RGV through a comprehensive multilevel intervention initiative focused on community education, patient navigation, and training of local providers. METHODS We initiated a program in the RGV which consisted of (1) community education, (2) patient navigation, and (3) a training/mentoring program for local medical providers including hands-on training courses coupled with telementoring using Project ECHO® (Extension for Community Health Outcomes). We assessed the number of women undergoing cervical cancer screening, diagnosis, and treatment at three participating clinics caring for underserved women in the region. RESULTS From November 2014 to October 2018, 14,846 women underwent cervical cancer screening. A total of 2030 (13.7%) women underwent colposcopy for abnormal results (179% increase over baseline) and 453 women underwent loop electrosurgical excision procedures (LEEPs) for treatment of cervical dysplasia. Invasive cancer was diagnosed in 39 women who were navigated to a gynecologic oncologist for treatment. Seven local medical providers were trained to perform colposcopy and/or LEEP. Project ECHO telementoring videoconferences were held every 2 weeks for a total 101 sessions with an average of 22 participants per session and a total of 180 patient cases presented and discussed. CONCLUSIONS Our program led to a large number of women undergoing diagnosis and treatment of cervical dysplasia in the RGV. If sustained, we anticipate these efforts will decrease cervical cancer rates in the region. The program is currently being expanded to additional underserved areas of Texas and globally to low- and middle-income countries.
Collapse
Affiliation(s)
- M P Salcedo
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Federal University of Health Sciences of Porto Alegre (UFCSPA)/Irmandade Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil
| | - R Gowen
- Su Clínica, Brownsville, TX, USA
| | - A M Rodriguez
- The University of Texas Medical Branch, Galveston, TX, USA
| | - S Fisher-Hoch
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - M Daheri
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - L Guerra
- Su Clínica, Brownsville, TX, USA
| | - P A Toscano
- UTHealth McGovern Medical School, Houston, TX, USA
| | - M Gasca
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - J Morales
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | | | | | - E Marin
- Su Clínica, Brownsville, TX, USA
| | - C Perez
- Su Clínica, Brownsville, TX, USA
| | - M Guerra
- The University of Texas Medical Branch, Galveston, TX, USA
| | - A Milbourne
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M L Varon
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - B Reininger
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - M E Fernandez
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - T Ogburn
- The University of Texas Rio Grande Valley Medical School, Edinburg, TX, USA
| | - P E Castle
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - J McCormick
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - E Baker
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Hawk
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - K M Schmeler
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Unit 1362, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| |
Collapse
|
35
|
[Recurrent laryngeal papillomatosis]. HNO 2023; 71:77-82. [PMID: 36477391 PMCID: PMC9895037 DOI: 10.1007/s00106-022-01250-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
Human papillomaviruses (HPV) 6 and 11 cause 90% of recurrent laryngeal papillomatosis (RLP). It is unclear whether recurrences are caused by new infections or the spread of infected cells. Symptomatic and sometimes curative treatment is laser surgery or conventional microsurgical removal. RLP surgery aims to relieve shortness of breath and improve the voice. Patients (especially children) are affected by voice problems, repetitive surgeries, pulmonary manifestations, and psychological trauma. Vaccination with Gardasil 9 (Merck & Co., Rahway, NJ, USA) prevents new infections with HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58 and induces vaccine antigen-specific antibodies and CD4+ T helper cells. According to current studies, RLP can be avoided with prophylactic vaccination. The treatment is associated with a general vaccination risk (European Medicines Agency approval: girls and boys from 9 years). Studies also show that the vaccine after removal of HPV-associated neoplasia/papilloma prevents recurrences. Extension of the vaccination recommendation to prevent recurrences of HPV-associated diseases in men may promote applicability and herd immunity. For rare and treatment-refractory cases with laryngotracheal involvement, systemic therapy with bevacizumab (e.g. Avastin; Genentech, San Francisco, CA, USA), a VEGF antibody, is a promising adjuvant treatment option.
Collapse
|
36
|
HPV vaccination coverage and factors among American Indians in Cherokee Nation. Cancer Causes Control 2022; 34:267-275. [PMID: 36542212 PMCID: PMC9768789 DOI: 10.1007/s10552-022-01662-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE We estimated human papillomavirus (HPV) vaccine initiation coverage among American Indian adolescents and identified factors associated with HPV vaccination among parents of these adolescents. METHODS We developed, tested, and disseminated a survey to a random sample of 2,000 parents of American Indian adolescents aged 9-17 years who had accessed Cherokee Nation Health Services from January 2019 to August 2020. We used log-binomial regression to estimate the unadjusted and adjusted weighted prevalence proportion ratios (PPR) and 95% confidence intervals (CI) for adolescent HPV vaccine initiation. RESULTS HPV vaccine initiation coverage (≥ 1 dose) was 70.7% among adolescents aged 13-17 years. The prevalence of HPV vaccine initiation was higher among American Indian adolescents whose parents were aware of the HPV vaccine (adjusted weighted PPR 3.41; 95% CI 2.80, 4.15) and whose parents received a recommendation from their provider (adjusted weighted PPR 2.70; 95% CI 2.56, 2.84). The most common reasons reported by parents to vaccinate their children were to protect them against HPV-associated cancers (25.7%) and receiving a recommendation from a healthcare provider (25.0%). Parents cited vaccine safety concerns as the main reason for not getting their children vaccinated (33.2%). CONCLUSIONS HPV vaccine initiation coverage among American Indian adolescents in Cherokee Nation was consistent with the national survey estimates. However, allaying parental concerns about vaccine safety and encouraging providers to recommend the HPV vaccine could improve coverage.
Collapse
|
37
|
Kirtland KA, Raghunathan T, Patel Murthy B, Li J, White K, Gibbs-Scharf L, Harris L, Zell ER. Estimating vaccination coverage for routinely recommended vaccines among children aged 24 months and adolescents aged 13 through 17 years using data from immunization information systems in the United States. Vaccine 2022; 40:7559-7570. [PMID: 36357292 DOI: 10.1016/j.vaccine.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To use a model-based approach to estimate vaccination coverage of routinely recommended childhood and adolescent vaccines for the United States. METHODS We used a hierarchical model with retrospective cohort data from eleven IIS jurisdictions, which contains vaccination records submitted by providers. Numerators included data from 2014 to 2019 at the county level for 2.4 million children at age 24 months and 14.4 million adolescents aged 13-17. Age-appropriate Census populations were used as denominators. Covariates associated with childhood and adolescent vaccinations were included in the model. Model-based estimates for each county were generated and aggregated to the national level to produce national vaccination coverage estimates and compared to National Immunization Survey (NIS) estimates of vaccination coverage. Trends of estimated vaccination coverage were compared between the model-based approach and NIS. RESULTS From 2014 to 18, model-based national vaccination coverage estimates were within ten percentage points of NIS-Child vaccination coverage estimates for most vaccines among children at age 24 months. One notable difference was higher model-based vaccination coverage estimates for hepatitis B birth dose compared to NIS-Child coverage estimates. From 2014 to 19, model-based national vaccination coverage estimates were within ten percentage points of NIS-Teen vaccination coverage estimates for most vaccines among adolescents aged 13-17 years. Model-based vaccination coverage estimates were notably lower for varicella, MMR, and Hepatitis B compared to NIS-Teen coverage estimates among adolescents. Trends in estimates of national vaccination coverage were similar between model-based estimates for children and adolescents as compared to NIS-Child and NIS-Teen, respectively. CONCLUSIONS A hierarchical model applied to data from IIS may be used to estimate coverage for routinely recommended vaccines among children and adolescents and allows for timely analyses of childhood and adolescent vaccines to quickly assess trends in vaccination coverage across the United States. Monitoring real-time vaccination coverage can help promote immunizations to protect children and adolescents against vaccine-preventable diseases.
Collapse
Affiliation(s)
| | | | - Bhavini Patel Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ji Li
- Kapili Services, LLC, Orlando, FL, USA
| | | | - Lynn Gibbs-Scharf
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaTreace Harris
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | |
Collapse
|
38
|
Calo WA, Lennon RP, Ruffin Iv MT, Keller C, Spanos K, D'Souza G, Kraschnewski JL. Support for HPV vaccine school-entry requirements in the United States: The role of exemption policies. Vaccine 2022; 40:7426-7432. [PMID: 36030125 DOI: 10.1016/j.vaccine.2022.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/23/2022] [Accepted: 08/09/2022] [Indexed: 01/28/2023]
Abstract
In the United States (U.S.), only five states or territories require human papillomavirus (HPV) vaccination for school attendance, even though almost all U.S. jurisdictions have debated adopting this type of policy. In this U.S. based study, we sought to estimate the level of support for HPV vaccine school-entry requirements with varying exemption policies and documentation procedures to obtain exemptions. Between July and August 2019, we conducted a web-based survey with a national sample of 1,109 U.S. parents of 11- to 17-year-olds. The survey assessed support for four school-entry vaccine requirement policies: without exemption or with exemption for medical, religious or philosophical reasons. Analyses used multivariable logistic regression to assess correlates of support for each policy. Overall, 38% of parents agreed with laws requiring HPV vaccination for school attendance without exemptions. When including exemption provisions, agreement increased to 45% for philosophical reasons, 50% for religious reasons, and 59% for medical reasons. Parents more often agreed on requirements without any exemptions if they were female (OR = 1.37, 95% CI:1.01-1.87), their child had initiated HPV vaccination (OR = 2.05, 95% CI:1.50-2.87), reported high levels of vaccine confidence (OR = 2.41, 95% CI:1.77-3.27), or reported having values similar to those of the people in their community (OR = 1.85, 95% CI:1.39-2.47). Parents more often agreed with requirements that included religious or philosophical exemptions if they reported having values similar to their community or high levels of psychological reactance (all p <.05). Many parents also supported requiring a written notice signed by a health care provider (40%) or religious leader (49%) to obtain a medical or religious exemption, respectively. In conclusion, exemption policies greatly increase parent support of school-entry requirements for HPV vaccination but may decrease their impact in practice. A large number of U.S. parents support strict documentation to obtain exemptions, signaling a promising area of policymaking to strengthen vaccine policies for school attendance.
Collapse
Affiliation(s)
- William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA; Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA.
| | - Robert P Lennon
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Mack T Ruffin Iv
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Chelsea Keller
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Katherine Spanos
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Gail D'Souza
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Jennifer L Kraschnewski
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA; Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
39
|
Shin MB, Ko LK, Ibrahim A, Mohamed FB, Lin J, Celentano I, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The Impact of a Comic Book Intervention on East African-American Adolescents' HPV Vaccine-Related Knowledge, Beliefs and Intentions. J Immigr Minor Health 2022; 24:1489-1500. [PMID: 35357620 PMCID: PMC10129048 DOI: 10.1007/s10903-022-01359-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/27/2022]
Abstract
HPV vaccine uptake is low among East African-American (EAA) adolescents. We developed a comic book and evaluated the impact on HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. The intervention was delivered to HPV-unvaccinated EAA adolescents attending educational dinners with their mothers. Adolescents aged 14-17 were sequentially assigned alternately to a pre- or post-test. Results were compared with chi-squared tests and generalized estimating equation models adjusted for age, gender, and mother's language. Among 136 (pre-test = 64, post-test = 72) participants (90% Somali), pre/post differences were observed for proportions of correct responses to questions on HPV (44.0% vs. 82.9%, RR:1.87[95%CI 1.54-2.27]), HPV-vaccine knowledge (42.8% vs. 75.4%, RR:1.74[95%CI 1.46-2.07]), comfort discussing HPV/HPV vaccine with parents (57.8% vs. 90.3% somewhat/very comfortable, RR:1.55[95%CI 1.24-1.94]), and willingness (37.5% vs. 83.3% probably/definitely willing, RR:2.16[95%CI 1.55-3.01]) and intention (34.4% vs. 86.1% somewhat/very likely, RR:2.38[95%CI:1.69-3.37]) to get vaccinated. The intervention improved participants' HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. Similar interventions could be adapted for other racial/ethnic minorities.
Collapse
Affiliation(s)
- Michelle B Shin
- School of Nursing, University of Washington, Seattle, WA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Linda K Ko
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anisa Ibrahim
- Harborview Medical Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
- Somali Health Board, Seattle, WA, USA
| | | | - John Lin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Isabelle Celentano
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Megha Shankar
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Medicine, University of California, San Diego, CA, USA
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Barbra A Richardson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA, 98195, USA.
| |
Collapse
|
40
|
Footman A, Kanney N, Niccolai LM, Zimet GD, Overton ET, Davies SL, Van Der Pol B. Parents' Acceptance of COVID-19 Compared to Human Papillomavirus Vaccines. J Adolesc Health 2022; 71:673-678. [PMID: 36208985 PMCID: PMC9533113 DOI: 10.1016/j.jadohealth.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/21/2022] [Accepted: 07/31/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The first vaccine against SARS-CoV-2 (COVID-19) for adolescents 16 years and older in the United States received Emergency Use Authorization in December 2020. Soon after its approval, parents expressed concerns about vaccine safety for adolescents. Similar concerns about vaccine safety partially explain suboptimal human papillomavirus (HPV) vaccine uptake. This qualitative study explores similarities and differences in parents' attitudes about these two vaccines. METHODS Parents were recruited through social media and at health centers in Alabama. Semi-structured interviews with parents of adolescents aged 9-17 years were conducted before and after Alabama expanded age eligibility to those 16 and older. Topics included knowledge about HPV and COVID-19 vaccines, and parents' intentions to have children vaccinated. Interviews were analyzed using thematic analysis. RESULTS From March 11, 2021 to April 24, 2021, 21 in-depth interviews were conducted. Parents discussed the importance of HPV and COVID-19 vaccines for protecting their children's health but differences between the two related to community protection. Parents were concerned about vaccine safety but media coverage about the COVID-19 vaccine led to more favorable attitudes about the benefits of vaccination, which was not observed for HPV vaccines. Instead for HPV vaccination, parents wanted their healthcare providers' opinions about the vaccine before making a vaccination decision. DISCUSSION Parents had similar concerns about HPV and COVID-19 vaccines. Although provider recommendations can improve vaccine uptake, local news reports were seen to have a positive impact on COVID-19 vaccine acceptance in lieu of provider recommendation. Disseminating information online could be beneficial to promote HPV and COVID-19 vaccines.
Collapse
Affiliation(s)
- Alison Footman
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama.
| | - Nita Kanney
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama
| | - Linda M Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Gregory D Zimet
- Indiana University, School of Medicine, Indianapolis, Indiana
| | | | - Susan L Davies
- Tulane University, School of Social Work, New Orleans, Louisiana
| | - Barbara Van Der Pol
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama; University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama
| |
Collapse
|
41
|
Bhoopathi V, Bhagavatula P, Singh M. Health literacy and its association with human papilloma virus vaccination among adults: Findings from the behavioral risk factor surveillance system. Hum Vaccin Immunother 2022; 18:2135930. [PMID: 36302123 PMCID: PMC9746451 DOI: 10.1080/21645515.2022.2135930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Health literacy is associated with the utilization of preventive health services. We examined the association between health literacy (HL) levels and receipt of at least one dose of the human papilloma virus (HPV) vaccination. We analyzed the data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) among adults aged 18 to 32. The primary outcome variable was the 'yes/no' response to the question that assessed whether the participant received at least the first dose of HPV vaccination. The primary independent variable was a summative HL score (range 3 through 12) we created for each respondent by adding the scores for all three HL questions. We performed bivariate and multivariable (logistic regression) analyses to examine the relationship between study variables. The analytical sample of 6,731 adults aged 18 to 32 met the eligibility criteria. Regression analyses showed that the odds of having received at least one dose of HPV vaccination increased by 13% for every unit increase in health literacy score (Odds ratio: 1.13, 95% CI:1.06-1.21, p < .0001). Age, gender, marital status, race/ethnicity, insurance status, and having regular access to a personal doctor were predictors of HPV vaccination status. This study showed that higher levels of HL may contribute to the uptake of at least one dose of the HPV vaccine. Health care and public health organizations, health care professionals, and policymakers should emphasize improving the health literacy levels of the patients and the public to increase the uptake of the HPV vaccine.
Collapse
Affiliation(s)
- Vinodh Bhoopathi
- Section of Public and Population Health, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA,CONTACT Vinodh Bhoopathi Section of Public and Population Health, University of California at Los Angeles School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA90095-1668, USA
| | - Pradeep Bhagavatula
- Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Maharaj Singh
- Marquette University College of Nursing, Milwaukee, WI, USA
| |
Collapse
|
42
|
Carey KA, Newman LM, Spicknall IH. Estimating the population level impact of a gonococcal vaccine candidate: Predictions from a simple mathematical model. Vaccine 2022; 40:7176-7181. [PMID: 36333224 DOI: 10.1016/j.vaccine.2022.10.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Neisseria gonorrhoeae cross-protection was suggested in a New Zealand meningitis B vaccine. We modeled the potential impact of similar vaccines on gonorrhea prevalence in heterosexuals in the United States. METHODS Our mathematical model incorporated infection, behavior, and vaccination dynamics. Approximate Bayesian Computation calibrated our model to US prevalence. Primary analyses assumed New Zealand vaccine characteristics: 30% efficacy and 2-year duration of protection. We estimated impact under two vaccine coverages (20%, 50%). RESULTS Reduction in gonorrhea prevalence ranged from 4.8 to 39.4%, depending on vaccine coverage. Vaccine impact was correlated with both size of the highly sexually active subpopulation and sexual mixing between high and low activity subpopulations. CONCLUSIONS A meningitis vaccine providing low efficacy cross-protection against gonorrhea acquisition and short duration of protection could result in a large reduction in gonorrhea prevalence in the United States. Potential dual protective effects can be considered when making vaccine recommendations.
Collapse
Affiliation(s)
- Kelly A Carey
- Office of Data Science and Emerging Technologies, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Lori M Newman
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Ian H Spicknall
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STDs, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| |
Collapse
|
43
|
Kim SJ, Schiffelbein JE, Imset I, Olson AL. Countering Antivax Misinformation via Social Media: Message-Testing Randomized Experiment for Human Papillomavirus Vaccination Uptake. J Med Internet Res 2022; 24:e37559. [PMID: 36422887 PMCID: PMC9732752 DOI: 10.2196/37559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/02/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Suboptimal adolescent human papillomavirus (HPV) vaccination rates have been attributed to parental perceptions of the HPV vaccine. The internet has been cited as a setting where misinformation and controversy about HPV vaccination have been amplified. OBJECTIVE We aimed to test message effectiveness in changing parents' attitudes and behavioral intentions toward HPV vaccination. METHODS We conducted a web-based message-testing experiment with 6 control messages and 25 experimental messages and 5 from each of the 5 salient themes about HPV vaccination (theme 1: safety, side effects, risk, and ingredient concerns and long-term or major adverse events; theme 2: distrust of the health care system; theme 3: HPV vaccine effectiveness concerns; theme 4: connection to sexual activity; and theme 5: misinformation about HPV or HPV vaccine). Themes were identified from previous web-based focus group research with parents, and specific messages were developed by the study team using content from credible scientific sources. Through an iterative process of message development, the messages were crafted to be appropriate for presentation on a social media platform. Among the 1713 participants recruited via social media and crowdsourcing sites, 1043 eligible parents completed a pretest survey questionnaire. Participants were then randomly assigned to 1 of the 31 messages and asked to complete a posttest survey questionnaire that assessed attitudes toward the vaccine and perceived effectiveness of the viewed message. A subgroup of participants (189/995, 19%) with unvaccinated children aged 9 to 14 years was also assessed for their behavioral intention to vaccinate their children against HPV. RESULTS Parents in the experimental group had increased positive attitudes toward HPV vaccination compared with those in the control group (t969=3.03, P=.003), which was associated with increased intention to vaccinate among parents of unvaccinated children aged 9 to 14 years (r=1.14, P=.05). At the thematic level, we identified 4 themes (themes 2-5) that were relatively effective in increasing behavioral intentions by positively influencing attitudes toward the HPV vaccine (χ25=5.97, P=.31, root mean square error of approximation [RMSEA]=0.014, comparative fit index [CFI]=0.91, standardized root mean square residual [SRMR]=0.031). On the message level, messages that provided scientific evidence from government-related sources (eg, the Centers for Disease Control and Prevention) and corrected misinformation (eg, "vaccines like the HPV vaccine are simply a way for pharmaceutical companies to make money. That isn't true") were effective in forming positive perceptions toward the HPV vaccination messages. CONCLUSIONS Evidence-based messages directly countering misinformation and promoting HPV vaccination in social media environments can positively influence parents' attitudes and behavioral intentions to vaccinate their children against HPV.
Collapse
Affiliation(s)
- Sunny Jung Kim
- Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Jenna E Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Inger Imset
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Ardis L Olson
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| |
Collapse
|
44
|
Olusanya OA, White B, Malik F, Hester KA, Davis RL, Bednarczyk RA, Shaban-Nejad A. Healthcare professionals' perceptions and recommendations regarding adolescent vaccinations in Georgia and Tennessee during the COVID-19 pandemic: A qualitative research. PLoS One 2022; 17:e0277748. [PMID: 36399477 PMCID: PMC9674128 DOI: 10.1371/journal.pone.0277748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Despite its benefits, HPV vaccine uptake has been historically lower than other recommended adolescent vaccines in the United States (US). While hesitancy and misinformation have threatened vaccinations for many years, the adverse impacts from COVID-19 pandemic on preventive services have been far-reaching. OBJECTIVES To explore the perceptions and experiences of adolescent healthcare providers regarding routine vaccination services during the COVID-19 pandemic. METHODOLOGY Between December 2020 and May 2021, in-depth qualitative interviews were conducted via Zoom video conferencing among a purposively selected, diverse group of adolescent healthcare providers (n = 16) within 5 healthcare practices in the US southeastern states of Georgia and Tennessee. Audio recordings were transcribed verbatim and analyzed using a rapid qualitative analysis framework. Our analysis was guided by the grounded theory and inductive approach. RESULTS Participants reported that patient-provider communications; effective use of presumptive languaging; provider's continuing education/training; periodic reminders/recall messages; provider's personal conviction on vaccine safety/efficacy; early initiation of HPV vaccination series at 9 years; community partnerships with community health navigators/vaccine champions/vaccine advocates; use of standardized forms/prewritten scripts/standard operating protocols for patient-provider interactions; and vaccine promotion through social media, brochures/posters/pamphlets as well as outreaches to schools and churches served as facilitators to adolescent HPV vaccine uptake. Preventive adolescent services were adversely impacted by the COVID-19 pandemic at all practices. Participants highlighted an initial decrease in patients due to the pandemic, while some practices avoided the distribution of vaccine informational materials due to sanitary concerns. CONCLUSION As part of a larger study, we provided contextual information to refine an intervention package currently being developed to improve adolescent preventive care provision in healthcare practices. Our results could inform the implementation of comprehensive intervention strategies that improve HPV vaccination rates. Additionally, lessons learned (e.g. optimizing patient- provider interactions) could be adopted to expand COVID-19 vaccine acceptance on a sizable scale.
Collapse
Affiliation(s)
- Olufunto A. Olusanya
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
- * E-mail: (OAO); (AS-N)
| | - Brianna White
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Kyra A. Hester
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Robert L. Davis
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Arash Shaban-Nejad
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
- * E-mail: (OAO); (AS-N)
| |
Collapse
|
45
|
Koh E, Kim Y. Risk Association of Liver Cancer and Hepatitis B with Tree Ensemble and Lifestyle Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15171. [PMID: 36429890 PMCID: PMC9690999 DOI: 10.3390/ijerph192215171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
The second-largest cause of death by cancer in Korea is liver cancer, which leads to acute morbidity and mortality. Hepatitis B is the most common cause of liver cancer. About 70% of liver cancer patients suffer from hepatitis B. Early risk association of liver cancer and hepatitis B can help prevent fatal conditions. We propose a risk association method for liver cancer and hepatitis B with only lifestyle features. The diagnostic features were excluded to reduce the cost of gathering medical data. The data source is the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2019. We use 3872 and 4640 subjects for liver cancer and hepatitis B model, respectively. Random forest is employed to determine functional relationships between liver diseases and lifestyle features. The performance of our proposed method was compared with six machine learning methods. The results showed the proposed method outperformed the other methods in the area under the receiver operator characteristic curve of 0.8367. The promising results confirm the superior performance of the proposed method and show that the proposed method with only lifestyle features provides significant advantages, potentially reducing the cost of detecting patients who require liver health care in advance.
Collapse
Affiliation(s)
- Eunji Koh
- School of Industrial and Management Engineering, Korea University, 145 Anamro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Younghoon Kim
- Department of Industrial and Management Systems Engineering, Kyung Hee University, 1732, Deogyeong-daero, Giheung-gu, Yongin-si 17104, Republic of Korea
| |
Collapse
|
46
|
Berenson AB, Chang M, Hawk ET, Ramondetta LM, Hoang T. Vulvar Cancer Incidence in the United States and its Relationship to Human Papillomavirus Vaccinations, 2001-2018. Cancer Prev Res (Phila) 2022; 15:777-784. [PMID: 35969832 DOI: 10.1158/1940-6207.capr-22-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/13/2022] [Accepted: 08/01/2022] [Indexed: 01/31/2023]
Abstract
The human papillomavirus (HPV) vaccine was indicated for the prevention of vulvovaginal cancers in 2008, but its impact on the incidence of vulvar cancers within the US is unknown. To determine this, we conducted a secondary analysis of 88,942 vulvar cancer cases among women 20+ years old using the US Cancer Statistics 2001-2018 databases. Data were stratified by tumor behavior (in situ or invasive), age (20-44, 45-64, 65+ years old), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic), and US census region (Northeast, South, Midwest, West), and incidence rates and average annual percentage changes (AAPC) were calculated by group. Reversing previous trends, the incidence of vulvar carcinoma in situ significantly decreased between 2001 and 2018 among women from all age groups, races/ethnicities, and regions (combined AAPC, -4.3; 95% confidence interval (CI), -4.7 to -3.8). The incidence of invasive vulvar squamous cell carcinoma decreased significantly among 20- to 44-year-old women (AAPC, -0.8; 95% CI, -1.3 to -0.3), but significantly increased among those 45 to 64 (AAPC, 2.3; 95% CI, 1.8-2.8) and 65+ years old (AAPC, 1.2; 95% CI, 1.1-1.4). Regardless of tumor behavior, incidence was highest among non-Hispanic Whites and the Midwest region. Overall, the significant declines in vulvar carcinoma in situ among all ages, as well as invasive vulvar cancer among younger women, are encouraging and complement other recent data suggesting HPV vaccinations are already reducing anal and cervical cancer incidence. Over time, further declines in vulvar carcinoma incidence are likely as uptake and completion rates of the HPV vaccine increase in the US. PREVENTION RELEVANCE We found evidence that HPV vaccinations likely contributed to a decrease in the incidences of vulvar carcinoma in situ and invasive vulvar carcinoma among 20- to 44-year-old women between 2001 and 2018. Our data add to the growing evidence that HPV vaccinations are reducing the incidence of HPV-related anogenital cancers.
Collapse
Affiliation(s)
- Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas.,Department of Obstetrics & Gynecology, The University of Texas Medical Branch, Galveston, Texas.,Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mihyun Chang
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas
| | - Ernest T Hawk
- Department of Clinical Cancer Prevention, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lois M Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Thao Hoang
- Graduate School of Biomedical Sciences, The University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
47
|
Lindsay AC, Delgado D, Valdez MJ, Granberry P. Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: A qualitative study. Glob Public Health 2022; 17:2883-2897. [PMID: 34605379 PMCID: PMC8976858 DOI: 10.1080/17441692.2021.1985580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
This descriptive qualitative study explored Latinx fathers' awareness, knowledge, and acceptability of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analysed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Nineteen, majority foreign-born Latinx fathers participated. Four main themes and two subthemes emerged from the analyses. Results found fathers' low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers' positive attitudes toward vaccines in general. Moreover, results revealed fathers trust in healthcare providers and high willingness to vaccinate their children against HPV if recommended by their child's primary healthcare provider. Findings indicate the need for increased efforts to raise awareness and knowledge among Latinx fathers of HPV and the HPV vaccine. Given the limited research focused on Latinx fathers, the study's findings are valuable in building a knowledge foundation for developing future studies and interventions to promote the HPV vaccine targeting Latinx fathers living in the United States. Future research should quantify Latinx fathers' awareness, knowledge, and acceptability of the HPV vaccine for their sons and daughters and assess fathers' role in the decision-making process to vaccinate their children against HPV.
Collapse
Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Denisse Delgado
- Department of Public Policy and Public Affairs, McCormack Graduate School of Policy and Global Studies, University of Massachusetts—Boston, Massachusetts, USA
| | - Madelyne J. Valdez
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts—Boston, Massachusetts, USA
| | - Phillip Granberry
- College of Liberal Arts and The Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts—Boston, Massachusetts, USA
| |
Collapse
|
48
|
Herrman A, Ruisinger JF, Moore EE, Melton BL. Assessing the impact of a pharmacy-provided personalized vaccination recommendation on immunization rates of adolescents. J Am Pharm Assoc (2003) 2022:S1544-3191(22)00362-4. [PMID: 36424294 PMCID: PMC9595482 DOI: 10.1016/j.japh.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/26/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescents should receive timely doses of recommended vaccinations. The coronavirus disease 2019 (COVID-19) vaccination approval for adolescents presented an opportunity for community pharmacists to address gaps in adolescent immunization schedules. OBJECTIVES The objectives of this research were to (1) identify adolescent immunization gaps, (2) identify number of patients receiving recommended vaccination(s) at the community pharmacy, and (3) determine how many vaccinations were administered after the intervention. METHODS Three pharmacies conducted the prospective intervention. Adolescents aged 11-17 years initiating the Pfizer-BioNTech COVID-19 vaccination series were eligible to receive a personalized vaccination recommendation (PVR), which included up to 3 other vaccinations. State immunization information systems were assessed after dose 1 of the COVID-19 vaccine to create the recommendation(s) and reassessed 6 months after providing the PVR for accepted recommendations. Patient demographics and number of vaccinations administered were assessed using descriptive statistics. RESULTS Of the 225 adolescents who received COVID-19 vaccine dose 1, 74.7%, 75.1%, and 83.1% were indicated to receive tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal conjugate (MenACWY), or human papillomavirus (HPV) vaccine, respectively. Thirty-three (14.7%) adolescents were up to date on all 3 vaccinations assessed. Of the 225 adolescents, 180 returned to the same location for COVID-19 vaccine dose 2 and received a PVR. Forty-two caregivers reported that their adolescent previously received 1 or more of the recommended vaccinations, indicating that state immunization information systems were inaccurate. Six months after the PVRs were given, 24 vaccinations had been administered. CONCLUSIONS Most adolescents presenting for a COVID-19 vaccine were indicated, according to state immunization information systems, to receive at least 1 additional vaccination. After pharmacist-provided PVR and education, vaccine uptake occurred. Considering caregiver-reported inaccuracies, pharmacists should be cognizant of potential discrepancies when providing PVRs. In addition, this study highlights the value of a state immunization information system.
Collapse
Affiliation(s)
- Adrianna Herrman
- Correspondence: Adrianna Herrman, PharmD, PGY1 Pharmacy Resident, 5300 Speaker Rd, Kansas City, KS 66106
| | | | | | | |
Collapse
|
49
|
Simonart T, Lam Hoai XL, de Maertelaer V. Worldwide Evolution of Vaccinable and Nonvaccinable Viral Skin Infections: Google Trends Analysis. JMIR DERMATOLOGY 2022; 5:e35034. [PMID: 37632891 PMCID: PMC10334945 DOI: 10.2196/35034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 08/24/2022] [Accepted: 09/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most common viral skin infections are not reportable conditions. Studying the population dynamics of these viral epidemics using traditional field methods is costly and time-consuming, especially over wide geographical areas. OBJECTIVE This study aimed to explore the evolution, seasonality, and distribution of vaccinable and nonvaccinable viral skin infections through an analysis of Google Trends. METHODS Worldwide search trends from January 2004 through May 2021 for viral skin infections were extracted from Google Trends, quantified, and analyzed. RESULTS Time series decomposition showed that the total search term volume for warts; zoster; roseola; measles; hand, foot, and mouth disease (HFMD); varicella; and rubella increased worldwide over the study period, whereas the interest for Pityriasis rosea and herpes simplex decreased. Internet searches for HFMD, varicella, and measles exhibited the highest seasonal patterns. The interest for measles and rubella was more pronounced in African countries, whereas the interest for HFMD and roseola was more pronounced in East Asia. CONCLUSIONS Harnessing data generated by web searches may increase the efficacy of traditional surveillance systems and strengthens the suspicion that the incidence of some vaccinable viral skin infections such as varicella, measles, and rubella may be globally increasing, whereas the incidence of common nonvaccinable skin infections remains stable.
Collapse
Affiliation(s)
- Thierry Simonart
- Department of Dermatology, Delta Hospital, Centre Hospitalier Interrégional Edith Cavell, Université Libre de Bruxelles, Brussels, Belgium
| | - Xuân-Lan Lam Hoai
- Department of Dermatology, St Pierre - Brugmann - Hôpital Universitaire des Enfants Reine Fabiola University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Viviane de Maertelaer
- Department of Biostatistics, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
50
|
Mouttapa M, Cunningham M, Tanjasiri SP. Awareness of and Support for HPV Vaccination Among Pacific Islander Women in Southern California. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1372-1377. [PMID: 33539008 PMCID: PMC8333191 DOI: 10.1007/s13187-021-01965-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Pacific Islander (PI) women experience disproportionately high rates of cervical cancer and mortality and have lower rates of Pap testing. Since up to 70% of cervical cancers could be prevented by being vaccinated for human papilloma virus (HPV), this cross-sectional study explored the predictors of HPV and vaccine awareness, receipt of the vaccine, and attitudes toward vaccinating children among adult PI women in southern California, who historically have low rates of HPV vaccination and high rates of cervical cancer that could be prevented with HPV vaccination. Participants (n=148) consist a subsample of Chamorro, Samoan, and Tongan women, ages 21 to 65 years, who were in a larger randomized community study to promote Pap testing. Overall, younger age and higher American acculturation were significantly associated with ever hearing about HPV and the vaccine. However, American acculturation was also associated with negative attitudes toward vaccinating their children for HPV. This paper provides preliminary insights into barriers and facilitators to HPV vaccination among PIs in the USA and also informs the development of educational programs to reduce cervical cancer incidence and mortality in this underserved population.
Collapse
Affiliation(s)
- Michele Mouttapa
- Department of Public Health, California State University, Fullerton, CA, USA.
| | - Melissa Cunningham
- Department of Public Health, California State University, Fullerton, CA, USA
| | | |
Collapse
|