Search

Introduction Human papillomavirus (HPV) is a common sexually transmitted virus that infects over 13 million people every year. Over 80% of sexually active adults will acquire HPV at some point in their lives, which is concerning since certain high-risk strains of HPV can cause six types of cancer. Vaccination against HPV is safe and effective, but despite high vaccine efficacy, vaccination rates are low among both service members and civilians. Materials and methods We conducted a retrospective, cross-sectional study to identify the percentage of United States Military Academy (USMA) Cadets who had received at least one HPV vaccine and those who completed the vaccine series. Deidentified vaccination and demographic data were retrieved from the Defense Health Agency Military Health System Data Repository (MDR) for all Cadets who were enrolled at USMA between January 2018 and May 2022 (graduating classes of 2018-2025). To identify the population of Cadets for our study and confirm presence of "any" vaccine in the MDR, Tdap vaccination information was also retrieved. The study population was defined as any Cadet who was enrolled at USMA between January 2018 and May 2022 (graduating classes of 2018-2025) and had record of an HPV and/or Tdap vaccine in the MDR. We compared demographic information between the identified population and known demographics of the USMA population to confirm that the retrieved data were consistent with population demographics. Descriptive statistics were performed to identify demographic differences based on vaccinated and unvaccinated Cadets and to determine the percentage of Cadets who received at least one HPV vaccine. Vaccine series completion was defined as the receipt of three HPV vaccine doses among those who reported receiving at least one dose of HPV vaccine or two doses if vaccinated before the age 15. Results A total of 9,567 Cadets were assessed for eligibility with 9,433 having Tdap and/or HPV vaccine on record. Of these Cadets, 5,738/9,433 (60.8%) had received at least one HPV vaccine. Of those starting the series, 4,492 completed the two- or three-dose series for a completion rate of 47.6%. We found HPV vaccine completion rate among female Cadets (55.6%) is higher than that of male Cadets (45.2%). More Cadets from minority groups received one vaccine; however, full completion rates were similar for both the groups (48.1%). In contrast, the percentage of Cadets vaccinated against Tdap was 97.2%. Most of those vaccinated received their first vaccine between the ages of 11 and 15 (53.0%) and their final vaccine after they turned 16 (68.9%). Conclusion Though the vaccination rate among the Corps of Cadets is comparable to the public, it is still less than the 80.0% goal set by the Healthy People 2030 objective. Based on these results, we recommend that the USMA modify its policy on HPV vaccine administration to encourage more vaccine uptake. We also conclude that further studies on the rationale for avoiding the vaccine are necessary to better inform educational campaigns and mitigate stigma. [ABSTRACT FROM AUTHOR]

Background High-risk human papillomavirus causes cervical cancer. Vaccines have been developed that significantly reduce the incidence of preinvasive and invasive disease. This population-based observational study used linked screening, immunization, and cancer registry data from Scotland to assess the influence of age, number of doses, and deprivation on the incidence of invasive disease following administration of the bivalent vaccine. Methods Data for women born between January 1, 1988, and June 5, 1996, were extracted from the Scottish cervical cancer screening system in July 2020 and linked to cancer registry, immunization, and deprivation data. Incidence of invasive cervical cancer per 100 000 person-years and vaccine effectiveness were correlated with vaccination status, age at vaccination, and deprivation; Kaplan Meier curves were calculated. Results No cases of invasive cancer were recorded in women immunized at 12 or 13 years of age irrespective of the number of doses. Women vaccinated at 14 to 22 years of age and given 3 doses of the bivalent vaccine showed a significant reduction in incidence compared with all unvaccinated women (3.2/100 000 [95% confidence interval (CI) = 2.1 to 4.6] vs 8.4 [95% CI = 7.2 to 9.6]). Unadjusted incidence was significantly higher in women from most deprived (Scottish Index of Multiple Deprivation 1) than least deprived (Scottish Index of Multiple Deprivation 5) areas (10.1/100 000 [95% CI = 7.8 to 12.8] vs 3.9 [95% CI = 2.6 to 5.7]). Women from the most deprived areas showed a significant reduction in incidence following 3 doses of vaccine (13.1/100 000 [95% CI = 9.95 to 16.9] vs 2.29 [95% CI = 0.62 to 5.86]). Conclusion Our findings confirm that the bivalent vaccine prevents the development of invasive cervical cancer and that even 1 or 2 doses 1 month apart confer benefit if given at 12-13 years of age. At older ages, 3 doses are required for statistically significant vaccine effectiveness. Women from more deprived areas benefit more from vaccination than those from less deprived areas. [ABSTRACT FROM AUTHOR]

Objective: Understanding HPV vaccination willingness and its influencing factors among female sex workers (FSWs) in entertainment venues in an urban area of Guangxi, China. Methods: From 15 August to 15 October 2022, FSWs in entertainment venues with commercial sex trade in an urban area of Guangxi were selected as the study subjects for the questionnaire survey using the method of intentional sampling. The questionnaire based on the information-motivation-behavior (IMB) skills model was used to collect the basic characteristics, HPV and HPV vaccine-related information and cognition, motivation to vaccinate, behavioral skills and willingness to vaccinate from the research targets. A multifactor logistic regression model was used to analyze the factors influencing the research targets' willingness to receive HPV vaccination. Results: Of the 921 research targets, 712 (77.31%) were willing to receive HPV vaccination. The higher the level of knowledge regarding HPV and HPV vaccine-related information, the higher the motivation for HPV vaccination. In addition, the higher the behavioral skills score, the higher the willingness of FSWs in entertainment venues to receive HPV vaccination (P<0.001). FSWs in entertainment venues with lower venue grades [OR(95% CI)=0.693 (0.539, 0.891), P=0.004] were more reluctant to receive HPV vaccination. Those who favored the effectiveness of the vaccine in preventing the disease [OR(95% CI)=2.144 (1.449, 3.174), P<0.001] and those who had heard of HPV vaccine [OR(95% CI)=2.105 (1.451, 3.054), P<0.001], were able to perceive the benefits of HPV vaccination [OR(95% CI)=1.134 (1.045, 1.230), P=0.002]. These individuals acquired greater behavioral skills i.e., self-decision making for HPV vaccination [OR(95% CI)=1.130 (1.008, 1.267), P=0.036] and self-efficacy [OR(95% CI)=1.135 (1.081, 1.191), P<0.001] and they were more willing to receive HPV vaccine. Conclusions: There was a relatively high HPV vaccination willingness among FSWs in entertainment venues in an urban area of Guangxi, China. Attention should be focused on introducing the benefits of primary prevention measures such as the HPV vaccine for individuals and behavioral skills for HPV vaccination in order to increase their willingness to be vaccinated thus increasing their HPV vaccination rate. [ABSTRACT FROM AUTHOR]

Background Human papillomavirus (HPV) vaccination has shown high efficacy against anal HPV infection and lesions in clinical trials, and the HPV prevalence and type distribution in anal precancers and cancer predict a high preventable potential for HPV vaccination. However, the real-world effectiveness of HPV vaccination against anal high-grade lesions and cancer is yet to be shown. Methods We investigated HPV vaccine effectiveness against anal high-grade squamous intraepithelial lesion (HSIL) or worse in a nationwide cohort including all Danish women aged 17-32 years during October 2006 to December 2021 (n = 968 881). HPV vaccinations and first occurrence of anal HSIL or worse were retrieved from nationwide registries. Women were considered vaccinated after first dose and classified by age at vaccination. Using Cox regression, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for anal HSIL or worse according to vaccination status. Results During follow-up, the number of incident histological anal HSIL or worse cases was 37 in unvaccinated women, and less than 5 and 26 in women vaccinated at ages younger than 17 years and 17-32 years, respectively. The overall number of cancers was less than 5. Compared with unvaccinated women, the risk of histological anal HSIL or worse was reduced for women vaccinated at age younger than 17 years (HR = 0.30, 95% CI = 0.10 to 0.87). For women vaccinated at age 17-32 years, the hazard rate of anal HSIL or worse was 1.21 (95% CI = 0.73 to 2.03). Conclusion This is the first study to demonstrate that HPV vaccination at a younger age is associated with substantially reduced risk of anal HSIL or worse in the general population. [ABSTRACT FROM AUTHOR]

Purpose: Studies reported that early diagnosis, treatment, and prevention of cervical cancer are influenced by knowledge, beliefs, and attitude toward screening. This descriptive-comparative study aimed to assess human papilloma virus (HPV) knowledge, attitudes, and beliefs in university students and the affecting factors and to compare between Turkish and Ghanaian students. Methods: The sample consists of 933 university students studying in 4 different faculties in 2 universities from Turkey and Ghana. The data were collected between November 2019 and February 2020. The study's data were analyzed using Analysis of Variance, Pearson Correlation test, t-test, and Mann–Whitney U test. Results: The findings of the study showed that none of the students in both countries had HPV vaccination. It was found that students have low level of knowledge about HPV infection and vaccine (3.28 ± 2.14) and positive attitudes (16.57 ± 3.28) and beliefs (36.74 ± 6.55) toward vaccine. The attitude score of the Ghanaian students (17.54 ± 3.23) was found to be significantly higher than the Turkish students (15.74 ± 3.09). The knowledge score of the Ghanaian students who had sexual intercourse was found to be significantly higher than others. The findings of the study revealed that the students of both countries had low level of knowledge about HPV infection and vaccine and positive attitudes and beliefs toward the vaccine. Conclusions: It is recommended to increase effective interventions to increase the knowledge level of university students about HPV infection and vaccine. In addition, the vaccine should be included in the immunization program in both countries. [ABSTRACT FROM AUTHOR]

Formulations of human papillomavirus (HPV) 16, 18, and 31 L1 capsomere protein antigens were spray dried to obtain glassy microspheres that were then coated by atomic layer deposition (ALD) with nanometer-thin protective layers of alumina. Spray-drying was used to formulate human papillomavirus (HPV) 16, 18, and 31 L1 capsomere protein antigens within glassy microspheres to which nanoscopic protective layers of alumina were applied using ALD. Suspensions of alumina-coated, capsomere-containing microparticles were administered in a single dose to mice. ALD-deposited alumina coatings provided thermostability and a delayed in vivo release of capsomere antigens, incorporating both a prime and a boost dose in one injection. Total serotype-specific antibody titers as well as neutralizing titers determined from pseudovirus infectivity assays were unaffected by incubation of the ALD-coated vaccines for at 4, 50, or 70 °C for three months prior to administration. In addition, even after incubation for three months at 70 °C, single doses of ALD-coated vaccines produced both higher total antibody responses and higher neutralizing responses than control immunizations that used two doses of conventional liquid formulations stored at 4 °C. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is the most common Human Papilloma Virus (HPV)-related disease among women. Since 2008, HPV vaccination has been routinely recommended for pre-adolescent and adolescent girls in Uganda as the primary preventive measure for cervical cancer. However, in Uganda, most especially in Lira district, there is limited literature on HPV vaccination uptake and associated factors among girls aged 9-14years. This study assessed the uptake of HPV vaccine and associated factors among in-school girls aged 9–14 years in Lira City, northern Uganda. Methods: A cross-sectional study was conducted among 245 primary school girls aged 9–14 years in Lira City, northern Uganda. Multistage sampling technique was used to sample eligible participants and data was collected using interviewer administered questionnaire. Data was analysed using SPSS version 23.0. Descriptive statistics and multivariate logistic regression at 95% level of significance were used to identify the level of HPV vaccine uptake and predictors respectively. Results: HPV vaccination uptake was at 19.6% (95% CI,14.8–25.1) among the school girls aged 9–14 years in Lira City, northern Uganda. The mean age of the girls was 12.11 (± 1.651) years. Predictors that were independently associated with HPV vaccine uptake included; recommendation from health worker [aOR 9.09, 95% CI (3.19–25.88), P ≤ 0.001], taught about cervical cancer at school [aOR,12.56, 95% CI (4.60–34.28), P ≤ 0.001], and exposure to outreach clinics [aOR, 4.41, 95% CI (1.37–14.19), P = 0.013]. Conclusion: The study found that one in five of the school girls in Lira City, northern Uganda. received HPV vaccine. Girls who were taught about cervical cancer at school, exposure to outreach clinics and received health worker recommendation had more odds of receiving HPV vaccine than their counter parts. The Ministry of Health should strengthen school based cervical cancer education, awareness raising about HPV vaccination and health worker recommendations to improve HPV vaccine uptake among school girls in Uganda. [ABSTRACT FROM AUTHOR]

Democratic access to scientific evidence contributes to the freedom of individuals to make informed decisions regarding scientific findings that affect their lives. In the case of the human papilloma virus (HPV), which causes cervical cancer, a debate exists regarding preventing HPV infection that is not supported by evidence-based interventions. For instance, there are positions both in favor of and against an HPV vaccine that are not evidence-based, thus preventing women from deciding freely whether to be vaccinated. Based on a communicative approach, this article describes the use of communicative focus groups and communicative daily life stories in which the researcher shares up-to-date information on HPV prevention, particularly through vaccination and screening, with high-schoolgirls in an urban context in Spain. Through the focus groups and daily life stories, the young women evaluated the impact of evidence-based dialogues, which could increase their opportunities to make free choices regarding the HPV vaccine and other medicines. [ABSTRACT FROM AUTHOR]

Background Human papillomavirus (HPV) is a common sexually transmitted infection implicated in 5% of cancers worldwide including most cervical cancer cases. In the UK, the HPV vaccine has been offered routinely to girls aged 11–13 since 2008 while cervical screening is offered to women aged 25–64. HPV testing will soon replace cytology as the primary screening method. This research evaluates what healthcare professionals (HCPs) across the UK know about HPV. Methods A total of 643 UK-based HCPs from primary and secondary care took part in an anonymous cross-sectional survey between March and April 2018. The survey measured general HPV knowledge; HPV triage and test of cure knowledge; HPV vaccine knowledge; attitudes to the HPV vaccine and self-perceived adequacy of knowledge. Results Participants had a generally good understanding of HPV and the vaccination but there were gaps in detailed knowledge of the National Health Service HPV testing processes. There were some gaps in knowledge about the health sequelae of HPV for males. Years since HPV training was associated with triage and test of cure and vaccine knowledge scores. Furthermore, nurses and doctors in colposcopy clinics had much greater odds of having higher knowledge across all domains than other roles. In total, 76.2% of participants felt adequately informed about HPV and 35.6% made suggestions for improvements in training, many of which requested additional frequency and topics. Conclusion Our results suggest that additional training is needed to ensure HCPs are equipped to deal with the changing landscape of HPV screening and vaccination in the UK. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus vaccination and cervical screening are lacking in most lower resource settings, where approximately 80% of more than 500 000 cancer cases occur annually. Visual inspection of the cervix following acetic acid application is practical but not reproducible or accurate. The objective of this study was to develop a "deep learning"-based visual evaluation algorithm that automatically recognizes cervical precancer/cancer.Methods: A population-based longitudinal cohort of 9406 women ages 18-94 years in Guanacaste, Costa Rica was followed for 7 years (1993-2000), incorporating multiple cervical screening methods and histopathologic confirmation of precancers. Tumor registry linkage identified cancers up to 18 years. Archived, digitized cervical images from screening, taken with a fixed-focus camera ("cervicography"), were used for training/validation of the deep learning-based algorithm. The resultant image prediction score (0-1) could be categorized to balance sensitivity and specificity for detection of precancer/cancer. All statistical tests were two-sided.Results: Automated visual evaluation of enrollment cervigrams identified cumulative precancer/cancer cases with greater accuracy (area under the curve [AUC] = 0.91, 95% confidence interval [CI] = 0.89 to 0.93) than original cervigram interpretation (AUC = 0.69, 95% CI = 0.63 to 0.74; P < .001) or conventional cytology (AUC = 0.71, 95% CI = 0.65 to 0.77; P < .001). A single visual screening round restricted to women at the prime screening ages of 25-49 years could identify 127 (55.7%) of 228 precancers (cervical intraepithelial neoplasia 2/cervical intraepithelial neoplasia 3/adenocarcinoma in situ [AIS]) diagnosed cumulatively in the entire adult population (ages 18-94 years) while referring 11.0% for management.Conclusions: The results support consideration of automated visual evaluation of cervical images from contemporary digital cameras. If achieved, this might permit dissemination of effective point-of-care cervical screening. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to identify the stronger responders behind the fluctuating coverage with the HPV-vaccine in Denmark in order to facilitate information campaigns targeted at specific subgroups. Methods Newspaper articles published from 2006 to 2009 with information about coverage with the HPV-vaccine in Denmark were identified from the database Infomedia.dk. Vaccination coverage of recent years was retrieved from the publically accessible statistics from the State's Serum Institute. Data on average disposable income nationally and for each municipality was retrieved from Statistics Denmark. Results According to numbers published in newspapers, girls residing in municipalities with a high disposable income were the first ones to secure the HPV-vaccine in Denmark. Years later, at the start of the debate about possible side effects of the HPV-vaccine, the decline in vaccination coverage was slightly steeper for girls from high income municipalities than for girls from low income municipalities. Conclusions Girls from municipalities with a high disposable income seem to be the stronger responders of the fluctuating coverage with the HPV-vaccine in Denmark. This was the case both during the initial surge in coverage after the vaccine's introduction on the market, and during the later decline following the debate on possible side effects. Identification of this dispersion pattern enables health authorities to initiate targeted information campaigns. [ABSTRACT FROM AUTHOR]

Background: This study tested the influence of the 'Protect Their Future' video intervention on adult intentions to vaccinate their adolescents. Method: The study included 529 parents of 11- to 19-year-old adolescents in Appalachian Kentucky enrolled in group randomized controlled trial arms at 14 health clinic and community sites (seven in each arm) across eight counties. Approximately half the parents (n = 263) were enrolled in the full intervention. Participants in the intervention and control did not significantly differ by education, race, percentage working full-time or gender. Results: Individuals in the intervention were 3.2 times more likely (P = .005) to intend for their female adolescent to receive HPV immunization. However, there was no support for the multivariate model for male HPV immunization. Inconsistent reasoned action findings for HPV, meningitis and flu intentions are also discussed. Conclusions: This study suggests the importance of immunization-specific information motivating parents embedded in a general 'adolescent vaccination platform' promotion video may be most supportive in immunization contexts where the descriptive norms are well established parents, as is currently the case for meningitis, flu and female HPV immunization rates. Implications for male HPV parental education needs are discussed. [ABSTRACT FROM AUTHOR]

Background In Denmark, the human papillomavirus (HPV) vaccines have been suspected of adverse events since 2014. However, as no causal associations between the HPV vaccines and numerous diseases have been demonstrated, factors prior to vaccination may influence the risk of suspecting the HPV vaccines of causing symptoms. We studied the associations between individual and parental socioeconomic characteristics and the risk of referral to a diagnostic centre in a female population aged 11–29 years with a first HPV vaccination in January 2008 to June 2015. Methods Individual and parental data from national registries were linked using the unique personal identification number. Logistic regression analyses were used to estimate crude and adjusted odds ratio's according to each individual and parental socioeconomic factor with two-sided 95% 95% CI. Results The cohort consisted of 453 216 individuals of which 1316 (0.29%) were referred to a diagnostic centre in 2015. Having a mother outside the workforce or an unemployed mother was associated with an increased risk of referral, while girls and women who had fathers with a higher educational level were less likely to be referred. In addition, women aged 20–29 years who were unemployed or outside the workforce prior to vaccination had increased odds of being referred to a diagnostic centre. Conclusion We found social inequality in the referral to a diagnostic centre following HPV vaccination. This might be explained by an increased morbidity in girls and women of lower socioeconomic status. [ABSTRACT FROM AUTHOR]

Aim: Cervical cancer is one of the most common malignancies among Women. Cervical cancer ranks as the number one cancer among Indian females which accounts for 35% of all cancers in women. Objective: The Present study aims to access the female college students in Chennai. The high mortality rate is due to late stage reporting of the disease. Early detection of clinical features and treatment thereafter can reduce the mortality rate. Methods: A Study was a prospective cross-sectional study method. Sampling is done by prevalence sampling procedure. Women who satisfied the inclusion criteria were included in the study. A Questionaire was developed to assess the knowledge of cervical cancer among the female college students. Results: In this study we intended to assess the knowledge and attitudes towards cervical cancer screening and prevention among 100 professional college female students with a mean age of 18 years. All the respondents were single. Majority of the respondents were not aware about the cervical cancer. PAP smear testing, and human papilloma virus vaccine in 2019. Manifestations of most cancers stigma had been defined in terms of experienced(enacted)stigma, Such as isolation or verbal stigma, and expected (fear of)stigma, need to a most cancers diagnosis be disclosed. Conclusion: The examine results provide perception at the know-how and attitudes that physicians around Mangalore, India, have in regard to HPV and the potential for an HPV vaccination implementation application. This organization of health practitioner individuals has now not formerly been surveyed and shows new ways to approach a ordinary HPV vaccination program in India. Stigma was a feared final results of a most cancers analysis and defined as a barrier to screening, early analysis and remedy seeking for girls with symptoms. [ABSTRACT FROM AUTHOR]

The Japanese immunization program has made considerable recent progress. The introduction of several new vaccines, especially foreign-produced vaccines, and the inclusion of important new vaccines in the National Immunization Program (NIP) are closing the “vaccine gap”, i.e., the delay in the Japanese immunization program relative to programs in other developed countries. Major progress in the Japanese immunization program since 2014 includes (1) elimination of measles in March 2015, (2) introduction of a varicella vaccine as a routine immunization in the NIP in October 2015, and (3) introduction of hepatitis B virus vaccines as routine immunizations in the NIP in October 2016. Despite these promising developments, important issues remain. First, the government withdrew the active recommendation for human papilloma virus vaccines temporarily in 2013. The withdrawal has continued and unresolved despite new scientific evidence confirming the safety of these vaccines. Second, a few important voluntary vaccines, including vaccines for mumps and rotavirus, have not been included in the NIP since their introduction to Japan. Finally, there are concerns related to a shortage of mandatory domestic vaccines, which was caused by a natural disaster in the area where a vaccine-producing factory was located. Additionally, the manufacturer included unauthorized additives in some vaccine products with falsifying the production-process records. To avoid problems related to vaccine shortages, essential vaccines need to be stockpiled, and the future vaccine needs for children should to be discussed. New initiatives must continue to close the vaccine gap, as this will protect children living in Japan from vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk of Guillain-Barré syndrome (GBS) after human papilloma virus (HPV) vaccine given to 12–18 year old girls in England. Methods Hospital Episode Statistics (HES) were searched using data to March 2016 to identify incident cases of GBS in female patients aged from 11 to 20 years eligible to have received the HPV vaccine since its introduction as a 3 dose schedule in September 2008. Diagnosis was confirmed by the case’s general practitioner (GP) who also provided HPV vaccination dates. The risk of admission within 3 months (primary risk window) 6 and 12 months of any dose was assessed using the self-controlled case-series (SCCS) method in vaccinated girls with age, season and time-period adjustment. The risk before and after the change in 2012 from bivalent vaccine to quadrivalent vaccine was also assessed. Results A total 244 episodes were initially identified which reduced to 101 episodes in 100 girls when just including cases where the GP could be contacted, at least one vaccine dose was given, and GBS was confirmed or classed as probable. Nine, 14 and 24 GBS admissions occurred within 3, 6, 12 months of a dose respectively. The relative incidence (RI) for the 3 month risk period was 1.04 (95% confidence interval 0.47–2.28), for the 6 month period 0.83 (0.41–1.69) and for the 12 month period 1.10 (0.57–2.14). When restricting to 79 confirmed cases the RI in the 3 month risk period was 1.26 (0.55–2.92) and the RI 1.61 (0.39–6.54) for quadrivalent vaccine compared to 0.84 (0.30–2.34) for bivalent. Conclusion We found no evidence of an increased risk of GBS following HPV vaccination in England and, based on the upper end of the 95% CI for the RI and the number of HPV vaccine doses given in England, can exclude a risk of about 1 per million doses. [ABSTRACT FROM AUTHOR]

Aim To determine the impact of human papilloma virus (HPV) vaccination on knowledge, perception of sexual risk and need for continued safe sexual behavior among Indonesian girls. Methods A comparative cross-sectional study was carried on in Denpasar, the capital city of Bali, Indonesia, during September 2015-February 2016. A total of 828 adolescent girls (12-16 years) were recruited to assess their knowledge on HPV/HPV vaccine, perception of sexual risks and need for continued safe sexual behavior. Results A total of 419 girls (50.7%) had received HPV vaccination prior to the study, 76.4% of whom (320/419) had sufficient knowledge about HPV. HPV vaccination was a strong and independent predictor of higher HPV/HPV vaccine knowledge (adjusted OR [AOR], 9.358; 95%CI: 6.816-12.849, P < 0.001). HPV vaccination (AOR, 0.107; 95%CI: 0.074-0.155, P < 0.001) and higher knowledge level (AOR, 0.667; 95%CI: 0.464-0.958, P = 0.028) were associated with lower perceived HPV risk. Despite the low risk perception, most of the vaccinated girls (408/419, 97.4%) continued to perceive higher need for safe sexual behaviors. On multivariate analysis, higher knowledge was the independent predictor for higher perceived need for safe sexual behaviors (AOR, 4.260; 95%CI: 2.016-9.001, P < 0.001). Conclusion The HPV vaccination was associated with higher knowledge and appropriately lower perception of HPV risk. Despite the vaccination, most of the adolescents continued to perceive a need for safer sexual behavior. All adolescent girls should receive HPV vaccination in order to reduce cervical cancer burden in the future. [ABSTRACT FROM AUTHOR]

Aim: In this study, determining professional knowledge and practice of nurses working in hospitals of a university about cervix cancer and Human Papilloma Virus (HPV) vaccine, and their perceptions towards HPV vaccine was aimed. Material and Methods: The population of this descriptive comparative study was composed of 528 woman nurses who were working in three hospitals. The study was completed with the participation of 246 nurses (%46.5). The data of the study were obtained via a questionnaire including 33 questions. In data analysis, the percentage distributions, mean and tendency measures were calculated and the differences between variables were analyzed by Chi-square test, Mann Whitney-U test and Kruskal Wallis test. Results: Of the participant nurses, 89.9% didn't know the side effects of HPV vaccine, 76.2% didn't know the number of doses, 83.5% didn't know the scheme of dose and 72.5% didn't know the route of administration. Of the nurses, 73.5% were uncertain or had negative perceptions about having vaccine. Of the nurses, 6.5% had provided consultation about HPV vaccine and 5.7% administered HPV vaccination at least once. Conclusion: Developing nurses' knowledge and practices towards HPV vaccine by providing necessary information and counsulting education towards the vaccine during in-service trainings in hospitals, supporting more positive opinions towards the vaccine may contribute better understanding towards the importance of the vaccine and reducing frequency of cervix cancer in society. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study is to investigate knowledge, attitudes and behaviours concerning cervical cancer, HPV and HPV vaccine of female students studying at a university in a health related department and explore variables affecting taking the vaccine.Methods: The research group consists of female students attending a health related department in Balıkesir University. The data of this cross-sectional research was collected via surveys.Results: The average total knowledge score of the students concerning risks, symptoms and screening methods of cervical cancer and HPV vaccines was 14.15 ± 6.7. The HPV knowledge score of the students attending the faculty of medicine was higher compared to the students attending other departments and their HPV vaccine knowledge score was higher compared to the students attending nursing and paramedics students. The HPV vaccine knowledge score of the students attending the department of midwifery was significantly higher compared to other students. Only 0.9 % of the students took the vaccine. One third of the students who did not take the vaccine did not know that the vaccine was available in our country. In terms of the department that they attended, the students with a higher total knowledge score compared to the average (OR:1.5) and students with history of cancer in their families (OR:1.6) were more likely to consider taking the vaccine.Conclusions: Research group's knowledge on risk factors of cervical cancer, Pap smear test, symptoms and prevention ways of cancer, HPV and HPV vaccine was low. [ABSTRACT FROM AUTHOR]

Abstract: The human papilloma virus (HPV) vaccines were introduced to reduce the incidence of cervical cancer. The bivalent vaccine is effective against HPV-16, -18, -31, -33 and -45 while the quadrivalent vaccine is effective against HPV-16, 18, 31, 6 and 11 types. The immunisation, recommended for adolescent females, has led to high vaccine coverage in many countries. Along with the introduction of the HPV vaccines, several cases of onset or exacerbations of autoimmune diseases following the vaccine shot have been reported in the literature and pharmacovigilance databases, triggering concerns about its safety. This vaccination programme, however, has been introduced in a population that is at high risk for the onset of autoimmune diseases, making it difficult to assess the role of HPV vaccine in these cases and no conclusive studies have been reported thus far. We have thus analysed and reviewed comprehensively all case reports and studies dealing with either the onset of an autoimmune disease in vaccinated subject or the safety in patients with autoimmune diseases to define the role of the HPV vaccines in these diseases and hence its safety. A solid evidence of causal relationship was provided in few cases in the examined studies, and the risk vs. benefit of vaccination is still to be solved. The on-going vigilance for the safety of this vaccine remains thus of paramount importance. [Copyright &y& Elsevier]

Aim: The aim of our study was to evaluate the level of knowledge of the adolescent girls who presented to our clinic about human papilloma virus (HPV) infection and HPV vaccine. Material and Methods: Five hundred and one adolescent girls aged between 13 and 18 years who presented to the gynecology outpatient clinic between March 2012 and March 2013 were asked to answer the questions of the questionnaire about HPV and HPV vaccine. The “Participant Information Form” and “HPV Information Assessment Form” were used by examination of the related literature by the investigators. The data obtained were entered into the computer using the SPSS 16.5 program and evaluated. Descriptive statistics were shown with mean, standard deviation, number and percentage values. Results: The mean age of 501 subjects who were included into the study was 15.92 years. 390 subjects (77.8%) who were included in the study had no information about HPV. 111 subjects (22.2%) stated that they heard of HPV before or had information about HPV. The mean age of the subjects who had information about human papilloma virus was found to be 16.52 years. The mean age of 390 subjects (77.8%) who had no information about human papilloma virus was 15.75 years. It was found that only one of the subjects (0.9%) was vaccinated with HPV vaccine. When the subjects who did not wish to be vaccinated were asked for the reason, 40.9% stated that the reason was inadequate information, 26.4% stated that the reason was high cost, 16.4% stated that the reason was the fact that they did not consider themselves at risk and 16.4% stated that the reason was the fact that they were afraid of side effects. Conclusions: In our study, it was found that the adolescent girls who constituted our study group had insufficient information about HPV and HPV vaccine. Verbal, written and visual communication tools and internet should be used intensively and efficiently for the objective of introducing HPV vaccine and teaching the precautions related with prevention of cervix cancer in terms of public health. Primarily pediatrician and gynecologists and family physicians who give service for the adolescence age group should be supported to develop appropriate attitudes and behaviors related with HPV vaccine and infection. [ABSTRACT FROM AUTHOR]

Aim: In June 2006, the human papillomavirus (HPV) vaccine, Gardasil, was licensed for use in the United States. We examined whether paediatricians would recommend the vaccine, obstacles they encountered and characteristics associated with not recommending the HPV vaccine to all eligible patients. Methods: Four hundred fifty general paediatricians, 200 members of the section of infectious diseases and 200 members of the section of adolescent medicine of the American Academy of Pediatrics web-based directory were surveyed. Results: Of 752 eligible paediatricians, 373 (50%) responded. Eighty-eight percent (292 of 332) of respondents stated that they would give the vaccine to all, 36 (11%) would give it to some and 4 (1%) would give it to none of their eligible patients. The main obstacles were cost and safety; a minority expressed concern about the vaccine's potential impact on adolescent sexual activity. Physicians who would not recommend HPV vaccination to all eligible patients were more likely to be generalists, have higher intrinsic religiosity, self-describe as conservative, report later adoption of new drugs/vaccines, and would not encourage vaccinating their own daughter or the daughter of a close friend. Conclusion: Although paediatricians are highly supportive of the HPV vaccine, certain characteristics may predict reluctance to immunize. [ABSTRACT FROM AUTHOR]

Background There are more than one million international college students in the United States. The University of Southern California hosts about 5,000 Chinese International Students (CIS). HPV-related cancers are common in China and the HPV vaccine was only recently introduced to the Chinese population. CIS in the United States have low HPV vaccination rates upon arrival. Once these students become aware of the affordability and the accessibility of the vaccine, they often contact a provider to start the vaccination series. The HPV vaccine is available to all eligible students at the USC student health center and is free of charge to students with Aetna Student Health Insurance. We examined the impact of a peer-to-peer education program about HPV disease and vaccination amongst CIS and assessed the impact of the program via an analysis of HPV immunization rates amongst CIS. Methods The study was IRB approved. Mandarin-speaking USC students volunteered to serve as peer educators in response to an inquiry from academic advisors. 18 CIS were trained by MiOra as Immunization Community Health Educators (ICHE) on HPV disease and vaccination as well as sexually transmitted infections and prevention. CIS educated peers at tables set up throughout USC. Results Initial data from 100 CIS students who were surveyed and educated in April 2019 were analyzed. 59 out of 99 (59.6%) students reported that they have either received or are in the process of receiving the HPV vaccine. 93 out of 99 (93.9%) indicated "no knowledge" or "some knowledge" about HPV and HPV vaccine while only 6 students (6.1%) reported "a great deal of knowledge." 56 out of 99 (56.6%) thought that it is "unlikely" or "impossible" for them to acquire HPV. 92 out of 97 (94.9%) said they would be interested in getting vaccinated if it were free. Conclusion Many CIS have limited understanding of HPV risk factors and HPV vaccine; however, when informed, the majority of students indicated they would likely vaccinate if it was covered by insurance. Peer-to-peer education was very effective. Of the first 400 students educated, 80 visited the student health center. This is an ongoing project. We will continue to collect and report data on the impact of the peer-to-peer education and factors influencing. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background The various screening methods for include Paps smear, VIA (Visaul inspection with acetic acid), HPV screening etc. Female relatives of any cancer patients are attractive population for screening programmes as they may be receptive to cancer screening awareness initiatives. Methods Prospective Single institutional study among the female relatives of cancer patients visiting OPDs was done. Questionnaire was given by oncology nurses on the various topics of Knowledge, Attitude and Practice of cervical cancer and screening. 9 questions on personal demographic and social details; 12 questions about knowledge about cervical cancer, screening and HPV vaccination. Attitude assessed by 6 questions with 3 point Likert scale of "Agree, Neutral and Disagree". Barrier in Pap smear, HPV testing and HPV vaccination assessed by 4 options to choose (no idea, harmful, no facility, fear of results). Practice was assessed by asking whether they have undergone Pap smear, HPV testing or if any of the family member has got HPV vaccination. Mean scores were calculated for knowledge section. The attitude was taken favourable if the scores were less than 12(the total if all neutral options are selected by patient). Descriptive statistics was used for analysis with SPSS version 20. Results 42 female relatives participated in the study. Their median age was 35.5yrs (22-70). Most of them had studied from 6-10 class (38%). Majority were married (80%). Median age of marriage was 20yrs (14-35) and mostly belonged to middle class. The knowledge as assessed using mean knowledge score was 27% (poor <50%). Awareness about cervical cancer, screening and vaccination was 64%, 43%, 24% respectively. The overall attitude towards vaccination was unfavourable (74%). Main barrier in HPV vaccination, Pap smear and HPV testing reported by patient was lack of any idea about the same (90%). Practice of either Pap smear, HPV testing or HPV vaccination was only 10% in this population. Conclusions There is significant lack of knowledge, attitude and practice for carcinoma screening and vaccination in the female relatives of cancer patients who visited HBCHRC, a tertiary cancer centre in rural India. The lack of knowledge is the main barrier and needs urgent steps to correct it. Legal entity responsible for the study Homi Bhabha Cancer Hospital and Research Centre, Visakhapatanam. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States, with an annual incidence rate of approximately 14 million people. The HPV vaccine has been demonstrated to be highly effective in the prevention of HPV infection and HPV-associated diseases. This study aims to evaluate the impact of HPV vaccine on the prevalence of HPV infection in the United States and evaluate the trends of disease prevalence pre- and post-HPV vaccine implementation. Methods We conducted a secondary data analysis of the National Health and Education Survey (NHANES) for trends in HPV infection from 2003 to 2016. The analysis was grouped into a pre-HPV vaccine implementation (2003–2006) cohort including 4064 females, aged 18–59 years; and a post-HPV vaccine implementation (2007–2016) cohort which included 10718 females, aged 18–59 years. Further analysis of HPV infection prevalence, pre- and post-HPV vaccine implementation, stratified by sociodemographic characteristics were conducted. Results The prevalence of HPV infection prior to HPV vaccine implementation was 43.98% (95 CI 42.71%–46.58%) compared with 40.55% (95 C.I 40.55%–40.56%) in the post-HPV vaccine implementation era. Among females with HPV infections in the post-HPV vaccine implementation cohort 82.6 (95% CI 80.41%–83.42%) were unvaccinated. In both cohorts, black females had a significantly higher prevalence of HPV with a prevalence rate of 18.56% (95% CI 18.23%–20.56%) in the pre-HPV vaccine implementation cohort, and 15.61% (95% CI 14.82 – 19.4%) in the post-HPV vaccine implementation cohort. Females with less than high school education had a higher prevalence of HPV in the pre and post- HPV vaccine implementation cohorts with prevalence rates of 25.77% (95% CI 23.44%–28.72%) and 24.96% (95% CI 23.41%–25.67%), respectively. Conclusion The results suggest that HPV infection prevalence has declined since the implementation of HPV vaccine to US national immunization program. Our findings highlight disparities in HPV infection prevalence by race and educational status, and these patterns are in keeping with HPV-associated disease such as warts and HPV-associated cancers. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background Social media is frequently used to share medical information. Current European regulatory guidance for the pharmaceutical industry calls for reporting valid adverse events (AE) derived from social media as well as consideration of non-valid AEs. This guidance is followed when our company utilizes social media related to any company products and interests. Here we evaluate its application to vaccines. Methods Posts collected from all screened social media sources (company owned, or company reviewed) were examined (August 1, 2017–February 28, 2019) to identify safety-related information pertaining to any of its 14 licensed vaccines. Posts were classified as valid cases (i.e. containing information about company product, AE, and identifiable reporter), non-valid cases (i.e. company product, AE, but missing an identifiable reporter), or not relevant (no safety-related information; not further analyzed). Valid cases were added to the company's safety database; non-valid cases were reviewed for trends requiring further analysis. Both, valid and non-valid cases, were analyzed as part of routine safety surveillance Results Among 69,682 vaccine-related posts reviewed, 285 (0.4%) were valid; 11,464 (16.5%) were non-valid; 47,966 (83.1%) were not relevant. Most non-valid cases concerned the company's 4-valent (8,934 [78%]) or 9-valent (1,420 [12%]) human papillomavirus vaccines, followed by its measles-mumps-rubella (336 [2.9%]), pneumococcal (282 [2.5%]), and herpes zoster (246 [2.1%]) vaccines. Review of data from selected temporal spikes in posts demonstrated that they were usually attributable to increased reposts of an original post or to personal views, rather than containing incremental factual new safety data. Conclusion Fewer than 1% of posts from relevant social media sources contained sufficient information to be considered valid cases. No new safety signals were identified for any of the vaccines from social media cases (valid or non-valid). Among posts containing safety information, the nature of this information tends to be redundant or sentimental, precluding meaningful safety analyses. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background Since human papillomavirus (HPV) vaccine introduction in the United States in 2006, cervical pre-cancer incidence has declined in young women, but pre-cancer trends have not been reported by race/ethnicity. We evaluated trends in cervical pre-cancers from 2008 to 2016 in non-Hispanic (NH) white, NH black, NH Asian, and Hispanic women identified through active population-based surveillance in the 5-site Human Papillomavirus Vaccine Impact Monitoring Project (HPV-IMPACT). Methods We analyzed data on cervical intraepithelial neoplasia (CIN) grades 2–3 and adenocarcinoma in situ (CIN2+) cases aged 20–39 years. Annual CIN2+ rates per 100,000 women were calculated stratified by race/ethnicity in 5-year age groups, using multiple imputation to account for 10% missing race/ethnicity data. Rates were also calculated using estimated numbers screened for cervical cancer to control for known declines in screening. Trends, evaluated using JoinPoint software, are presented as average annual percentage changes (AAPC) with 95% confidence intervals (CI). Results A total of 18,222 CIN2+ cases (62% NH white, 16% NH black, 16% Hispanic, 6% Asian) were reported from 2008 to 2016. CIN2+ rates among 20–24 year-olds declined significantly in all groups: NH white, AAPC: −14.2 (95% CI: −16.3, −12.1); NH black, AAPC: −15.5 (−19.5, −11.4); Asian, AAPC: −14.8 (−20.5, −8.8); Hispanic, AAPC: −14.3 (−17.9, −10.5). In 25–29 year olds, a significant decline was observed for NH whites only (AAPC: −2.4, [−4.0, −0.8]). No declines were seen in 30–34 or 35–39 year olds. Among screened 20–24 year-olds, significant but smaller declines were observed (AAPC: −9.8 to −8.4); no declines were observed in screened 25–29 year olds or older groups. Conclusion In this evaluation of CIN2+ trends by race/ethnicity during the HPV vaccine era, the significant declines in 20–24 year olds across all groups, including among screened women, is consistent with equitable vaccine impact on CIN2+. Disclosures All Authors: No reported Disclosures. [ABSTRACT FROM AUTHOR]

Background: In 2014, Denmark experienced a rapid decline in vaccination uptake for the human papillomavirus (HPV) vaccine after a successful introduction of the vaccine in 2009. Before the decline, the uptake of the first HPV vaccine was around 90% for girls born in the period 1998 to 2000, while it dropped to 54% for girls born in 2003. The decline followed negative public attention from 2013 coinciding with increasing suspected adverse-event reporting to the Danish Medicines Agency. The aim of this study is to describe the HPV-vaccination uptake, to quantify relevant HPV-related media coverage, and analyse the relation between media coverage and HPV-vaccination acceptance in Denmark in year 2009-2016.Methods: Three types of data were used for the analysis: Immunisation data from 243,415 girls, media coverage (8524 news items) and Google search activity. We used changes in the correlation between media coverage and vaccination uptake to identify a changing point in their relationship. The relationship before and after the changing point was analysed determined on the interactions between vaccination uptake, media and search activity, with search activity as a proxy for public attention.Results: We identified July 2013 as a changing point in the relationship between media coverage and vaccination uptake. We found no significant relationship between media coverage and vaccination uptake in the first part of the time series (June 2009 to June 2013), whereas from July 2013 and onwards there was a negative Pearson's correlation of - 0.52. The changing point coincides with both an increase in Google searches for "HPV side effects" and media coverage with negative content.Conclusions: Following a successful launch of the HPV-vaccination programme, concerns about vaccine safety shifted the public opinion and the coverage by the media. The noticeable shift in correlation between vaccination uptake and media coverage before and after July 2013 could indicate that increased media coverage influenced the decline in vaccination uptake. Media monitoring may represent an important tool in future monitoring and assessment of confidence in vaccination programmes. [ABSTRACT FROM AUTHOR]

Recent progress in the Japanese immunization program has partially closed the "vaccine gap," i.e., the deficiencies in that program relative to immunization programs in other developed countries. During the last several years, seven new vaccines (12 new products, excluding influenza vaccines) have been introduced in Japan. Five of these new vaccines are produced outside Japan and four are now included as routine vaccines in the National Immunization Program, which is a new development in the licensing and financial support of imported vaccines. However, along with this progress, important concerns have arisen regarding the Japanese immunization program. A rubella epidemic among adults, in 2012-2013, resulted in more than 40 cases of congenital rubella syndrome as of March 2014. In addition, the temporary withdrawal of the active governmental recommendation for human papilloma virus vaccines, in 2013-2014, highlighted challenges in the current Japanese immunization system. Furthermore, some important vaccines - including vaccines for hepatitis B virus, mumps, varicella, and rotavirus - are still not included in the National Immunization Program and have been categorized as voluntary vaccines since their introduction. The possibility of their inclusion in the National Immunization Program remains a matter for discussion. We hope that future initiatives will further address the vaccine gap and protect Japanese children from vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]