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ObjectiveA better understanding of factors associated with cervical cancer screening can inform strategies for cervical cancer prevention. This study examined the relationship between age at human papillomavirus (HPV) vaccination and participation in cervical cancer screening among a nationally representative sample of women in the United States.MethodsWe utilized data from the National Survey of Family Growth for the years 2015-2019 focusing on women aged 18-24 vaccinated against HPV. Age at first HPV immunization was analyzed as both a dichotomous (vaccinated at 9-12 vs. 13-23 years) and a continuous variable. The outcome measured was ever having a Pap smear. Multivariable logistic regression that accounted for complex survey design was employed to estimate adjusted prevalence ratios and differences from average marginal predictions.ResultsThe study comprised 981 individuals, representing 6.05 million women. Over half of the study population had a Pap test (57.4%). Women vaccinated at ages 9-12 were less likely to participate in screening compared to those vaccinated at ages 13-23 [risk difference: -9.1, 95% confidence interval (CI) -16.7 to -1.5)] which translates into 120,260 fewer women nationwide getting cervical cancer screening. Each 1-year increase in age at first vaccination was associated with a 1.1% (95% CI, -0.1 to 2.4%) higher probability of having a Pap test, but this linear trend was not statistically significant.ConclusionsOur study underscores the importance of promoting cervical cancer screening not only among unvaccinated women but also among those who received the HPV vaccine at the recommended ages of 9-12.

Human papillomavirus (HPV) is the most common sexually transmitted infection on U.S. college campuses. Although HPV vaccination is recommended through age 26, current efforts to improve vaccination rates have predominantly focused on adolescents. Consequently, vaccine uptake remains suboptimal among young adults. This represents a significant missed opportunity, as young adults face the highest risk for new HPV infections. To contextualize the factors impacting decision-making process for this vulnerable population, this study reports key themes that emerged from in-depth interviews with participants (N = 30) who had completed an online intervention study for HPV vaccination among college students. Twelve (40%) of the interviewees vaccinated after exposure to the intervention. Findings centered around empowerment among young adults as the facilitator to get the HPV vaccine: key themes emerged were (1) convenience is critical and empowering; (2) adulthood identity, marked by a heightened sense of autonomy, accountability, and responsibility for self/future self and others, is empowering; (3) equal access to health care and preventive resources is empowering, especially for participants with low socioeconomic status; and (4) accurate knowledge provided in the intervention destigmatized HPV vaccination to empower young adults to make informed decisions. Digital interventions with messages highlighting a newly gained autonomy, future-oriented self and social responsibility, inclusive and accurate knowledge, and providing navigation to improve access may enhance HPV vaccination among young adults.

Human papillomavirus (HPV) vaccination rates remain suboptimal among young Black adults (18–26 years). Research focused on HPV vaccination among young Black adults is limited. Guided by the Theory of Planned Behavior, we developed #HPVvaxtalks, a theoretically grounded and culturally appropriate Facebook intervention in collaboration with a youth community advisory board (YCAB) to increase awareness of HPV risk factors, risk perception, HPV vaccine-related knowledge, vaccination intention, and uptake for Black individuals. Engagement with YCAB members fostered opportunity to discuss priorities reflecting the community's interest and make #HPVvaxtalks more relevant. This article describes the YCAB engagement and collaborative process in the development and refinement of posts/messages for #HPVvaxtalks. Five young Black adults (18–26 years of age) were invited to become members of a YCAB. YCAB reviewed the preliminary version of #HPVvaxtalks intervention materials and provided critiques and suggestions for refinement. Following the completion of the collaborative process, YCAB members completed individual interviews to reflect on the process. Feedback from YCAB participants focused on the relevance, engagement, clarity, and organization of the content and the media utilized. Participants suggested using "memes" to improve cultural relevance and engagement for young Black individuals. All YCAB members expressed satisfaction with the development process. Collaboration with a YCAB was crucial in developing a culturally relevant and acceptable #HPVvaxtalks intervention, which includes 40 messages/posts for young Black adults. Undergoing the iterative process of intervention development and refinement with the priority population can be an essential component in the design and implementation of health promotion activities. [ABSTRACT FROM AUTHOR]

Aim: The aim was to identify maternal and paternal socioeconomic and demographic characteristics for non-initiation and non-completion of the human papillomavirus (HPV) vaccination among Danish girls including time-trends. Methods: This nationwide register-based cohort study included all girls residing in Denmark who were offered free-of-charge HPV vaccination as a part of the childhood vaccination program between 2009 and 2018 (birth cohorts 1996–2005). The study samples included 296,461 daughter–mother dyads and 291,025 daughter–father dyads. Data from the Danish Vaccination Register were linked with socioeconomic and demographic data from Statistics Denmark. HPV vaccination status was classified as 'non-initiation' for girls who received no HPV vaccine and as 'non-completion' for girls who initiated the HPV vaccination program but did not receive all the scheduled HPV vaccines. Data were analyzed using logistic regression models. Results: Non-initiation of HPV vaccination was 13.7%, and non-completion was 24.2% among girls who initiated the HPV vaccination program. Girls of parents who were descendants of immigrants (adjusted odds ratio: 1.50; 95% confidence interval: 1.35–1.68), were at least 35-years old at time of birth, had basic or no education, had a low income, were not in the labor market, and were unmarried had the highest non-initiation and non-completion odds. The associations between socioeconomic and demographic characteristics and HPV vaccination uptake were similar for mothers and fathers. Conclusions: Despite free-of-charge availability to HPV vaccination in Denmark, we found disparities in non-initiation and non-completion of HPV vaccination among Danish girls by both mothers' and fathers' socioeconomic and demographic characteristics. [ABSTRACT FROM AUTHOR]

Background/Objectives: Human papillomavirus (HPV) is linked to multiple cancers that can be prevented through vaccination. While the optimal age for vaccination is in childhood and adolescence, vaccination recommendations include adults through age 26 who missed childhood/adolescent vaccination. There are limited data about disparities among adults eligible for catch-up HPV vaccination. We conducted a comprehensive examination of HPV vaccination among US young adults, disaggregating the group by race/ethnicity and nativity status to identify subgroups that may require additional interventions. Methods: We analyzed 2019 and 2022 data of individuals aged 18–26 years from the National Health Interview Survey. Generalized linear models using Poisson regression with log link were used to examine the receipt of 1+ dose of HPV vaccine, race/ethnicity, and nativity (i.e., US- versus foreign-born) status. Results: The overall receipt of 1+ doses of HPV vaccine was 47.5%. The vaccination rate among the US-born group was 49.7% versus 31.9% among the foreign-born group with an adjusted prevalence ratio (APR) of 0.72; (95% CI, 0.62–0.82). Foreign-born non-Hispanic (NH) Black individuals (APR 0.31; 95% CI, 0.13–0.70) were less likely to be vaccinated against HPV than foreign-born NH White individuals, while US-born NH Asians (APR 1.27; 95% CI, 1.09–1.48) had a higher prevalence of the vaccination than the US-born NH White group. Additionally, foreign-born NH Asian (APR 0.60; 95% CI, 0.46–0.77), NH Black (APR 0.27; 95% CI, 0.12–0.61), and Hispanic (APR 0.76; 95% CI, 0.60–0.97) populations were less likely to be vaccinated than their respective US-born counterparts. Conclusion: Profound HPV vaccination inequalities exist among US young adults with particularly low vaccine coverage among racially and ethnically minoritized immigrant populations. [ABSTRACT FROM AUTHOR]

Background: Anal HPV infection can cause squamous intraepithelial lesions (SILs), which are precursors of anal squamous cell carcinoma (SCC). The early detection of HPV infections and improvement of effective screening programmes are, therefore, essential to prevent progression from pre-cancerous lesions to SCC, especially in people living with HIV (PLWH), who represent a population at higher risk of HPV infection and associated lesions. Among prevention strategies, HPV vaccination is relevant too, but its efficacy in persons already infected by HPV is still debated. Methods: This is a retrospective single-center study on a cohort of PLWH who performed longitudinal screening for anal dysplasia and HPV infection. The screening included cytological and molecular analyses. Results: A total of 110 PLWH performed at least one anal HPV screening, with an overall prevalence of HPV infection of 86.4% [23.6% low risk (LR)-HPV and 62.7% high risk (HR)-HPV genotypes]. Abnormal cytology was demonstrated in 39.1% of subjects, of whom ASCUS 6.4%, LSIL 30.9% and HSIL 1.8%. In total, 80 patients (72.7%) had an available longitudinal screening. No patient developed SCC during follow-up. However, a high incidence of new cytological abnormalities and new HPV infections was observed. On the other side, clearance of some HPV genotypes was also frequent, confirming that HPV infection is a dynamic process. A CD4 cell count > 500/mmc was an independent predictor of HPV clearance. HPV vaccination was performed on 30.9% of patients. A trend toward an increased clearance of HPV genotypes included in 9-valent vaccine was observed in vaccinated patients (40.6% versus 30.8% in unvaccinated, p = 0.079). Conclusions: A high prevalence of HPV infection and SILs was observed in our cohort of PLWH. A high incidence of new HPV infections and HPV-associated lesions was also observed in the longitudinal cohort, highlighting the need of strengthening immunization programs and continuous screening for anal HPV infection. Whether HPV vaccination may be efficacious in patients already infected by HPV remains to be determined. [ABSTRACT FROM AUTHOR]

Introduction: Human Papillomavirus (HPV) vaccine uptake in the French Caribbean has remained below 25% since introduction in 2007, which is well behind national and international targets. Using a discrete choice experiment (DCE), we explored parental preferences around HPV vaccination and optimized communication content in a sample of parents of middle-school pupils in Guadeloupe. Methods: We conducted a cross-sectional survey in public and private middle age schools in Guadeloupe in June 2023 using an online questionnaire. Across a series of nine hypothetical scenarios, participants were asked to decide to vaccinate or not and how certain they were about this choice. Scenarios differed by five attributes (diseases characteristics, vaccine safety, health professionals or institutions promoting vaccination, social conformity and optimal vaccination age). We used random effect logit and linear regression models to estimate the effects of attribute levels on vaccine acceptance and vaccine eagerness. Results: A total of 389 parents out of the 23,184 pupils' parents completed the DCE survey. The attributes with a significant effect size on theoretical vaccine acceptance were "social conformity" and "optimal vaccination age". Overall, the odds of scenarios stating high vaccine coverage in adolescents were at least 1.8 (95% CI: 1.2—2.6) times more likely to yield theoretical vaccine acceptance compared to a low vaccine uptake reference. The odds of providing scientific explanation along with age yielded theoretical vaccination acceptance respectively up to 3.2 times higher (95% CI: 1.7 to 6.1) in parents reporting an un vaccinated child and not intention to vaccinate. For vaccine eagerness, we observe significant positive effects of communication content overall when stating high vaccination uptake in adolescents or scientific evidence along with age or mentioning cancer prevention. Parents always refusing vaccination remained unsensitive to communication contents. Discussion and conclusion: These original DCE results highlighted the need for tailoring specific HPV vaccination promotion communication in a French Caribbean setting. Contextual features such as sexuality concerns as regard to age and peers' adhesion to vaccination have to be thoroughly considered. The nationwide HPV vaccination campaign in middle schools should adapt communication in order to raise HPV vaccine uptake in the French Caribbean. [ABSTRACT FROM AUTHOR]

Background: Ensuring vaccine access is a prerequisite for promoting human papilloma virus (HPV) vaccination. Although HPV vaccination efforts in China have primarily focused on young females, little research has examined the difficulties they face in accessing the HPV vaccine and its impact on vaccine uptake and intention. This study analyzed the overall perception of access difficulties to HPV vaccines, as well as three specific vaccine access difficulties, and examined their influencing factors among female university students in China. We also examined the associations between overall and specific vaccine access difficulties and HPV vaccination intention and uptake. Methods: A cross-sectional study was conducted among female university students from eight universities or colleges in Zhejiang Province, China, from December 2020 to January 2021. Logistic regressions were used to identify factors associated with both overall and specific perceptions of vaccine access difficulties. A multivariable logistic regression model and a multiple linear regression model were used to explore factors influencing HPV vaccine uptake and vaccine intention by controlling for potential confounding factors, respectively. Results: A total of 3176 female university students were included in this study. The proportion of female students perceiving overall difficulty in obtaining HPV vaccine, as well as difficulties in accessing the desired type of HPV vaccine, HPV vaccination centers, and HPV vaccination information, were 60.6%, 57.7%, 60.7%, and 54.0%, respectively. Perceived overall difficulty in obtaining HPV vaccine, as well as difficulties in accessing the desired type of HPV vaccine, HPV vaccination centers, and HPV vaccination information were associated with HPV vaccine uptake and intention. Conclusions: Chinese female university students generally perceived various difficulties in accessing HPV vaccine. It is crucial to improve access to HPV vaccine, optimize the layout and service quality of HPV vaccination centers, and enhance the dissemination and transparency of HPV vaccine information. More efforts are needed to provide a strong guarantee for HPV vaccination uptake among female university students. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) vaccination during the postpartum period is an opportunity for vaccine eligible individuals to be vaccinated. Objective: Identify predictors of vaccine acceptance in the postpartum period among patients aged 18–26. Study Design: A retrospective chart review was conducted to evaluate the rate of HPV vaccination to eligible postpartum patients aged 18–26 who delivered between January 2021 and May 2023 at our institution. Clinical and demographic data were extracted. Comparisons were made between fully vaccinated individuals and those who were unvaccinated or incompletely vaccinated. Variables significantly associated with vaccination status or acceptance were included in a multivariable logistic regression model. Results: Of the 1,130 patients who met the study inclusion criteria, 42.1% were eligible for postpartum HPV vaccination. The average age was 23 years, the majority White (74.5%), and English speaking (93.1%). Nineteen percent of eligible patients accepted HPV vaccination, with differences between those who accepted or declined the vaccine identified in: preferred language, tobacco use, delivering provider's specialty, and receiving any vaccination during pregnancy. Spanish-speaking patients had >5× the odds of accepting the vaccine compared with English-speaking patients. Smokers, patients delivered by a family medicine provider, and those who accepted any vaccine during pregnancy had more than twice the odds of receiving the vaccine postpartum. Conclusion(s): The postpartum period remains an opportunity to provide HPV vaccination. Our study identified patients less likely to be vaccinated prior to delivery, as well as patients who are more likely to accept vaccinations postpartum. [ABSTRACT FROM AUTHOR]

Health care disruptions associated with the COVID-19 pandemic have caused persistent decreases in human papillomavirus (HPV) vaccination uptake in Germany. The objective of this study was to estimate the cumulative deficit in first doses of the HPV vaccine administered to girls in Germany since the beginning of the pandemic and the projected time to recover from this deficit at different catch-up vaccination uptake levels, focusing on girls 9–14 years of age. This study used a published HPV vaccination modeling tool. Retrospective vaccination data from 2019 were used to calculate the baseline vaccination rate, while data from 1 January 2020 to 31 December 2023 were used to estimate the size and duration of the HPV vaccination deficit accrued since the beginning of the COVID-19 pandemic. We modeled scenarios in which the rate of monthly vaccinations increased from the 2023 average to 5%, 10%, or 15% above the baseline 2019 level. The average monthly number of first doses of HPV vaccine administered to girls 9–14 years of age was 7.4% below the 2019 baseline level in 2020, 21.2% below baseline in 2021, 21.0% below baseline in 2022, and 19.5% below baseline in 2023. At a catch-up vaccination uptake of 5–15% above the 2019 baseline, there would be an estimated accumulated deficit of 267,052–285,798 first doses by 31 December 2024 that would clear between October 2029–April 2040. A catch-up vaccination uptake of 12.3% (11.9–12.7%) every month above baseline would be needed to clear the accumulated deficit by the end of 2030. Conclusions: Significant HPV vaccination deficits have accrued in Germany since the beginning of the COVID-19 pandemic. Sustained efforts to vaccinate the affected cohorts are now needed to mitigate the long-term impacts of the vaccination deficit. What is known: • Health care disruptions associated with the COVID-19 pandemic have caused persistent decreases in human papillomavirus (HPV) vaccination uptake in Germany. What is new: • Our model projected that the HPV vaccination deficit would be cleared between October 2029 (15% above the 2019 baseline level) and April 2040 (5% above the 2019 baseline level). • A catch-up rate of 12.3% (11.9–12.7%) above the 2019 baseline level would be needed to clear the HPV vaccination deficit by 31 December 2030. • Sustained efforts to vaccinate the affected cohorts are now needed to mitigate the long-term impacts of the accrued vaccination deficit on mortality, morbidity, and health care costs from HPV-associated diseases. [ABSTRACT FROM AUTHOR]

The Federal Cervical Cancer Collaborative (FCCC) was established by the Health Resources and Services Administration Office of Women's Health and its interagency partners within the U.S. Department of Health and Human Services. Its primary mission, aligned with the goals of the Cancer Moonshot (https://www.cancer.gov/research/key‐initiatives/moonshot‐cancer‐initiative/implementation/prevention‐early‐detection), is to accelerate control of cervical cancer within safety‐net settings of care. This interagency partnership works in close collaboration to reduce disparities in cervical cancer care, particularly among populations that are geographically isolated, economically challenged, and medically underserved. The FCCC bridges federal priorities of cancer research from the National Institutes of Health National Cancer Institute to health care delivery in Health Resources and Services Administration–supported and safety‐net settings of care. In this commentary, FCCC activities are discussed to improve cervical cancer prevention and control through vaccination, screening, and management of preinvasive cervical disease in safety‐net settings of care. These activities include the development and implementation of an evidence‐based, action‐oriented provider toolkit and federal opportunities report. The FCCC's efforts to increase the readiness of safety‐net settings of care to implement the 2019 American Society for Colposcopy and Cervical Pathology Risk‐Based Management Consensus Guidelines for patients with abnormal cervical cancer screening results are discussed. Also described are the results from a survey of National Cancer Institute–designated cancer centers, designed to inform future efforts to strengthen referrals and care coordination with safety‐net settings of care. The Federal Cervical Cancer Collaborative strives to reduce the burden of cervical cancer for all individuals in the United States through meaningful and culturally appropriate public health interventions. This commentary discusses activities of the Federal Cervical Cancer Collaborative to improve cervical cancer prevention and care in safety‐net settings of care. [ABSTRACT FROM AUTHOR]

Background/Objectives: Human papillomavirus (HPV) is the primary cause of high-grade cervical lesions and cervical cancer worldwide. In Norway, HPV vaccination was introduced in 2009 for seventh-grade girls and extended through a catch-up program from 2016 to 2019 for women born between 1991 and 1996. This study evaluates the impact of the catch-up vaccination program on the incidence of HPV and high-grade cervical lesions in Troms and Finnmark. Methods: We analyzed data from 40,617 women aged 26 to 30 who underwent cervical screening between 2009 and 2023 in Troms and Finnmark, including 1850 women with high-grade cervical lesions (CIN2+) on biopsy. Using linear regression, we assessed trends in high-grade lesion incidence per 1000 screened women and the association between vaccination status and HPV-16/18 incidence. Results: Between 2017 and 2023, the incidence of high-grade cervical lesions significantly decreased: CIN2+ decreased by 33.4%, and CIN3+ decreased by 63.4%. Significant reductions in HPV-16/18-associated high-grade cervical lesions were observed among vaccinated women, with the proportion of CIN2+ cases due to HPV-16 and 18 decreasing from 56.8% in 2017 to 40.7% in 2023, reflecting a 55.8% reduction in the absolute number of cases caused by these high-risk HPV types. Comparing unvaccinated women aged 25–26 in 2016 and vaccinated women in 2023, HPV-16 incidence decreased from 5.1% to 0.1%, and HPV-18 incidence decreased from 3.3% to 0.0%. Conclusions: The catch-up vaccination program significantly reduced the incidence of HPV-16/18 and high-grade cervical lesions in Troms and Finnmark, even with the lower vaccination coverage observed in the catch-up program. These findings demonstrate the effectiveness of HPV vaccination programs in reducing HPV infections and associated cervical lesions. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adequate knowledge and correct attitudes about the HPV vaccine influence awareness of the importance of preventing HPV-related diseases, which is particularly important for future healthcare professionals. We aim to examine the share of correct answers and the prevalence of different attitudes about the HPV vaccine among active regular students of the Faculty of Medicine in Novi Sad. Methods: A cross-sectional study was conducted from 1 to 30 November 2023 using a structured survey questionnaire. Results: A total of 1760 students were included, of which 78% were female, with an average age of 21 years. Students who participated in prior HPV education) demonstrated significantly higher knowledge (81.92% vs. 65.60%, p < 0.001) and were more likely to recommend the vaccine to patients (89.91% vs. 82.99%, p < 0.001). Almost all vaccinated students (99.41%) would recommend the vaccine, compared to 82.91% of unvaccinated students (p < 0.001). Students who actively sought HPV information also showed a higher likelihood of recommending the vaccine (93.05% vs. 83.02%, p < 0.001). Moreover, those with sufficient self-assessed knowledge were more inclined to recommend the vaccine (89.88%) than those with insufficient knowledge (81.66%, p < 0.001). The analysis demonstrated that an increase in the number of correct answers in the knowledge evaluation corresponds to higher odds of recommending the HPV vaccine to patients (OR = 1.23, 95% CI 1.17–1.28). Positive attitudes prevailed, with 68.89% supporting more education on HPV vaccination. Conclusions: Students who previously attended education on HPV infection/vaccination and those who would recommend the vaccine have significantly higher levels of knowledge. The study highlights the importance of HPV-related education in shaping future healthcare professionals' attitudes and knowledge. [ABSTRACT FROM AUTHOR]

Abstract Background Men’s involvement in and support for women’s decision-making concerning human papillomavirus (HPV) vaccination is crucial. However, the support provided by men to promote HPV vaccination among women, as a crucial part of intimate relationships has received limited attention. This study examined the behaviors and willingness of young Chinese adult men to support HPV vaccination in women and explored potential factors influencing supportive behaviors and willingness. Methods From December 2020 to January 2021, a cross-sectional study was conducted among 1014 young men from eight universities in Zhejiang Province, China. The survey questionnaire assessed behaviors and willingness to support HPV vaccination, HPV-related knowledge, information seeking for male HPV vaccination, attitudes toward women’s vaccination benefits, and sociodemographic variables. Multivariable logistic regression analyses adjusting for all covariates were used to identify factors associated with supportive behaviors and willingness. Results Only 48.4% of respondents reported having acquired and shared information about HPV vaccination with loved ones, whereas 41.3% recommended HPV vaccination. Approximately 80% of the participants without supportive behaviors reported a willingness to support the vaccination. Positive attitudes toward the benefits of women’s HPV vaccination, active seeking of information on male HPV vaccination, and relevant sociodemographic and health-related variables were associated with vaccination-supportive behaviors or willingness. Conclusions Young men expressed a relatively low level of support for female HPV vaccination. Promoting active information seeking regarding HPV vaccination among men and emphasizing the benefits of HPV vaccination for women could potentially foster more supportive behaviors. Targeted health education should include men to promote their involvement in shared decision-making regarding female HPV vaccinations.

Abstract Background All for Them is a theory-based and evidence-informed multilevel, multicomponent program delivered through schools to increase HPV vaccination among medically underserved youth across Texas. Given the potential logistical challenges of program implementation, understanding how to best support the implementation and sustainment of the program is critical. The overall goals of this study are twofold: 1) develop a multifaceted implementation strategy, Implementing All for Them (IM-AFT); and 2) evaluate the impact of IM-AFT on implementation outcomes for schools and healthcare providers to successfully implement All for Them in their respective settings. Methods This study is underpinned by a comprehensive and synergistic conceptual framework. We will use Social Cognitive Theory and the Interactive Systems Framework for Dissemination and Implementation to inform important individual and organizational factors to target as part of implementation strategy development. We will use this formative work and Implementation Mapping, a systematic, iterative process that guides the use of theories, models, and frameworks, to develop IM-AFT. The three core aims of the present study are connected to the five tasks of Implementation Mapping. For Aim 1, we will develop IM-AFT using a community-based participatory research-informed approach, including a qualitative assessment of needs and assets associated with program implementation and identification of behavioral and psychosocial objectives to determine implementation outcomes. For Aim 2, we will use a mixed-methods approach to assess user experience with the IM-AFT prototype to test its feasibility, usability, and acceptability. For Aim 3, we will use a descriptive checklist to assess the impact of IM-AFT on user fidelity of program implementation. Discussion This paper presents the detailed protocol for developing and evaluating IM-AFT to successfully implement All for Them, leveraging a systematic, community- and theory-based approach and user experience with the strategy prototype. This study will contribute to expanding limited scientific knowledge about using multiple sources to develop and evaluate specified implementation strategies for effective implementation of school-based vaccination programs. Theory-based IM-AFT will guide collaborations between schools and community health centers to improve HPV and other adolescent vaccination rates in underserved communities in Texas.

Abstract Introduction Human Papillomavirus is responsible for about 5% of the global cancer burden. In Nigeria, cervical cancer is the second most common cancer among women. The Federal Government of Nigeria and partners recently introduced Human Papillomavirus (HPV) vaccination into routine immunization beginning with 15 States and the Federal Capital Territory. This study assesses HPV vaccine knowledge, attitude and program satisfaction among parents and caregivers of vaccine recipients in Ogun State, Nigeria. Methods This is a cross-sectional study with sample size of 1012 respondents, carried out during the 5-day HPV immunization campaign in all 20 Local Government Areas in Ogun State, Nigeria. Data was collected using interviewer-administered questionnaires. Univariate analysis was done using frequency tables and bivariate analysis using Chi-square test. Multivariate analysis was carried out to identify the determinants of knowledge of HPV, knowledge of cervical cancer and programme satisfaction. Results All the respondents had heard of HPV vaccine and 67.5% had heard of cervical cancer. Eighty-two percent of the respondents heard of HPV vaccine for the first-time during the introduction programme. Eighty-two percent of respondents had good knowledge of HPV vaccine and 47.7% had good knowledge of cervical cancer. Forty-four percent of respondents heard about HPV vaccine via town/market announcers, 36.2% via radio, and 28.6% via social media. Common reasons respondents vaccinated their wards include, because there was a campaign (51.8%), to prevent cervical cancer (48.9%), and because it is free (38.3%). Twenty-nine percent were very satisfied with the HPV vaccination program and 63.2% were satisfied. All the respondents had positive attitude towards HPV vaccination, although 94.1% had heard messages discouraging people from vaccinating their wards. Respondents living in rural communities had higher odds of having good knowledge of HPV vaccine (aOR 2.232, 95% CI 1.527–3.263, p-value ≤ 0.001). Fathers with tertiary education were more likely to be satisfied with the programme (aOR 5.715, 95% CI 1.142–28.589, p-value = 0.034), Conclusion Knowledge of HPV vaccination was high and was informed by the HPV vaccination introduction programme. Use of outreaches, awareness drives, and provision of free vaccines should be intensified to further promote HPV vaccine uptake in Nigeria.

Background A bivalent human papillomavirus vaccine (2vHPV) is currently used in the Netherlands; a nonavalent vaccine (9vHPV) is also licensed.Research design and methods We compared the public health and economic benefits of 2vHPV- and 9vHPV-based vaccination strategies in the Netherlands over 100 years using a validated deterministic dynamic transmission metapopulation model.Results Compared to 2vHPV, the 9vHPV strategy averted an additional 3,245 cases of and 825 deaths from 9vHPV-strain-attributable cancers, 4,247 cases of and 190 deaths from recurrent respiratory papillomatosis (RRP), and 1,009,637 cases of anogenital warts (AGWs), with an incremental cost-effectiveness ratio (ICER) of €4,975 per quality-adjusted life year (QALY) gained. The ICER increased in a scenario with increased HPV vaccination coverage rates and was relatively robust to one-way deterministic sensitivity analyses, with variation in the disease utility parameter having the most impact. When catch-up vaccination for individuals ≤26 years of age was added to the model, vaccinating with 9vHPV averted additional cancers and AGWs compared to 2vHPV vaccination.Conclusion Our analyses predict that transitioning from a 2vHPV- to a 9vHPV-based vaccination strategy would be cost-effective in the Netherlands.

Background: Human papillomavirus (HPV) poses a significant health burden, yet the vaccine which successfully prevents HPV and its associated cancers remains underutilized. Nurses play a crucial role in patient education and advocacy for HPV vaccination. This study explores how knowledge, along with cultural, religious, and social beliefs, shapes the attitudes of Israeli nurses and nursing students toward the HPV vaccine and their advocacy efforts. Methods: A cross-sectional study was conducted from August 2023 to January 2024 using an anonymous online questionnaire distributed via Facebook groups targeting Israeli nurses and nursing students. The questionnaire assessed demographic data, HPV-related knowledge, and attitudes toward HPV vaccination. Results: The study included 458 participants (229 nurses and 229 nursing students). Significant knowledge gaps were found, with 52% of participants incorrectly believing that the vaccine can cure existing infections and 47% mistakenly believing that it is administered in a single dose. Logistic regression revealed that nurses working in community settings were more likely to have positive attitudes toward HPV vaccination (OR = 2.98, 95% CI: 1.84–4.85). Higher levels of HPV-related knowledge (OR = 3.35, 95% CI: 2.10–5.35) and secular or traditional religious affiliations (OR = 2.45, 95% CI: 1.52–3.97) were strongly associated with positive attitudes toward and advocacy for the vaccine. Conclusions: Targeted educational programs addressing knowledge gaps, especially those tailored to Israel’s cultural and religious diversity, are crucial for empowering nurses and nursing students as advocates for HPV vaccination. Enhancing their understanding of HPV can increase vaccine uptake, reduce the incidence of HPV-related diseases, and strengthen public health initiatives in Israel.

Abstract Despite the common belief that human papillomavirus (HPV) primarily affects women, it is imperative to recognize and address the impact of HPV on boys and men. Overlooking the health implications for males is a notable gap, as efforts have predominantly focused on preventing HPV-related infections in women. This commentary aims to emphasize the importance of HPV awareness and vaccination for boys and men by highlighting the prevalence and consequences of HPV infection, elaborating on the associated health risks, elucidating the benefits of vaccination, and urging readers to recognize the necessity of protecting males from HPV. In addition, the increase in HPV-related cancers in men underscores the urgent need for increased awareness and vaccination. Although specific testing for HPV in men is not available, the inclusion of men and boys in gender-neutral vaccination programs can help reduce the harmful effects of this virus in both genders.

Background Human papillomavirus (HPV) vaccination among children and adolescents is crucial for the prevention of HPV-related diseases later in life. However, HPV vaccination uptake remains suboptimal in this population. This protocol outlines a comprehensive review that aims to evaluate the effectiveness of interventions targeting parents and parent-adolescent dyads in improving HPV vaccination uptake among children and adolescents aged 9-18 years. Objective The objective of this study is to assess the impact of parent-directed and parent-adolescent dyad interventions on HPV vaccination uptake in children and adolescents aged 9-18 years. Specific objectives include reviewing existing literature on parent-oriented and parent-adolescent dyad interventions, assessing vaccination uptake, identifying influencing factors, and providing evidence-based recommendations for intervention development and implementation. Methods A systematic review will be conducted, encompassing literature published up to the present day. Various databases will be searched for relevant studies on parent-focused and parent-adolescent dyad interventions aimed at improving HPV vaccination uptake. Data extraction and analysis will be performed to assess the proportion of children and adolescents receiving HPV vaccination following interventions, factors influencing vaccination uptake, and completion rates of the recommended vaccine series. Results The review findings will be analyzed using appropriate statistical methods, including meta-analysis to estimate the overall effect size of interventions. Subgroup and sensitivity analyses will be conducted to explore heterogeneity and assess the robustness of the results. Conclusion This protocol outlines a comprehensive review that will contribute to the current understanding of the effectiveness of parent-oriented and parent-adolescent dyad interventions in improving HPV vaccination uptake among children and adolescents. The findings will inform the development and implementation of targeted interventions to address barriers and improve vaccination coverage, ultimately reducing the burden of HPV-related diseases.

Background: All for Them is a theory-based and evidence-informed multilevel, multicomponent program delivered through schools to increase HPV vaccination among medically underserved youth across Texas. Given the potential logistical challenges of program implementation, understanding how to best support the implementation and sustainment of the program is critical. The overall goals of this study are twofold: 1) develop a multifaceted implementation strategy, Implementing All for Them (IM-AFT); and 2) evaluate the impact of IM-AFT on implementation outcomes for schools and healthcare providers to successfully implement All for Them in their respective settings. Methods: This study is underpinned by a comprehensive and synergistic conceptual framework. We will use Social Cognitive Theory and the Interactive Systems Framework for Dissemination and Implementation to inform important individual and organizational factors to target as part of implementation strategy development. We will use this formative work and Implementation Mapping, a systematic, iterative process that guides the use of theories, models, and frameworks, to develop IM-AFT. The three core aims of the present study are connected to the five tasks of Implementation Mapping. For Aim 1, we will develop IM-AFT using a community-based participatory research-informed approach, including a qualitative assessment of needs and assets associated with program implementation and identification of behavioral and psychosocial objectives to determine implementation outcomes. For Aim 2, we will use a mixed-methods approach to assess user experience with the IM-AFT prototype to test its feasibility, usability, and acceptability. For Aim 3, we will use a descriptive checklist to assess the impact of IM-AFT on user fidelity of program implementation. Discussion: This paper presents the detailed protocol for developing and evaluating IM-AFT to successfully implement All for Them, leveraging a systematic, community- and theory-based approach and user experience with the strategy prototype. This study will contribute to expanding limited scientific knowledge about using multiple sources to develop and evaluate specified implementation strategies for effective implementation of school-based vaccination programs. Theory-based IM-AFT will guide collaborations between schools and community health centers to improve HPV and other adolescent vaccination rates in underserved communities in Texas. [ABSTRACT FROM AUTHOR]

Background: Men's involvement in and support for women's decision-making concerning human papillomavirus (HPV) vaccination is crucial. However, the support provided by men to promote HPV vaccination among women, as a crucial part of intimate relationships has received limited attention. This study examined the behaviors and willingness of young Chinese adult men to support HPV vaccination in women and explored potential factors influencing supportive behaviors and willingness. Methods: From December 2020 to January 2021, a cross-sectional study was conducted among 1014 young men from eight universities in Zhejiang Province, China. The survey questionnaire assessed behaviors and willingness to support HPV vaccination, HPV-related knowledge, information seeking for male HPV vaccination, attitudes toward women's vaccination benefits, and sociodemographic variables. Multivariable logistic regression analyses adjusting for all covariates were used to identify factors associated with supportive behaviors and willingness. Results: Only 48.4% of respondents reported having acquired and shared information about HPV vaccination with loved ones, whereas 41.3% recommended HPV vaccination. Approximately 80% of the participants without supportive behaviors reported a willingness to support the vaccination. Positive attitudes toward the benefits of women's HPV vaccination, active seeking of information on male HPV vaccination, and relevant sociodemographic and health-related variables were associated with vaccination-supportive behaviors or willingness. Conclusions: Young men expressed a relatively low level of support for female HPV vaccination. Promoting active information seeking regarding HPV vaccination among men and emphasizing the benefits of HPV vaccination for women could potentially foster more supportive behaviors. Targeted health education should include men to promote their involvement in shared decision-making regarding female HPV vaccinations. [ABSTRACT FROM AUTHOR]

AbstractIn the United States, HPV vaccination is available for unvaccinated 27 to 45 year olds based on a shared clinical decision with a health care provider. Since the implementation of the guideline, little has been known about provider perceptions of this recommendation. The purpose of this study was to elucidate health care provider perspectives on HPV vaccination for 27 to 45 year olds in the United States. Semi-structured interviews were conducted virtually with 18 health care providers regarding current HPV vaccination practices for 27 to 45 year olds, perceptions of the guideline, and shared clinical decision-making needs. Thematic analysis was conducted using interview transcripts, and interrater reliability was achieved for >10% of the transcripts. Overall, most participants reported that they have recommended HPV vaccination to patients aged 27 to 45 year olds; however, they applied various criteria to guide these discussions. Some participants considered the patients’ relationship statuses, sexual partnerships, past HPV infection history, and age. Potential needs to facilitate shared clinical decision-making processes included medical record prompts and brief educational materials. While most health care providers in this sample discussed HPV vaccination with their patients ages 27 to 45 years old, there were inconsistencies in the interpretation of the guideline. The lack of specificity in the recommendation will likely result in significant and potentially inequitable implementation difficulties. [ABSTRACT FROM AUTHOR]

Introduction: Human Papillomavirus is responsible for about 5% of the global cancer burden. In Nigeria, cervical cancer is the second most common cancer among women. The Federal Government of Nigeria and partners recently introduced Human Papillomavirus (HPV) vaccination into routine immunization beginning with 15 States and the Federal Capital Territory. This study assesses HPV vaccine knowledge, attitude and program satisfaction among parents and caregivers of vaccine recipients in Ogun State, Nigeria. Methods: This is a cross-sectional study with sample size of 1012 respondents, carried out during the 5-day HPV immunization campaign in all 20 Local Government Areas in Ogun State, Nigeria. Data was collected using interviewer-administered questionnaires. Univariate analysis was done using frequency tables and bivariate analysis using Chi-square test. Multivariate analysis was carried out to identify the determinants of knowledge of HPV, knowledge of cervical cancer and programme satisfaction. Results: All the respondents had heard of HPV vaccine and 67.5% had heard of cervical cancer. Eighty-two percent of the respondents heard of HPV vaccine for the first-time during the introduction programme. Eighty-two percent of respondents had good knowledge of HPV vaccine and 47.7% had good knowledge of cervical cancer. Forty-four percent of respondents heard about HPV vaccine via town/market announcers, 36.2% via radio, and 28.6% via social media. Common reasons respondents vaccinated their wards include, because there was a campaign (51.8%), to prevent cervical cancer (48.9%), and because it is free (38.3%). Twenty-nine percent were very satisfied with the HPV vaccination program and 63.2% were satisfied. All the respondents had positive attitude towards HPV vaccination, although 94.1% had heard messages discouraging people from vaccinating their wards. Respondents living in rural communities had higher odds of having good knowledge of HPV vaccine (aOR 2.232, 95% CI 1.527–3.263, p-value ≤ 0.001). Fathers with tertiary education were more likely to be satisfied with the programme (aOR 5.715, 95% CI 1.142–28.589, p-value = 0.034), Conclusion: Knowledge of HPV vaccination was high and was informed by the HPV vaccination introduction programme. Use of outreaches, awareness drives, and provision of free vaccines should be intensified to further promote HPV vaccine uptake in Nigeria. Plain language summary: Human Papillomavirus (HPV) vaccine was recently introduced into routine immunization in Nigeria, beginning with 15 States in the first phase. This study was carried out among 1012 parents/caregivers of adolescent girls who received the vaccine during the 5 days of the HPV immunization campaign in Ogun State, Nigeria. The study assessed the knowledge of HPV vaccine, attitude towards HPV vaccine and satisfaction with the HPV vaccination introduction programme among these parents/caregivers. Questions were asked using a questionnaire by interviewers. All the respondents had heard of HPV vaccine and majority heard about the vaccine, the first time during the vaccine introduction activities. Most of the respondents had good knowledge of HPV vaccine (82.4%) and 47.7% had good knowledge of cervical cancer. Common sources of information on the HPV vaccine were via town/market announcers, via radio, and via social media. All the respondents had positive attitude towards cervical cancer, even though 94.1% had heard messages discouraging parents from vaccinating their wards. Majority heard such discouraging messages via WhatsApp. Common reasons parents/caregivers vaccinated their wards were: because there was a campaign, to prevent cervical cancer, and because it is free. Majority of respondents were very satisfied with the HPV vaccination program. The HPV vaccination introduction programme contributed to high knowledge of HPV vaccine. Use of outreaches, awareness drives, and provision of free vaccines should be intensified to promote HPV vaccine uptake in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) poses a significant health burden, yet the vaccine which successfully prevents HPV and its associated cancers remains underutilized. Nurses play a crucial role in patient education and advocacy for HPV vaccination. This study explores how knowledge, along with cultural, religious, and social beliefs, shapes the attitudes of Israeli nurses and nursing students toward the HPV vaccine and their advocacy efforts. Methods: A cross-sectional study was conducted from August 2023 to January 2024 using an anonymous online questionnaire distributed via Facebook groups targeting Israeli nurses and nursing students. The questionnaire assessed demographic data, HPV-related knowledge, and attitudes toward HPV vaccination. Results: The study included 458 participants (229 nurses and 229 nursing students). Significant knowledge gaps were found, with 52% of participants incorrectly believing that the vaccine can cure existing infections and 47% mistakenly believing that it is administered in a single dose. Logistic regression revealed that nurses working in community settings were more likely to have positive attitudes toward HPV vaccination (OR = 2.98, 95% CI: 1.84–4.85). Higher levels of HPV-related knowledge (OR = 3.35, 95% CI: 2.10–5.35) and secular or traditional religious affiliations (OR = 2.45, 95% CI: 1.52–3.97) were strongly associated with positive attitudes toward and advocacy for the vaccine. Conclusions: Targeted educational programs addressing knowledge gaps, especially those tailored to Israel's cultural and religious diversity, are crucial for empowering nurses and nursing students as advocates for HPV vaccination. Enhancing their understanding of HPV can increase vaccine uptake, reduce the incidence of HPV-related diseases, and strengthen public health initiatives in Israel. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer remains a significant global health concern, with some types of human papillomavirus (HPV) infection playing a pivotal role in its etiology. This research was conducted to explore the awareness and knowledge regarding Pap tests and HPV typing as screening tools for Cervical Cancer in Edo North, Nigeria. Methods: Data was collected with the use of a pretested structured questionnaire that includes open ended and close ended response format to assess knowledge. Data was analyzed using the IBM SPSS version 29. Results: This study utilized a descriptive cross-sectional study design with 113 participants aged 25–65 years. A significant knowledge gap regarding the purpose of Pap tests and HPV testing was observed, with only 32.7% of participants aware of their purpose. Only 20.4% of participants had undergone cervical screening, with inconsistencies in screening frequency. HPV vaccination rates were low, with only one vaccinated individual. Conclusion: This study reveals a concerning low level of awareness and knowledge among participants regarding Pap tests and HPV testing in cervical cancer screening. These findings emphasize the need for improved education and communication about cervical cancer screening methods to empower individuals to make informed decisions about their healthcare. [ABSTRACT FROM AUTHOR]

Despite the common belief that human papillomavirus (HPV) primarily affects women, it is imperative to recognize and address the impact of HPV on boys and men. Overlooking the health implications for males is a notable gap, as efforts have predominantly focused on preventing HPV-related infections in women. This commentary aims to emphasize the importance of HPV awareness and vaccination for boys and men by highlighting the prevalence and consequences of HPV infection, elaborating on the associated health risks, elucidating the benefits of vaccination, and urging readers to recognize the necessity of protecting males from HPV. In addition, the increase in HPV-related cancers in men underscores the urgent need for increased awareness and vaccination. Although specific testing for HPV in men is not available, the inclusion of men and boys in gender-neutral vaccination programs can help reduce the harmful effects of this virus in both genders. [ABSTRACT FROM AUTHOR]

This study was conducted to determine women's health beliefs about HPV and HPV vaccination and factors associated with health beliefs. This cross‐sectional study was conducted with 300 women aged 21–64 in Turkey. Data were collected using the human papillomavirus (HPV) knowledge scale (HPV‐KS) and the health belief model scale for human papillomavirus and its vaccination (HBMS‐HPVV). The mean age of the women who participated in the study was 35.16 ± 9.52 years. Of them, 72.3% heard of the HPV test, 30.3% had an HPV test, 62% heard of HPV vaccination, and 9.7% had HPV vaccination. Educational level, hearing about the HPV vaccine, and HPV knowledge level were significant predictors of perceived benefit (p <.001). HPV knowledge level significantly predicted perceived susceptibility (p <.001). HPV knowledge level and hearing about HPV tests and vaccines were significant predictors of perceived severity (p <.001). A high level of education, a high level of HPV knowledge, and hearing about HPV tests and the HPV vaccine positively affect women's health beliefs. Health belief model‐based education programs should be used to improve women's HPV knowledge and health beliefs about HPV and the HPV vaccine. In addition to women's health beliefs, cervical cancers can only be prevented by including the HPV vaccine in national immunization programs and increasing the coverage of HPV screening tests. [ABSTRACT FROM AUTHOR]

Purpose: Human papillomavirus (HPV) is the most common sexually transmitted infection, responsible for multiple HPV-related diseases, including almost all cervical cancers. The highly effective HPV vaccination has been recommended under the German HPV national immunization program (NIP) since 2007 and is reimbursed by health insurances. Vaccination uptake rates, however, remain suboptimal and data on the real-world impact of HPV vaccination in Germany are lacking. This study aims to demonstrate the population-level impact of Germany's NIP on HPV-related anogenital diseases among young women. Methods: Retrospective claims data analysis using a classic impact study design comparing disease prevalence among 28- to 33-year-old women before and after introduction of the HPV-immunization program in Germany. Claims data representing approximately two thirds of German health insurances were used. HPV-related disease outcomes included cervical cancer and high grade precancers (cervical intraepithelial neoplasia (CIN) 2+), anogenital warts, as well as vulvar, vaginal, and anal precancer/cancer. Results: Significant declines were seen for CIN2+, anogenital warts, and vaginal precancer/cancer. Prevalence of CIN2+ declined 51.1% from 0.92% (95% CI = 0.78%, 1.08%) to 0.45% (95% CI = 0.38%, 0.53%). There was a 38.6% decline in anogenital warts prevalence from 0.44% (95% CI = 0.36%, 0.54%) to 0.27% (95% CI = 0.22%, 0.32%) and 75.0% decline in vaginal precancer/cancer prevalence from 0.04% (95% CI = 0.02%, 0.07%) to 0.01% (95% CI = 0.00%, 0.02%). Conclusion: The German HPV-immunization program has led to significant declines in female anogenital disease among young women in Germany, highlighting the importance of the vaccination. Moreover, the data suggest that increasing vaccination coverage in Germany could further strengthen the public-health impact of its HPV-immunization program. [ABSTRACT FROM AUTHOR]

The study experimentally tested an intervention that debunks epistemically suspect beliefs about vaccines. After answering questions about pre‐existing epistemically suspect beliefs (irrational health beliefs and conspiracy mentality), 565 participants were randomly assigned into one of three conditions and exposed either to neutral information about domestic animals, salient epistemically suspect content about vaccination or an intervention that debunks epistemically suspect beliefs about vaccination. Afterwards, the participants answered questions about vaccination‐related conspiracy narratives (manipulation check), vaccination attitudes, intentions to vaccinate against HPV, support for an HPV vaccination programme and intentions to seek health guidance. Although the intervention demonstrated the potential to inhibit the endorsement of conspiracy narratives, we found no differences in the other outcome variables. Nevertheless, across the conditions, pre‐existing epistemically suspect beliefs were associated with less favourable attitudes towards vaccination, lower intentions to vaccinate against HPV, less support for the vaccination programme and lower intentions to seek health guidance. The results indicate that debunking may be futile in curbing long‐term negative impacts associated with epistemically suspect beliefs, and they contribute to the debate about assessing the effectiveness of interventions related to highly controversial topics such as vaccination. The study enhances understanding of persistent adverse impacts that epistemically suspect beliefs may have on public health outcomes. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) vaccination has been offered in over a hundred countries worldwide (including the United Kingdom, since September 2008). Controversy around adverse effects persists, with inconsistent evidence from follow-up of randomized controlled trials and confounding by indication limiting the conclusions drawn from larger-scale observational studies. This study aims to estimate the association between receiving a quadrivalent HPV vaccine and the reporting of short-term adverse effects and to demonstrate the utility of regression discontinuity design for examining side effects in routine data. Methods: We applied a novel regression discontinuity approach to a retrospective population-based cohort using primary care data from the UK Clinical Practice Research Datalink linked to hospital and social deprivation data. We examined the new onset of gastrointestinal, neuromuscular, pain, and headache/migraine symptoms using READ and International Classification of Diseases, tenth revision diagnostic codes. For each year between 2012 and 2017, we compared girls in school year 8 (born July/August) who were eligible to receive the vaccine with girls in year 7 (born September/October) who were not eligible. Results: Of the 21,853 adolescent girls in the cohort, 10,881 (50%) were eligible for HPV vaccination. There was no evidence of increased new gastrointestinal symptoms (adjusted odds ratio [OR]: 0.99; 95% confidence interval [CI]: 0.85, 1.15), headache/migraine symptoms (OR: 0.84; 95% CI: 0.70, 1.01), or pain symptoms (OR: 1.05; 95% CI: 0.95, 1.16) when comparing those eligible and ineligible for HPV vaccination. Conclusion: This study found no evidence that HPV vaccination eligibility is associated with reporting short-term adverse effects among adolescent girls. [ABSTRACT FROM AUTHOR]

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Human papillomavirus (HPV) is a widespread viral pathogen, responsible for a significant burden of cervical and other cancers worldwide. Over the past decades, the development and widespread adoption of prophylactic HPV vaccines have dramatically reduced the incidence of HPV-related diseases. However, despite the efficacy of these vaccines, global immunization efforts still face several obstacles, including low vaccination coverage in low- and middle-income countries, vaccine hesitancy, and disparities in access to healthcare. This review aims to provide a comprehensive overview of the current state of HPV vaccines, including their mechanisms of action, safety profiles, and real-world efficacy. We will explore the impact of HPV vaccines on cancer prevention, examine the challenges related to vaccine distribution and uptake, and assess the role of public health policies in improving global vaccination rates. Additionally, the review will highlight the latest advancements in therapeutic HPV vaccines, ongoing research into next-generation vaccines, and the potential of HPV vaccination strategies in the context of personalized medicine. By examining these factors, we aim to provide insights into the future directions of HPV vaccination and its role in global public health. [ABSTRACT FROM AUTHOR]

Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. Methods: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer's perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. Results: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11–24-year-old girls, which had an ICER of US$78.73/DALYs averted. Conclusions: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya. [ABSTRACT FROM AUTHOR]

Objective of the study: to assess the awareness of human papilloma virus (HPV) infection and HPV-related diseases among the parents of children aged 9-18 years and adults, to determine the level of readiness to be vaccinated and to vaccinate their children against HPV; to identify existing barriers to this, and to explore how war affects perceptions of vaccination. Materials and methods. A qualitative exploratory research was conducted. The data were collected through focus group discussions. Parents of children aged 9-18 and adults (men aged 18-26, women aged 18-45) took part in the research. Results. Most respondents were aware of HPV infection and HPV-related diseases, adult women and parents of children aged 9-18 years were more aware than adult men. However, the level of knowledge was limited and generally insufficient. The majority of respondents recognize HPV as a serious problem that leads to cancer, but the opinion that HPV is not a big problem was quite often expressed among adults and parents. Only a part of the interviewed women was informed about HPV by gynecologists, while men did not receive any data on this issue from health workers at all. The research revealed an extremely low level of awareness among adults and parents of children about the availability of HPV vaccination and its features. Adults and parents explained their ignorance in this matter by the fact that doctors mostly do not tell patients about this vaccine and do not recommend vaccination against HPV. The vast majority of parents did not want to vaccinate their children against HPV due to the lack of information about its effectiveness and safety. But they were more likely to reconsider their decision after receiving more information about the vaccine. Less often, parents reported a potential willingness to vaccinate their child against HPV. Common barriers to vaccination are primarily related to doubts about vaccine safety, mistrust of the medical system and vaccine manufacturers, and lack of knowledge about how vaccines work, what they are made of, and how they affect the body. However, parents and adults overwhelmingly believe that their attitudes toward HPV vaccination will improve if free vaccination is introduced. In the regions closest to hostilities (East, South) the situation with vaccination during the war worsened to a greater extent than in other regions. Most adults did not change their attitudes about vaccination during the war, and for a minority of them vaccination became less important. A third of parents reported that the relevance and importance of vaccination for them decreased, for a third it remained unchanged, and for another third it increased. Conclusions. Widespread and insufficient awareness of HPV infection and HPV-related diseases among parents of children aged 9-18 years and adults. Adults and parents base their assumptions that HPV is not a serious problem on the lack of objective information from doctors, as well as in the mass media or social networks. Most adults and parents of children aged 9-18 are not currently ready to vaccinate themselves or their children against HPV. The war affected both access to vaccination and the perception of the relevance of vaccination, depending on the distance of the region of residence from the front line. Vaccination access decreased in regions near active hostilities, in small cities and rural areas. Efforts are needed to increase awareness of HPV vaccination, including the importance of informing parents and adults about the HPV vaccine, timely vaccination, and regular screenings. [ABSTRACT FROM AUTHOR]