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Increases in human papillomavirus vaccine coverage over 12 months among a community-recruited cohort of gay, bisexual, and other men who have sex with men in Canada.
Chambers, Catharine; Deeks, Shelley L; Sutradhar, Rinku; Cox, Joseph; de Pokomandy, Alexandra; Grennan, Troy; Hart, Trevor A; Lambert, Gilles; Moore, David M; Coutlée, François; Grace, Daniel; Grewal, Ramandip; Jollimore, Jody; Lachowsky, Nathan; Nisenbaum, Rosane; Ogilvie, Gina; Sauvageau, Chantal; Tan, Darrell H S; Burchell, Ann N.
  • Chambers C; University of Toronto, Toronto, Ontario, Canada; Unity Health Toronto, Toronto, Ontario, Canada.
  • Deeks SL; University of Toronto, Toronto, Ontario, Canada; Government of Nova Scotia, Halifax, Nova Scotia, Canada; Dalhousie University, Halifax, Nova Scotia, Canada.
  • Sutradhar R; University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada.
  • Cox J; McGill University, Montréal, Québec, Canada; Direction régionale de santé publique de Montréal, Montréal, Québec, Canada.
  • de Pokomandy A; McGill University, Montréal, Québec, Canada.
  • Grennan T; British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada.
  • Hart TA; University of Toronto, Toronto, Ontario, Canada; Toronto Metropolitan University (formerly Ryerson University), Toronto, Ontario, Canada.
  • Lambert G; Direction régionale de santé publique de Montréal, Montréal, Québec, Canada.
  • Moore DM; British Columbia Centre for Excellence in HIV/AIDS, Vancouver British Columbia, Canada.
  • Coutlée F; Université de Montréal, Montréal, Québec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
  • Grace D; University of Toronto, Toronto, Ontario, Canada.
  • Grewal R; University of Toronto, Toronto, Ontario, Canada; Unity Health Toronto, Toronto, Ontario, Canada.
  • Jollimore J; Community-Based Research Centre, Vancouver, British Columbia, Canada.
  • Lachowsky N; University of Victoria, Victoria, British Columbia, Canada.
  • Nisenbaum R; University of Toronto, Toronto, Ontario, Canada; Unity Health Toronto, Toronto, Ontario, Canada.
  • Ogilvie G; British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada.
  • Sauvageau C; Institut national de santé publique du Québec, Québec, Québec, Canada.
  • Tan DHS; Unity Health Toronto, Toronto, Ontario, Canada.
  • Burchell AN; University of Toronto, Toronto, Ontario, Canada; Unity Health Toronto, Toronto, Ontario, Canada. Electronic address: Ann.Burchell@unityhealth.to.
Vaccine ; 40(26): 3690-3700, 2022 06 09.
Article in English | MEDLINE | ID: covidwho-1873318
ABSTRACT

BACKGROUND:

Starting in 2015/16, most Canadian provinces introduced publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) aged ≤ 26 years. We estimated 12-month changes in HPV vaccine coverage among community-recruited GBM from 2017 to 2021 and identified baseline factors associated with vaccine initiation (≥1 dose) or series completion (3 doses) among participants who were unvaccinated or partially vaccinated at baseline.

METHODS:

We recruited sexually-active GBM aged ≥ 16 years in Montreal, Toronto, and Vancouver, Canada, from 02/2017 to 08/2019 and followed them over a median of 12 months (interquartile range = 12-13 months). We calculated the proportion who initiated vaccination (≥1 dose) or completed the series (3 doses) by 12-month follow-up. Analyses were stratified by city and age-eligibility for the publicly-funded programs at baseline (≤26 years or > 26 years). We used multivariable logistic regression to identify baseline factors associated with self-reported incident vaccine initiation or series completion.

RESULTS:

Among 165 unvaccinated participants aged ≤ 26 years at baseline, incident vaccine initiation (≥1 dose) during follow-up was 24.1% in Montreal, 33.3% in Toronto, and 38.9% in Vancouver. Among 1,059 unvaccinated participants aged > 26 years, incident vaccine initiation was 3.4%, 8.9%, and 10.9%, respectively. Higher education and trying to access pre-exposure prophylaxis for HIV were associated with incident vaccination among those aged ≤ 26 years, while younger age, residing in Vancouver (vs. Montreal), being diagnosed with anogenital warts, having both government and private extended medical insurance, and being vaccinated against influenza were associated with incident vaccination among those aged > 26 years.

CONCLUSIONS:

We observed substantial gains in HPV vaccine coverage among young GBM within 5 + years of targeted program implementation, but gaps remain, particularly among older men who are ineligible for publicly-funded programs. Findings suggest the need for expanded public funding or insurance coverage for HPV vaccines.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Papillomavirus Infections / Papillomavirus Vaccines / Sexual and Gender Minorities Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Humans / Male Country/Region as subject: North America Language: English Journal: Vaccine Year: 2022 Document Type: Article Affiliation country: J.vaccine.2022.05.019

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Papillomavirus Infections / Papillomavirus Vaccines / Sexual and Gender Minorities Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Humans / Male Country/Region as subject: North America Language: English Journal: Vaccine Year: 2022 Document Type: Article Affiliation country: J.vaccine.2022.05.019