Human Papillomavirus vaccination coverage among the female population living in the state of Goiás, Brazil, 2014-2020: a time series study / Cobertura de vacunación contra el Virus del Papiloma Humano en la población femenina residente em el estado de Goiás, Brasil, 2014-2022: serie temporal / Cobertura da vacina contra papilomavírus humano na população feminina residente no estado de Goiás, 2014-2022: série temporal

Abstract Objective: To analyze the temporal trend of human papillomavirus (HPV) vaccination coverage among the female population aged 10 to 14 years, living in the state of Goiás, Brazil, between 2014 and 2022. Methods: This was an ecological time series study using data from the Brazilian National Health System Information Technology Department (Departamento de Informática do Sistema Único de Saúde - DATASUS); the annual vaccination coverage rate was calculated based on the number of second doses administered; the trend of the rates was analyzed using the Prais-Winsten model. Results: A total of 407,217 second doses of the quadrivalent HPV vaccine were administered to the female population aged 10-14 years, with annual vaccination coverage rates ranging from 12.3% (2019) to 30.0% (2015), and an annual percentage change (APC) of 0.7% (95%CI 0.9; 0.2; p-value = 0.030). Conclusion: In Góias state, the quadrivalent HPV vaccine coverage rate was below the national target (80%), showing a stationary trend in the time series.

Resumen Objetivo: Analizar la tendencia temporal de la cobertura de la vacuna contra el virus del papiloma humano (VPH), en la población femenina en Goiás, Brasil, entre 2014 y 2022. Métodos: Estudio de serie temporal con datos del Departamento de Informática del Sistema Único de Salud (Datasus); la tasa de cobertura vacunal anual fue calculada por el número de segundas dosis administradas y para el análisis de tendencias se utilizó Prais-Winsten. Resultados: Se administraron 407.217 segundas dosis de la vacuna tetravalente contra el VPH en la población femenina de 10 a 14 años en Goiás, con tasas de cobertura vacinal anual variando entre 12,3% (2019) y 30,0% (2015), y una variación porcentual anual (VPA) de 0,7% (IC95% 0,9;0,2; p-valor = 0,030). Conclusión: La tasa de cobertura de la vacuna tetravalente contra el VPH en Goiás quedó por debajo de la meta nacional (80%), con tendencia estacionaria en la serie temporal.

Resumo Objetivo: Analisar a tendência temporal da cobertura da vacina contra o papilomavírus humano (human papillomavirus, ou HPV), na população feminina com idade de 10 a 14 anos, residente no estado de Goiás, Brasil, entre 2014 e 2022. Métodos: Estudo ecológico de série temporal com dados obtidos do Departamento de Informática do Sistema Único de Saúde (Datasus); calculou-se a taxa de cobertura vacinal anual considerando-se o número de segundas doses administradas; a tendência das taxas foi analisada utilizando-se o modelo de Prais-Winsten. Resultados: Foram aplicadas 407.217 segundas doses da vacina quadrivalente contra HPV na população feminina de 10-14 anos, com taxas de cobertura vacinal anual a variar entre 12,3% (2019) e 30,0% (2015), e uma variação percentual anual (VPA) de 0,7% (IC95% 0,9;0,2; p-valor = 0,030). Conclusão: Em Goiás, a taxa de cobertura da vacina quadrivalente contra HPV esteve aquém da meta nacional (80%), com tendência estacionária da série temporal.

Comparación de protocolos de vacunación contra el virus del papiloma humano en Ecuador y América Latina / Comparation of vaccination protocols against the human papillomavirus in Ecuador and Latin America

INTRODUCCIÓN: El virus del papiloma humano (VPH), con más de 100 tipos, es de transmisión sexual. Varios países de América Latina han introducido las vacunas contra el VPH. Aunque América Latina es la región que más rápido avanzó en la vacunación contra el VPH, sus sistemas de seguimiento y vigilancia son aún deficientes. OBJETIVO: Comparar las diferentes estrategias de vacunación contra el VPH en Ecuador y América Latina. MÉTODO: Revisión bibliográfica, en la que se obtuvo información de documentos gubernamentales y artículos indexados en los últimos 5 años sobre las estrategias de vacunación contra el VPH en Ecuador y América Latina. RESULTADOS: La mayoría de los países de América Latina han logrado introducir la vacuna contra el VPH, excepto Venezuela, Martinica, Haití, Nicaragua y Cuba. CONCLUSIONES: Los protocolos de vacunación de Ecuador y América Latina necesitan mejorar sus sistemas de seguimiento y aumentar la expansión de datos de cobertura disponibles de manera consistente. Actualmente siguen existiendo desafíos para introducir las vacunas, lograr una alta cobertura y fortalecer el seguimiento, la evaluación y la notificación.

INTRODUCTION: The human papilloma virus (HPV), with more than 100 types, is a sexual transmission infection. Many Latin American countries have introduced the vaccines against the HPV. Although Latin América is the region which advanced faster against the HPV, its surveillance and follow-up systems are yet deficient. OBJECTIVE: To compare the different strategies to assume the vaccination against the HPV in Ecuador and Latin America. METHOD: Bibliographic review, in which information was obtained from government documents and articles indexed in the last five years on vaccination strategies against HPV in Ecuador and Latin America. RESULTS: Most Latin American countries have managed to introduce the vaccine against the HPV, except Venezuela, Martinica, Haiti, Nicaragua and Cuba. CONCLUSIONS: The vaccination protocols of Ecuador and Latin América need to improve their systems of follow-up and monitoring, and increase the expansion of available data in a consistent manner. Now, there are still existing challenges to introduce the vaccines, manage a high reach and fortify the follow-up, the evaluation, and the notification.

Awareness of HPV and HPV vaccines, acceptance to vaccination and its influence factors among parents of adolescents 9 to 18 years of age in China: A cross-sectional study.

BACKGROUND: Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake. METHODS: A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed. RESULTS: More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV. CONCLUSIONS: Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents. PRACTICE IMPLICATIONS: Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination.

Evaluation of Polish Adolescents' Knowledge About Human Papillomavirus and Vaccines.

Purpose: Human papillomavirus (HPV) vaccination can prevent more than 90% of cancers caused by HPV. However, they are still not common in Poland. The aim of the study was to evaluate Polish youths' knowledge of HPV vaccine and sexually transmitted diseases (STD). Methods: The cross-sectional study was performed with the use of an anonymous and voluntary survey distributed among 610 graduate high-school students, and 491 (81%) responded. Results: Only 24% were aware of potential oncological risk of HPV infection. Nearly all responders indicated HIV/AIDS as STD, while only 14% indicated HPV as well. In the opinion of 94% participants, vaccines are effective and safe, however, only 8% of girls and 5% of boys claimed that they were vaccinated against HPV. Simultaneously, 43% declared the will to vaccinate their own child in the future. As a barrier in performing HPV vaccinations, participants indicated first of all lack of enough knowledge (64%) and lack of awareness of the need to be vaccinated (51%). The main sources of knowledge about health were internet (93%) and school (67%). Only 10% of the participants had discussed the HPV and vaccine with a doctor. These adolescents had more knowledge about cervical cancer (P = 0.0002) and its relation to HPV infection (P = 0.0001). Conclusions: Polish adolescents present positive attitude toward HPV vaccines but their knowledge is still unsatisfactory. Schools and professional health providers should pay more attention to patient's education as well as developing online campaigns.

Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts.

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.

Preferences for Sexually Transmitted Infection and Cancer Vaccines in the United States and in China.

OBJECTIVES: This study assessed preferences for hypothetical vaccines for children in 2 large vaccine markets according to how the vaccine-preventable disease is transmitted via a discrete choice experiment. METHODS: Surveys in China (N = 1350) and the United States (N = 1413) were conducted from April to May 2021. The discrete choice experiment included attributes of cost, age at vaccination, transmission mode of the vaccine-preventable disease, and whether the vaccine prevents cancer. Preference utilities were modeled in a Bayesian, multinomial logistic regression model, and respondents were grouped by vaccine preference classification through a latent class analysis. RESULTS: Individuals favored vaccines against diseases with transmission modes other than sexual transmission (vaccine for sexually transmitted infection [STI] vs airborne disease, in the United States, odds ratio 0.71; 95% credible interval 0.64-0.78; in China, odds ratio 0.76; 95% credible interval 0.69-0.84). The latent class analysis revealed 6 classes: vaccine rejecters (19% in the United States and 8% in China), careful deciders (18% and 17%), preferring cancer vaccination (20% and 19%), preferring vaccinating children at older ages (10% and 11%), preferring vaccinating older ages, but indifferent about cancer vaccines (23% and 25%), and preferring vaccinating children at younger ages (10% and 19%). Vaccine rejection was higher with age in the United States versus more vaccine rejection among those at the age of 18 to 24 and ≥ 64 years in China. CONCLUSION: The public had strong preferences against giving their child an STI vaccine, and the class preferring a cancer vaccine was less accepting of an STI vaccine. Overall, this study points to the need for more education about how some STI vaccines could also prevent cancers.

Awareness about Human Papillomavirus Vaccine and Its Uptake among Women from North India: Evidence from a Cross-Sectional Study.

OBJECTIVE: This study aims to estimate the prevalence of human papillomavirus (HPV) vaccine usage and determine the factors for awareness about HPV vaccine among women in reproductive age group. METHODS: This is a cross-sectional survey under a cervical cancer prevention study. The sample size was 1020 women, aged 15-49 years [550 in Delhi and 470 in Rohtak]. Bivariate analysis and Fisher exact test along with binary logistic regression analysis were used to determine the factors for awareness. RESULT: About 18.0 % [Delhi: 24.2 % and Rohtak: 10.9 %] of the respondents had heard about the vaccine against cervical cancer. The women aged more than 30 years [AOR: 1.35; CI: 0.94, 1.94] were more likely to be aware of cervical cancer vaccine as compare to women of 30 years and less. However, the women from Rohtak [AOR: 0.90; CI: 0.48, 1.66] were less likely to be aware of vaccine against cervical cancer in reference to women aged 30 years and more [AOR: 1.61; CI: 1.01, 2.56] from Delhi. About 0.6 % [Delhi: 1.1 % and Rohtak: 0.0 %] of the respondents had received HPV vaccine. CONCLUSION: Women tend to have limited knowledge about cervical cancer vaccine and immunisation practices. The women's demographic makeup varied significantly between the two sites, i.e , Rohtak and Delhi, which had an impact on how well they understood and utilised the cervical cancer vaccination. It is worth mentioning that none of the women from Rohtak had received the immunisation. The awareness of the cervical cancer vaccine among women from the Rohtak was lower than the Delhi women.

The Prevalence of High-Risk Human Papillomavirus in Hungary-A Geographically Representative, Cross-Sectional Study.

Background: The estimated age-standardized incidence and mortality rates of cervical cancer in Hungary are substantially higher than the European average. In many countries, human papillomavirus (HPV) testing is the first-line method of cervical cancer screening in women >30 years. According to the European guidelines, evidence-based improvement of a national prevention strategy requires the monitoring of representative data. Methods: ThinPrep cervical samples were collected over a period of 8 months at 84 sampling sites, including 4,000 eligible samples with valid laboratory results from the screening target population of females aged 25-65 years, with addresses in the representative geographic area (19 counties and four major settlement types). Genotyping of high-risk HPV (hrHPV) was performed using the Confidence HPV-X (Neumann Diagnostics) and Linear Array HPV Genotyping (Roche) tests. Demographic data were collected using a questionnaire, enabling the analysis of hrHPV genotype distribution by age, geography, education, and HPV vaccination. Results: Overall, 446 samples were hrHPV-positive, showing a prevalence of 11.15% (9.73% age-representative), similar to the world average, higher than the European average, and lower than the Eastern-European average. After age standardization, no significant geographic differences were found, except for low hrHPV prevalence in villages (p = 0.036) and in those with elementary education (p = 0.013). Following genotypes 16 and 31, in order of frequency, certain non-vaccine hrHPV genotypes (HPV51, 66, 56) showed unexpectedly higher prevalence than international data. Conclusion: Our study provides the first geographically representative genotype-specific hrHPV prevalence baseline database in Hungary to support policy-making efforts. Significant correlations with demographic data have transferable conclusions.

Knowledge and Awareness of Polish Parents on Vaccination against Human Papillomavirus.

Background: Human papillomavirus (HPV) vaccinations are rare among Polish children, and the reasons are scant. The objective was to evaluate the knowledge, attitude and awareness of parents about HPV vaccination to investigate reasons for low HPV vaccination coverage. Methods: 387 parents of children hospitalized at the Children's Hospital were asked to participate in an anonymous and voluntary survey study. Three hundred and two surveys were returned. Results: Only 54% of participants have heard about HPV, while 26% know that it is a sexually transmitted disease. According to 71% of responders, vaccines are generally effective, and 63% claim that they are safe. However, only 5% of daughters and 4% of sons are vaccinated against HPV. A total of 25% of parents spoke with their doctor about HPV-related diseases and prevention methods. A higher level of education (p = 0.01), knowledge of sexually transmitted diseases (p < 0.0001), perceiving vaccination as an effective and safe prophylactic method (p < 0.0001), and conversations with a doctor (p < 0.0001) are strong motivators to vaccinate children against HPV. This decision is free of religious beliefs, origin, age, gender and the number of children. Conclusions: Polish parents have a positive attitude towards vaccination. They recognize the limitations of their knowledge and express a desire to further it. Educational activity is an important element of physicians' work.

Knowledge, Attitudes and Behaviors of Women who have or have not had human papillomavirus vaccine in Turkey about the Virus and the vaccine.

The awareness of Human Papillomavirus (HPV), the most common sexually transmitted disease in the world, and the frequency of vaccination vary across countries. In Turkey, the rate of HPV vaccination is quite low even amongin women, and there is not much data on the frequency of vaccination among men. This study aimedto investigate the difference in knowledge and attitude between Turkish women who had HPV vaccination and those who did not. Women between 18 and 65 living in a province in the central region of Turkey were included. Participants (n = 856) were selected by snowball sampling and with an online questionnaire. The collected data were analyzed by the SPSS programme. Descriptive statistical analysis, chi-square test, T-test for independent samples and one-way ANOVA was used. 67.3% of the participants had heard of HPV and 55.4% had heard of the HPV vaccine. The HPV vaccination rate was 3.6%. The most important source of information for those who reported getting vaccinated on HPV was their family physician. Additionally, the HPV Knowledge Scale total scores of those who received information from family physicians and gynecologists were higher than the others. The most frequent reasons they cited for not getting vaccinated were a lack of information and not having the vaccine covered by social security. It is important to include it in the national vaccination scheme in order to increase the HPV vaccination rate in low-income countries such as Turkey. Also, these findings show the prominence of family physicians in public education.

Human Papillomavirus Vaccination Status and Parental Endorsement Intentions among Undergraduate Student Nurses.

We identified factors associated with student nurses' Human Papillomavirus Vaccine (HPV) vaccination status and their intention to counsel parents on HPV vaccination. Undergraduate student nurses (N = 153) from a large university in the south participated. Descriptive statistics, chi-squared tests, and independent t-tests (p ≤ 0.05) were used to characterize the students' vaccination status. Logistic regression was used to identify factors associated with vaccination status. HPV vaccination rates were low. Students who were older and married or living with a partner were less likely to have completed the HPV vaccine series. The most commonly cited reason for non-initiation and non-completion was the lack of provider endorsement. Vaccination status did not differ significantly according to race/ethnicity, religion, skills, or intention to counsel parents. While intentions to counsel parents on HPV vaccination are high among student nurses, interventions to improve vaccination rates among student nurses are needed.

Prevalence of high-risk human papillomavirus genotypes in two regions of Peru.

OBJECTIVE: This study aims to discover the most prevalent high-risk (hr) HPV genotypes in the regions of Loreto and La Libertad, Peru. METHODS: In 2015, cervical cell samples were collected during pelvic examinations from women in the geographically distinct regions of Loreto and La Libertad, Peru. In 2017, additional samples were collected in La Libertad. A total of 429 women between the ages of 18 and 65 years living in these regions were enrolled in the study. All samples were analyzed by polymerase chain reaction for the hrHPV genotypes 16, 18, and 35. RESULTS: Sample collection from 126 women in 2015 in Loreto revealed an hrHPV incidence of 15.9% (20 of 126), with 60% (12 of 126) of HPV infections due to hrHPV 16. Samples from La Libertad revealed an hrHPV incidence of 14.5% incidence (44 of 303) (among 303 women). Of these infections, 38% (17) were attributable to hrHPV type 35 and 20% (9) were due to hrHPV type 16. CONCLUSION: The prevalence of hrHPV genotypes in Peru may differ from those observed in North America and Europe. Loreto appears to follow the prevalence trend observed in North America, with hrHPV type 16 accounting for the majority of cases. However, hrHPV type 35 may account for a greater contribution to the cervical cancer burden in La Libertad. Further research, specifically on cervical tumor specimens, is needed.

A National Survey of Obstetrician/Gynecologists' Knowledge, Attitudes, and Beliefs Regarding Adult Human Papillomavirus Vaccination.

Background: Many women see an obstetrician/gynecologist (OB/GYN) annually and receive their primary care from an OB/GYN. Understanding OB/GYNs' human papillomavirus (HPV) vaccination practices, including knowledge of and barriers to vaccination, is essential to design effective interventions to increase vaccination. This study evaluated OB/GYN knowledge, attitudes, and beliefs regarding vaccinating both younger (18-26 years) and mid-adult (27-45 years) women. Materials and Methods: Data were collected from OB/GYN providers in October 2019 through a nationwide web-based survey. Items included the following: HPV-related vaccination practices, recommendation strength, knowledge (seven items), benefits (four items), and barriers (eight items). Results: The sample (n = 224) was majority were White (69%), men (56%), and practice in suburban clinics (55%). Most (84%) reported they usually or always recommend HPV vaccine to eligible patients, but estimated only about half (51%) of other OB/GYNs did the same. Recommendation strength varied by patient age with 84% strongly recommending it to patients ≤18 years, compared with 79% and 25% strongly recommending to younger and mid-adult patients, respectively (p < 0.01). Participants reported lower benefits (p = 0.007) and higher barriers (p < 0.001) for 27- to 45-year-old patients compared with younger patients. Cost was the most frequently reported barrier, regardless of patient age. Overall knowledge was high (m = 5.2/7) but 33% of participants did not know the vaccine was safe while breastfeeding. Conclusions: Although providers reported strongly and consistently recommending the HPV vaccination to their adult patients, there were gaps in knowledge and attitudinal barriers that need to be addressed. Provider performance feedback may be important in improving HPV vaccination awareness among providers.

Social media engagement association with human papillomavirus and vaccine awareness and perceptions: Results from the 2017 US Health Information National Trends Survey.

Due to social media's ability to publicize misinformation about vaccines, there is a need to study associations between social media engagement (SME) with human papillomavirus (HPV) and vaccine-related awareness and beliefs. Therefore, the study objectives were to (1) describe the SME of a nationally representative sample of US adults, and (2) determine the associations between SME and HPV-related awareness, HPV-related knowledge, HPV vaccine-related awareness, and perceived HPV vaccine efficacy. In 2019, we completed a secondary analysis of the 2017 Health Information National Trends Survey (Cycle 5.1). We created the SME index from 5 social media items. For each outcome variable, 3 models using binary and multinomial logistic regression were estimated. SME in the sample (n = 3171) was low (M = 0.9; range: 0-2). Respondents with higher SME had higher odds of HPV awareness (AOR = 1.56; 95% CI = 1.23, 1.99). Higher SME was associated with awareness of the HPV vaccine (AOR = 1.46; 95% CI = 1.16, 1.85). Respondents with higher SME had higher odds of perceiving HPV vaccine to be "not at all successful" (AOR = 2.22; 95% CI = 1.16, 4.24), "a little successful" (AOR = 1.99; 95% CI = 1.35, 2.94), "pretty successful" (AOR = 1.40; 95% CI = 1.04, 1.89), and "very successful" (AOR = 1.40; 95% CI = 1.02, 1.92) compared to those who selected "don't know" after adjusting for demographics and internet use. Our study highlights novel findings using a comprehensive SME index with a national sample providing insight to leverage existing consumer behaviors to better connect and disseminate accurate HPV information in a more strategic manner.

Trends of Adverse Events Following Immunization (AEFI) Reports of Human Papillomavirus Vaccine in the Valencian Community-Spain (2008-2018).

Vaccine safety surveillance is essential in vaccination programs. We accomplished a descriptive study of surveillance AEFI-reporting rate in human papillomavirus (HPV) vaccine administered in the Valencian Community, Spain. Data were obtained from Spanish Pharmacovigilance Adverse Reactions Data (FEDRA). Reporting rates were calculated using local net doses distributed as the denominator. Trends were assessed using joinpoint regression with annual percent change (APC) reported. The AEFI-reports decreased between 2008 and 2018 in two periods, a fast decreasing rate from 2009 to 2011 (from 192.2 to 24.93 per 100000 doses; APC, -54.9%; 95%CI [-75.2; -17.7]), followed by a stable trend (-13% APC, 95%CI [-26.1; 2.4]). For the age group analysis, only the group aged 14-15 years old followed the same trend with -58.4% (95%CI [-73.9; -33.8]) APC during 2008-2011, and -8.8% (95%CI [-27.7; 15]) APC during 2011-2018. The majority of the reports (73.82%) were nonserious, involving reactions at or near the vaccination site, headache, and dizziness events. No death was reported. AEFI-reporting rates for HPV immunization in the Valencian Community have decreased considerably with two trend periods observed for girls aged 14-15 years old. Currently, the AEFI reporting rate shows a decreasing trend, perhaps following the Weber effect, and it could also be affected by media attention and coverage.

Factors Associated with Initiation of HPV Vaccination Among Young Women and Girls in Urban and Suburban New Orleans.

Vaccination coverage against human papilloma virus (HPV) in the United States remains low. This study aimed to identify factors associated with initiation of HPV vaccination among young women and girls in New Orleans, Louisiana. The study was conducted in Pediatrics and Obstetrics & Gynecology clinics in New Orleans between 2014 and 2017. Surveys were administered to women ages 18 through 26, and guardians of girls ages 12 through 17. Demographics, health history, sources of medical information, knowledge of HPV and HPV vaccination, opinions on vaccination, expected support for vaccination, and systems-level barriers were assessed. Participants self-reported discussion of the vaccine with a healthcare provider, and whether they or their child had been vaccinated. Participants were predominantly black and low-income. Among young adults, 61/121 (50%) had received any doses of the HPV vaccine; 71/94 (75%) of girls had received it (p < 0.01). In both groups, knowledge of the HPV vaccine, believing the vaccine was available from their usual healthcare provider, and having discussed the vaccine with their provider were associated with increased odds of vaccination. Among young adults, additional factors associated with vaccination were younger age, distance from a healthcare center, knowledge of HPV, and expectation of support from parents. Among guardians, holding negative views on vaccination was associated with decreased odds of vaccination. Discussion of the vaccine with a healthcare provider was the factor most strongly associated with initiation of HPV vaccination in both groups. The results provided actionable items to increase HPV vaccination uptake in these populations.

Summary of the evidence on the safety, efficacy, and effectiveness of human papillomavirus vaccines: Umbrella review of systematic reviews.

BACKGROUND: This objective of this umbrella review was to summarize the evidence on safety, efficacy, and effectiveness of human papillomavirus (HPV) vaccines in the general population. METHODS: The authors conducted a literature search and selected systematic reviews if they were published from January 2006 through November 2018, included randomized controlled trials or observational studies, related to the general population, and evaluated HPV vaccine-related clinical outcomes. The authors independently and in duplicate screened literature, extracted data, and appraised reviews using AMSTAR 2, a critical appraisal tool for systematic reviews. RESULTS: The authors selected 30 systematic reviews that included male and female participants aged 9 through 76 years from multiple countries. Reviews evaluated postvaccine seroconversion, HPV infection rates, precancerous or benign lesions, and adverse events; none of the researchers reported on oral or oropharyngeal lesions. Results from the reviews showed that, compared with those who received a placebo or non-HPV-type vaccine, HPV-vaccinated participants had statistically significantly higher rates of seroconversion and local adverse events, statistically significantly lower rates of HPV infection and condylomata lesions, and decreased rates of HPV-related precancerous lesions, which did not always attain statistical significance. CONCLUSIONS: Systematic reviews have found evidence that the available HPV vaccines are safe, effective, and efficacious against vaccine-type HPV infection and HPV-associated cellular changes, including precancerous and benign lesions. PRACTICAL IMPLICATIONS: Dentists may use this resource to better understand the literature on the potential harms and benefits of HPV vaccination.

Factors Affecting Delivery of the HPV Vaccination: A Focus Group Study With NHS School-Aged Vaccination Teams in London.

This study sought to identify barriers and facilitators to delivery of human papillomavirus (HPV) vaccination in schools. Four focus groups were conducted with 28 staff members, from four National Health Service school-aged vaccination (SAV) teams in London. Data were analyzed using thematic analysis. School engagement and support, and understanding and education about the vaccination (or conversely, a lack of) were identified as both barriers and facilitators. Limited school and team resources, fear of the vaccination, and poor consent form return were identified as barriers. Explanations for why some girls do not complete the vaccination series were provided. Individualizing approaches used to promote and encourage the vaccination was identified as a facilitating factor. Optimal delivery of the HPV vaccination program is dependent on school engagement and the allocation of time for SAV teams to promote vaccination uptake. Immunization program providers should work with schools to improve understanding and support of the HPV vaccination program.

The potential population-based impact of an HPV vaccination intervention in Colorado.

BACKGROUND: Human papillomavirus (HPV) infection is the most common cause of cervical cancer and can be prevented with vaccination, but HPV vaccination rates remain low. An intervention to improve health care provider communication about vaccination has been shown to increase HPV vaccination rates in an initial trial in Colorado, where about 160 cases of cervical cancer are diagnosed each year. METHODS: Census data were combined with Colorado cancer and immunization registry data to identify clinics in locations that would most benefit from implementation of this intervention to improve HPV vaccination rates. ArcGIS Pro was used to map cervical cancer incidence, immunization rates, population data, and location of clinics participating in practice-based research networks (PBRNs). Results from the provider communication intervention trial and published estimates of the number needed to vaccinate to prevent a case of cervical cancer were used to predict the number of cervical cancer cases prevented based on increased vaccination due to the intervention. RESULTS: Ninety-eight Colorado PBRN clinics were analyzed. For the 10 clinics with the highest predicted number of cervical cancer cases prevented, 5218 additional patients would be vaccinated and 43 cervical cancer cases prevented with implementation of the intervention. If implemented in all 98 clinics, the intervention would lead to 20 490 additional patients vaccinated (range 7-658/clinic) and 171 cases of cervical cancer prevented (range 0.05-5.48/clinic). CONCLUSIONS: Geographic data from cancer and immunization registries can inform the dissemination of evidence-based practices like the provider communication intervention for HPV vaccination to maximize impact on public health.