scholarly journals No Association between HPV Vaccination and Infertility in U.S. Females 18-33 Years Old

2019 ◽  
Author(s):  
Katherine E. Mooney ◽  
Nicholas B. Schmuhl ◽  
Xiao Zhang ◽  
Laura G. Cooney ◽  
James H. Conway ◽  
...  

ABSTRACTBackgroundHuman papillomavirus (HPV) vaccines have been recommended as primary prevention of HPV-related cancers for over 10 years in the United States, and evidence reveals decreased incidence of HPV infections following vaccination. However, concerns have been raised that HPV vaccines could decrease fertility. This study examined the relationship between HPV immunization and self-reported infertility in a nationally representative sample.MethodsData from the 2013-2016 National Health and Nutrition Examination Survey were analyzed to asses likelihood of self-reported infertility among women aged 20 to 33, who were young enough to have been offered HPV vaccines and old enough to have been queried about infertility (n=1,114). Two logistic regression models, stratified by marital history, examined potential associations between HPV vaccination and infertility. Model 1 assessed the likelihood of infertility among women who had never been pregnant or whose pregnancies occurred prior to HPV vaccination. Model 2 accounted for the possibility of latent and/or non-permanent post-vaccine infertility by including all women 20-33 years old.Results8.1% reported any infertility. Women who had ever been married and had received an HPV vaccine were less likely to report infertility (OR 0.04, 95% CI 0.01-0.57) in model 1. No other associations between HPV and infertility were found.ConclusionThere was no evidence of increased infertility among women who received the HPV vaccine. These results provide further evidence of HPV vaccine safety and should give providers confidence in recommending HPV vaccination. Further research should explore protective effects of HPV vaccines on female and male fertility.What is already known on this subject?Despite evidence that HPV vaccines are safe and effective, concerns persist regarding a purported link between HPV vaccination and infertility. These concerns were refuted by a recent population-based cohort study that found no association between the HPV vaccine and primary ovarian insufficiency.What this study adds?This study broadens the existing evidence by exploring possible associations between HPV vaccination and any self-reported infertility. There was no evidence of infertility among women 20-33 years old who received one or more doses of HPV vaccine. This result provides further evidence of HPV vaccine safety, diminishing remaining concerns among clinicians and the public.

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.


Sexual Health ◽  
2010 ◽  
Vol 7 (3) ◽  
pp. 291 ◽  
Author(s):  
Julia M. L. Brotherton ◽  
Julie Leask ◽  
Cath Jackson ◽  
Kirsten McCaffery ◽  
Lyndal J. Trevena

Background: Between 2007 and 2009, Australian general practitioners (GPs) were involved in implementing a population-based human papillomavirus (HPV) vaccination program. We investigated GPs’ experiences of delivering the HPV vaccine to women aged 18–26. Methods: We posted a survey to 1000 GPs. The survey was informed by 12 domains incorporating constructs from psychological theories that focus on individual and environmental barriers and facilitators to effective implementation of evidence-based practice by health professionals. Results: The response rate was 32%. The 298 vaccinating GPs were positive about HPV vaccine implementation as part of their professional role as a worthwhile initiative within existing general practice infrastructure. They had more negative views about some aspects of program organisation, such as the timelines and potential adverse impacts on cervical screening rates. Vaccine safety was not a key concern. Actual levels of knowledge about HPV were moderate (mean score 3.41 out of 6 (s.d. 0.99)) and contrasted with self-rated knowledge, which was high (93% perceived their knowledge to be adequate). Notably, there were unrealistic expectations about the likely reduction in Pap abnormalities due to vaccination, which is important to clarify to avoid loss of confidence in the vaccine when this reduction does not eventuate. Conclusions: Australian GPs viewed HPV vaccination of women aged 18–26 years as an integrated part of their routine practice, with positive attitudes regarding its benefits and achievability. GPs are well placed to implement mass immunisation programs as long as they are supported by effective and timely communication strategies and resources.


2011 ◽  
pp. 108-115
Author(s):  
Vu Quoc Huy Nguyen

Persistent infection with high-risk Human Papilloma Virus (HPV) has been identified as the causal factor of cervical cancer, with relative risk up to 300-400 folds. This very close relationship leads to the preventive strategy of vaccination against HPV infections and HPV-related lesions. The article describes molecular and immunologic characteristics of HPV, currently available HPV vaccines and its protective effects; the relationship between HPV vaccination and cervical cancer screening, and an introduction to therapeutic HPV vaccine trials.


2021 ◽  
pp. 101053952110274
Author(s):  
Sameer Vali Gopalani ◽  
Amanda E. Janitz ◽  
Sydney A. Martinez ◽  
Janis E. Campbell ◽  
Sixia Chen

Native Hawaiian and Pacific Islander (NHPI) adults bear a disproportionate burden of certain human papillomavirus (HPV)-associated cancers. In 2015, data from the National Health Interview Survey (NHIS) showed vaccination coverage among adults by racial and ethnic groups; however, coverage data for NHPI adults were unavailable. In this study, we estimated the initiation and completion of HPV vaccination and assessed the factors associated with vaccination among NHPI adults aged 18 to 26 years in the United States. We analyzed public data files from the 2014 NHPI NHIS (n = 1204). We specified sampling design parameters and fitted weighted logistic regression models to calculate the odds of HPV vaccine initiation. We developed a directed acyclic graph to identify a minimally sufficient set for adjustment and adjusted for insurance coverage (for education and ethnicity) and doctor visit (for insurance coverage, earnings, ethnicity, and sex). Overall, 24.9% and 11.5% of NHPI adults had initiated and completed the HPV vaccination series, respectively. Weighted logistic regression models elucidated that the odds of HPV vaccine initiation were higher for females (weighted odds ratio = 5.4; 95% confidence interval = 2.8-10.4) compared with males. Low vaccination coverage found among NHPI adults provides an opportunity for targeted programs to reduce the burden of HPV-associated cancers.


2021 ◽  
pp. 089011712110291
Author(s):  
Puneet Kaur Chehal ◽  
Livvy Shafer ◽  
Solveig Argeseanu Cunningham

Purpose: This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. Design: Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children’s Health. Setting: US, national. Subjects: Children ages 10-17 years (n = 34,640) Measures: Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. Analysis: Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. Results: An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. Conclusion: Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.


Author(s):  
Deborah Carr ◽  
Dawne M. Mouzon

The linkages between intimate relationships and superior physical and mental health are well documented. Contemporary scholars explore under what conditions, for which outcomes, for whom, and through which pathways marriage and other intimate partnerships affect health. The chapter summarizes conceptual frameworks for understanding marriage and health, and contemporary empirical studies yielding four main discoveries: Relationship status is powerfully linked to health in cross-sectional studies, yet weaker associations are found in longitudinal studies that account for social selection; the protective effects of romantic partnerships vary based on characteristics of the union; the marriage–health nexus varies based on gender, race, and age; and (d) integrative science approaches have advanced understanding of the pathways linking social relationships to health. The review draws on population-based longitudinal studies, notably the Midlife in the United States (MIDUS) study. Implications of contemporary research on marriage and health for policy and practice are highlighted.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1360
Author(s):  
Oluwafemifola Oyedeji ◽  
Jill M. Maples ◽  
Samantha Gregory ◽  
Shauntá M. Chamberlin ◽  
Justin D. Gatwood ◽  
...  

About 45:000 cancers are linked to HPV each year in the United States alone. The HPV vaccine prevents cancer and is highly effective, yet vaccination coverage remains low. Pharmacies can play a meaningful role in increasing HPV vaccination access due to their availability and convenience. However, little is known about pharmacists’ perceived barriers to HPV vaccination. The objective of this systematic review was to summarize existing literature on perceived barriers to administering HPV vaccination reported by pharmacists. Barriers identified from selected studies were synthesized and further grouped into patient, parental, (pharmacist’s) personal, and system/organization barrier groups. Six studies were included in this review. The cost of the HPV vaccine, insurance coverage and reimbursement were commonly reported perceived barriers. Adolescent HPV vaccination barriers related to parental concerns, beliefs, and inadequate knowledge about the HPV vaccine. Perceived (pharmacist’s) personal barriers were related to lack of information and knowledge about HPV vaccine and recommendations. At the system/organization level, barriers reported included lack of time/staff/space; difficulty in series completion; tracking and recall of patient; perceived competition with providers; and other responsibilities/vaccines taking precedence. Future strategies involving pharmacy settings in HPV-related cancer prevention efforts should consider research on multilevel pharmacy-driven interventions addressing barriers.


Author(s):  
Pooja Shah ◽  
Veena Shetty ◽  
Maithri Ganesh ◽  
Avinash K. Shetty

Cervical cancer is the second leading cause of cancer and one of the leading causes of cancer-related death in women in India. Human papillomavirus (HPV) vaccine uptake in India is low due to cost, low awareness of HPV, social stigma, and other factors. We assessed the awareness, attitudes, and beliefs regarding HPV and HPV vaccination and explored the barriers and challenges to HPV vaccine intent among women in Mangalore, India. An exploratory study was conducted using two focus group discussions (FGDs) and six in-depth one-on-one interviews. FGD-1 comprised nine women aged 18 to 26 years, and FGD-2 comprised seven women aged 27 to 45 years. The FGDs were recorded, transcribed, and analyzed using thematic content analysis. Themes identified were limited knowledge of HPV and vaccine, stigma associated with receiving HPV vaccine, vaccine safety concerns, and cost as a barrier to receiving vaccine. Participants expressed desire for physician and government recommendation of the HPV vaccine to validate vaccine intent. Contrasting themes between the two FGDs include support for vaccination at a younger age and lower perception of stigma and judgment in the 18- to 26-year-old group; however, participants in the 27- to 45-year-old group support vaccination at an older age and endorse greater fear of stigma and judgment associated with obtaining vaccination. Education regarding HPV-associated diseases and the HPV vaccine for the general public, physicians, and government officials in conjunction with lowering vaccine cost, improving vaccine access, and encouraging strong physician recommendations are key strategies to scale up HPV vaccine implementation in India.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Sher Afgan ◽  
Muhammad A Saleem

Background: A common question among men who are stroke survivors is whether stroke occurrence will interfere with sexual performance. The question continues to have major significance in resumption of normal activities and reintegration into society for stroke survivors. Methods: Using a standard questionnaire, we examined trends and prevalence of erectile dysfunction in regards to moderate (sometimes) to severe (always) disability to get and keep an erection adequate for satisfactory intercourse in a nationally representative sample of the United States population. We analyzed data from 4929 men who participated in National Health and Nutrition Examination Survey (NHANES) 2001 to 2004. Stroke was defined based on self-report of physician diagnosis. Results: Moderate to severe disability to get and keep an erection adequate for satisfactory intercourse was reported by 13 (6.4%) men with history of stroke and 276 (5.8%) without stroke, respectively (p=0.65). After adjustment for differences in age, men with history of stroke did not have any increase in risk of moderate to severe disability to get and keep an erection adequate for satisfactory intercourse (odds ratio [OR] 0.8; 95% confidence interval [CI] 0.4 to1.7). Conclusions: Erectile dysfunction was relatively infrequent among men with history of stroke and no higher than in men without stroke.


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