scholarly journals Moving toward the elimination of cervical cancer: modelling the health and economic benefits of increasing uptake of human papillomavirus vaccines

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
A. Smith ◽  
N. Baines ◽  
S. Memon ◽  
N. Fitzgerald ◽  
J. Chadder ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Health System ◽  
Hpv Vaccine ◽  
Vaccine Uptake ◽  
Immunization Programs ◽  
School Based ◽  
Incidence And Mortality ◽  
The Future ◽  
Hpv Vaccine Uptake

Background The human papillomavirus (hpv) is a common sexually transmitted infection and a primary cause of cervical cancer. The Government of Canada has set a target of reaching 90% hpv vaccine coverage among adolescents by 2025. Here, we examine hpv vaccine uptake in school-based immunization programs across Canada and explore how achieving the 90% target could affect the future incidence of cervical cancer, mortality, and health system expenditures in a cohort of Canadian women.Methods Data for hpv vaccine uptake in the most recent reported school year available in each jurisdiction were provided in 2017 by jurisdictional school-based immunization programs and were used to estimate a national weighted average of 67%. The OncoSim microsimulation model (version 2.5) was used to compare 3 different levels of hpv vaccine uptake (0%, 67%, 90%) on health and economic outcomes for a hypothetical cohort of all 5- to 10-yearold girls in Canada in 2015.Results Vaccine uptake for girls in school-based programs varied from 55.0% to 92.0% in the jurisdictions reviewed. The OncoSim model projects that increasing uptake to 90% from 67% would result in a 23% reduction in cervical cancer incidence rates (to 3.1 cases from 4.0 cases per 100,000, averaged across the lifetime of the cohort) and a 23% decline in the average annual mortality rate (to 1.0 deaths from 1.3 deaths per 100,000). Finally, the model projects that the health system will incur a cost of $9 million (1% increase) during the lifetime of the cohort if uptake is increased to 90% from 67%. Costs are discounted (1.5%) and expressed in 2016 Canadian dollars. Costs reflect the payer perspective.Conclusions Our model shows that increasing hpv vaccine uptake to 90% from current levels for girls in schoolbased immunization programs could result in substantial reductions in the future incidence and mortality rates for cervical cancer in Canada.

scholarly journals Barriers and Facilitators of Human Papillomavirus (HPV) Vaccination During the Implementation of the School-Based HPV Vaccine Program in Manizales, Colombia

2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 18s-18s
Author(s):  
Verónica Cordoba ◽  
Olga Lucía Tovar-Aguirre ◽  
Sandra Franco ◽  
María del Pilar Escobar ◽  
Nelson Enrique Arias ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Pap Smear ◽  
Hpv Vaccination ◽  
Barriers And Facilitators ◽  
Vaccine Uptake ◽  
Socioeconomic Level ◽  
Vaccination Rates ◽  
School Based

Abstract 43 Purpose Colombia implemented a school-based human papillomavirus (HPV) vaccination program that consisted of a three-dose series in girls age 9 years in 2012. In 2014, the program included girls up to the last grade of high school, and the second and third doses were scheduled at 6 and 60 months. After a mass psychogenic response after vaccination that occurred from May to October 2014 in Carmen de Bolivar, vaccination rates dropped from 80% in 2012 and 2013 to 18% in 2014. The aim of the current study was to identify barriers and facilitators of HPV vaccine uptake in Colombia. Methods To develop quantitative instruments for a population-based survey, we conducted 19 qualitative interviews and 18 focus groups between September 2016 and February 2017. Participants were girls who were eligible to receive vaccination between 2012 and 2014 and their parents or legal representatives. Results Forty-nine girls who were selected from six schools of low (n = 2), medium (n = 2), and high (n = 2) socioeconomic level and 58 of their parents participated in the study. Eighty-one percent (40 of 49) of girls were age 12 to 15 years at the time of interview. No girls from schools of a low socioeconomic level and only two of 20 of their parents knew the etiology of cervical cancer. Pap smear cytology and condom use were the methods of cervical cancer prevention that were most often mentioned by parents. Only vaccinated girls from schools of a high socioeconomic level considered the HPV vaccine to be a good prevention alternative. Facilitators in adults were the desire to prevent disease in general and HPV. For both girls and their parents, listening to positive information about the vaccine facilitated vaccine uptake. Negative media information about the effects of the vaccine from the 2014 psychogenic event was the main barrier for vaccine uptake or series completion. Fifty-seven percent of girls and 30% of parents mentioned that, at the time of vaccination, information about the HPV vaccine was received mainly through government massive media campaigns, whereas approxiamtely one half of both parents and girls did not receive information from schools or health care services. Conclusion Our results suggest that improving HPV vaccination rates in Colombia will require a comprehensive education program, including mass media information about the HPV vaccine. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

scholarly journals Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

2020 ◽  
Vol 21 (2) ◽  
pp. 203-208
Author(s):  
Lauren Walter ◽  
Elizabeth Leader ◽  
James Galbraith
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Cancer Risk ◽  
Hpv Vaccine ◽  
Vaccine Uptake ◽  
Cancer Risk Factors ◽  
Cervical Cancer Risk ◽  
Hpv Vaccine Uptake

Introduction: A vaccine targeting high-risk human papillomavirus (HPV) strains can effectively prevent HPV-associated cervical cancer risk. However, many girls and women do not receive the vaccine, more often those impacted by health disparities associated with race and/or socioeconomic status. This same disparate population has also been shown to be at higher risk for cervical cancer. Many of these women also rely on the emergency department (ED) as a safety net for their healthcare. This study sought to gather information pertaining to HPV and cervical cancer risk factors, awareness of HPV and the vaccine, as well as HPV vaccine uptake in female patients presenting to an ED. Methods: We obtained 81 surveys completed by female ED patients. Demographics included age, race, income, insurance status, primary care provider status, and known cervical-cancer risk factors. Subsequent survey questions explored respondents’ knowledge, familiarity, and attitudes regarding HPV, cervical cancer, and the HPV vaccine, including vaccination uptake rates. We analyzed data using descriptive statistics and Fisher’s exact test. Results: Approximately one in seven respondents (14.8%) had never previously heard of HPV and 32.1% were unaware of the existence of a HPV vaccine. Minority patients, including those who were Black and Hispanic patients, low income patients, and uninsured and publicly insured patients were less likely to be aware of HPV and the vaccine and likewise were less likely to be offered and receive the vaccine. More than 60% of all respondents (61.3%) had never previously been offered the vaccine, and only 24.7% of all respondents had completed the vaccine series. Conclusion: Female ED patients may represent an at-risk cohort with relatively low HPV awareness and low HPV vaccine uptake. The ED could represent a novel opportunity to access and engage high-risk HPV populations.

scholarly journals Predictors of Human Papillomavirus Vaccine uptake or intent among parents of preadolescents and adolescents

2017 ◽  
Vol 7 (6) ◽  
pp. 35 ◽  
Author(s):  
Kimberlee Dayal ◽  
Sarah Robinson ◽  
Jessica Schoening ◽  
Mary Catherine Smith ◽  
Son Chae Kim
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Parental Education ◽  
Hpv Vaccination ◽  
College Education ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Human Papillomavirus Vaccine ◽  
Hpv Knowledge ◽  
Hpv Vaccine Uptake

Aim: The aim of this study was to examine predictors of human papillomavirus (HPV) vaccine uptake or intent among parents of pre-adolescents and adolescents.Methods: A cross-sectional descriptive study was conducted among parents of girls aged 9 to 18 years, visiting two primary care clinics in central Texas from September to November 2015. Pearson’s product-moment correlation procedures and path analyses based on Health Belief Model were performed.Results: Path analysis showed that provider recommendation for HPV vaccination (β = 0.37; p < .001) and perceived HPV vaccine harm (β = -0.48; p < .001) had statistically significant direct effects on HPV vaccine uptake or intent. The perceived HPV vaccine effectiveness was directly influenced by HPV knowledge (β = 0.39; p < .001), empowerment in parent-provider relationships (β = 0.30; p = .006) and parental college education (β = 0.23; p = .039).}Conclusions: Together with parental empowerment fostering an equal partnership with providers, targeted education to improve parental HPV knowledge may convince them of the HPV vaccine effectiveness. This, in turn, may help them put the perceived HPV vaccine harm in proper perspective and allow them to make informed decisions regarding the timely HPV vaccination of their children. Because provider recommendation is one of the most important contributing factors for HPV vaccine uptake or intent, parental education and recommendations from nurses will help reduce the knowledge gaps and empower parents to make the timely decisions to vaccinate their children.

scholarly journals Human Papillomavirus (HPV) Vaccine Uptake and the Willingness to Receive the HPV Vaccination among Female College Students in China: A Multicenter Study

Vaccines ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 31 ◽  
Author(s):  
Dingyun You ◽  
Liyuan Han ◽  
Lian Li ◽  
Jingcen Hu ◽  
Gregory D. Zimet ◽  
...  
Keyword(s):  
College Students ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Geographical Region ◽  
Vaccine Uptake ◽  
Female College Students ◽  
Female College ◽  
To Receive ◽  
Hpv Vaccine Uptake

Background: This study aimed to determine human papillomavirus (HPV) vaccine uptake and willingness to receive HPV vaccination among female college students, in China, and its associated factors. Methods: An online cross-sectional survey of female college students across the eastern, central, and western regions of China was undertaken between April and September 2019. Partial least squares structural equation modeling (PLS-SEM) was used to examine factors associated with the HPV vaccine uptake and willingness to receive the HPV vaccine. Results: Among the total 4220 students who participated in this study, 11.0% reported having been vaccinated against HPV. There are direct effects of indicators of higher socioeconomic status, older age (β = 0.084 and p = 0.006), and geographical region (residing in Eastern China, β = 0.033, and p = 0.024) on HPV vaccine uptake. Higher knowledge (β = 0.062 and p < 0.000) and perceived susceptibility (β = 0.043 and p = 0.002) were also predictors of HPV vaccine uptake. Of those who had not received the HPV vaccine, 53.5% expressed a willingness to do so. Likewise, social economic status indicators were associated with the willingness to receive the HPV vaccine. Total knowledge score (β = 0.138 and p < 0.001), both perceived susceptibility (β = 0.092 and p < 0.001) and perceived benefit (β = 0.088 and p < 0.001), and sexual experience (β = 0.041 and p = 0.007) had a positive and significant direct effect on the willingness to receive the HPV vaccine, while perceived barriers (β = −0.071 and p < 0.001) had a negative effect on the willingness to receive the HPV vaccine. Conclusions: Geographical region and socioeconomic disparities in the HPV vaccination uptake rate and willingness to receive the HPV vaccine provide valuable information for public health planning that aims to improve vaccination rates in underserved areas in China. The influence of knowledge and perceptions of HPV vaccination suggests the importance of communication for HPV immunization.

Human papillomavirus (HPV) vaccination: from clinical studies to immunization programs

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Based ◽  
Immunization Programs ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Middle Income Countries

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.

scholarly journals Differences in human papillomavirus (HPV) vaccine uptake by nativity status among men aged 18–34 years

2019 ◽  
Vol 16 ◽  
pp. 101010 ◽  
Author(s):  
Eric Adjei Boakye ◽  
Wenhui Zeng ◽  
Samuel Governor ◽  
Shreya Nagendra ◽  
Betelihem B Tobo ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Vaccine Uptake ◽  
Nativity Status ◽  
Hpv Vaccine Uptake
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