Human papillomavirus vaccine uptake in adolescence and adherence to cervical cancer screening in Switzerland: a national cross-sectional survey.

OBJECTIVES: The objectives were to measure uptake of and factors associated with human papillomavirus (HPV) vaccination initiation and to determine whether HPV vaccination reduced the uptake of cervical cancer screening. METHODS: We conducted a cross-sectional survey in a random sample of Swiss women aged 18-49 years in 2014 (N = 3588). RESULTS: Vaccination initiation was 69.3% and full coverage (three doses) 54.1% for 18-20-year olds, respectively, 42.4% and 33.9% for 21-24-year olds. Women with ≥ 10 lifetime sexual partners were less likely to have received any HPV vaccination than women with ≤ 2 partners (18-20 years OR 0.2, 21-24 years OR 0.5). Amongst 1000 unvaccinated women (18-24 years), reasons for not having initiated vaccination were lack of information (22.5%) and fear of vaccine side effects (18.1%). Vaccination status was not associated with adherence to cervical cancer screening recommendations (OR 1.3). 95.4% of all vaccinated participants knew about the continued need for screening. CONCLUSIONS: Our data suggest that HPV vaccination is not associated with reduced uptake of cervical cancer screening. This study provides information that can be used to improve HPV vaccination uptake in Switzerland.

The Federal Vaccination Commission in Switzerland: an officially appointed independent commission ensuring evidence-based recommendations and transparent procedures.

The Commission Fédérale pour les Vaccinations (CFV; Federal Vaccination Commission), the Swiss National Immunization Technical Advisory Group (NITAG), was established in 2004 and is comprised of 15 core members and a few ex officio members. Its role is to serve as a scientific advisor to the authorities in making vaccination recommendations, and to act as a mediator between the authorities, experts, and the public on questions concerning vaccinations. The CFV requires all members to describe in detail any potential conflicts of interest. The CFV meets approximately five times per year, and the meetings' scope covers all questions concerning immunization. Economic considerations are taken into account when formulating recommendations. The committee disseminates data and information about its activities to the medical profession and the public using press releases, publications, factsheets and a website. Increasing public fears about adverse effects from vaccines has resulted in vaccinations being delayed or not given at all. Swiss health authorities consider it of great importance to clearly explain how their recommendations are made and how the CFV is crucial in this process.

Hepatitis A virus infections in travelers, 1988-2004.

BACKGROUND: Uncertainty exists about the current risk of hepatitis A virus infection in nonimmune travelers to destinations with high or intermediate risk of transmission. We analyzed recent epidemiological data on imported hepatitis A to determine region-specific attack rates and incidences. METHODS: Surveillance data on hepatitis A virus infections diagnosed during 1988-2004 were evaluated on the basis of notification by laboratories, additional reports of physicians, and traveler's statistics. This study focuses on international travelers with hepatitis A virus infection detected after their return to Switzerland. RESULTS: The rate of imported hepatitis A virus infections decreased 75% from 1988 to 2004 and accounted overall for 42% of all hepatitis A cases reported in Switzerland. The actual incidence of hepatitis A in travelers to countries of high or intermediate risk of transmission was 3.0-11.0 per 100,000 person-months abroad for all travelers and 6.0-28.0 per 100,000 for those presumed to be nonimmune. The actual proportion of those visiting friends and relatives among patients with hepatitis A has increased to 28.2%, with children aged 0-14 years predominating. Reductions in the incidence by hepatitis A vaccination were estimated to vary between 35.0% and 61.8% for different destinations. CONCLUSIONS: The risk of hepatitis A virus infections has decreased by a factor of 10-50-fold over time, compared with findings from older studies. The risk, however, remains very considerable at many destinations, including frequently visited places, such as Mexico. Children of immigrants are a high-risk population. Strategies are needed to reach those at highest risk.

Peritoneal schistosomiasis: an unusual laparoscopic finding.

Laparoscopic surgery is now a common procedure for the cure of appendicitis. Unexpected other laparoscopic findings can be a diagnostic challenge. The authors present a case in which, in addition to typical appendicitis, multiple whitish nodules were found diffusely on the peritoneal surfaces suggesting a differential diagnosis including miliary tuberculosis and carcinoma metastases. The final diagnosis of schistosomiasis, made by histology and serology, had not been suspected. This uncommon and rare presentation deserves to be reported, especially to physicians of nonendemic areas, in an era in which people travel extensively.