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1.
MMWR Morb Mortal Wkly Rep ; 70(12): 415-420, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33764964

RESUMO

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (1). Although most infections resolve without clinical sequalae, persistent HPV infection can cause cervical, other anogenital, and oropharyngeal cancers and anogenital warts. HPV vaccination has been recommended in the United States at age 11-12 years since 2006 for females and since 2011 for males. Catch-up vaccination is recommended through age 26 years.* A quadrivalent vaccine (4vHPV) targeting types 6, 11, 16, and 18 was mainly used until 2015, when a 9-valent vaccine (9vHPV), targeting the same four types as 4vHPV and five additional types (31, 33, 45, 52, and 58), was introduced; 9vHPV has been the only vaccine available in the United States since the end of 2016 (2). HPV vaccination coverage has increased but remains lower than that of other vaccinations recommended for adolescents (3). A decrease in prevalence of 4vHPV types detected in cervicovaginal swabs among young females from the prevaccine era (2003-2006) to 2007-2010 in the National Health and Nutrition Examination Survey (NHANES) was an early indicator of vaccine impact (2) and was also observed in later periods (4,5). NHANES data from 2017-2018 were included in this analysis to update HPV prevalence estimates among females aged 14-34 years. From the prevaccine era to 2015-2018, significant decreases in 4vHPV-type prevalence occurred among females aged 14-19 years (88%) and 20-24 years (81%). In sexually experienced females, 4vHPV-type prevalence decreased in those who reported receiving ≥1 HPV vaccine dose (97% among those aged 14-19 years, 86% among those aged 20-24 years) and in those who reported no vaccination (87% among those aged 14-19 years, 65% among those aged 20-24 years). Significant declines among unvaccinated females suggest herd effects. These data show increasing impact of HPV vaccination in the United States. HPV vaccination is a critical prevention tool against HPV infection, anogenital warts, and HPV-attributable precancers and cancers. HPV vaccination is highly effective and is recommended routinely at age 11-12 years and through 26 years for persons not already vaccinated.


Assuntos
Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Adolescente , Adulto , Feminino , Genótipo , Humanos , Papillomaviridae/genética , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
2.
Crit Rev Eukaryot Gene Expr ; 31(1): 61-69, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639056

RESUMO

The human papilloma virus (HPV) vaccine is the world's first proven and effective vaccine to prevent cancers in males and females when administered pre-exposure. Like most of the US, barely half of Vermont teens are up-to-date with the vaccination, with comparable deficits in New Hampshire and Maine. The rates for HPV vaccine initiation and completion are as low as 33% in rural New England. Consequently, there is a compelling responsibility to communicate its importance to unvaccinated teenagers before their risk for infection increases. Messaging in rural areas promoting HPV vaccination is compromised by community-based characteristics that include access to appropriate medical care, poor media coverage, parental and peer influence, and skepticism of science and medicine. Current strategies are predominantly passive access to literature and Internet-based information. Evidence indicates that performance-based messaging can clarify the importance of HPV vaccination to teenagers and their parents in rural areas. Increased HPV vaccination will significantly contribute to the prevention of a broadening spectrum of cancers. Reducing rurality-based inequities is a public health priority. Development of a performance-based peer-communication intervention can capture a window of opportunity to provide increasingly effective and sustained HPV protection. An effective approach can be partnering rural schools and regional health teams with a program that is nimble and scalable to respond to public health policies and practices compliant with COVID-19 pandemic-related modifications on physical distancing and interacting in the foreseeable future.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , População Rural/estatística & dados numéricos , Vacinação/métodos , Adolescente , /prevenção & controle , Feminino , Humanos , Masculino , New England/epidemiologia , Pandemias , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Saúde Pública/métodos , /fisiologia
3.
Value Health ; 24(1): 61-66, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33431154

RESUMO

OBJECTIVES: Cost-effectiveness analysis can guide decision making about health interventions, but the appropriate cost-effectiveness threshold to use is unclear in most countries. The World Health Organization (WHO) recommends vaccinating girls 9 to 14 years against human papillomavirus (HPV), but over half the world's countries have not introduced it. This study aimed to investigate whether country-level decisions about HPV vaccine introduction are consistent with a particular cost-effectiveness threshold, and to estimate what that threshold may be. METHODS: The cost-effectiveness of vaccinating 12-year-old girls was estimated in 179 countries using the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model, together with vaccine price data from World Health Organization's Market Information for Access to Vaccines database. In each year from 2006 to 2018, countries were categorized based on (1) whether they had introduced HPV vaccination, and (2) whether the incremental cost-effectiveness ratio for HPV vaccine introduction fell below a certain cost-effectiveness threshold. RESULTS: A cost-effectiveness threshold of 60% to 65% of GDP per capita has the best ability to discriminate countries that introduced vaccination, with a diagnostic odds ratio of about 7. For low-income countries the optimal threshold was lower, at 30% to 40% of GDP per capita. CONCLUSIONS: A cost-effectiveness threshold has some ability to discriminate between HPV vaccine introducer and non-introducer countries, although the average threshold is below the widely used threshold of 1 GDP per capita. These results help explain the current pattern of HPV vaccine use globally. They also inform the extent to which cost-effectiveness thresholds proposed in the literature reflect countries' actual investment decisions.


Assuntos
Análise Custo-Benefício/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/economia , Países em Desenvolvimento/economia , Saúde Global , Humanos , Programas de Imunização/economia , Programas de Imunização/estatística & dados numéricos , Modelos Econômicos , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida
4.
Methods Mol Biol ; 2197: 241-252, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32827141

RESUMO

Human papillomavirus (HPV) is a contagious cause of anogenital and oropharyngeal cancers developing from persistently infected and subsequently transformed basal keratinocytes of mucosal epithelium. DNA-based immunotherapy offers great potential for the treatment of persisting HPV infections and associated cancers. Preclinical testing of therapeutic DNA-based HPV-targeted immunotherapy requires robust animal models which mimic HPV-associated cancer disease in humans. Here we describe a detailed protocol of intradermal delivery of a therapeutic DNA vaccine and a grafting model of neoantigen expressing skin to evaluate vaccine efficacy against HPV16 mediated hyperproliferative epithelium in mice.


Assuntos
Vacinas Anticâncer/imunologia , Papillomavirus Humano 16/imunologia , Neoplasias/etiologia , Neoplasias/terapia , Infecções por Papillomavirus/complicações , Vacinas contra Papillomavirus/imunologia , Vacinas de DNA/imunologia , Animais , Vacinas Anticâncer/administração & dosagem , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Humanos , Imunização , Injeções Subcutâneas , Camundongos , Camundongos Transgênicos , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/administração & dosagem , Vacinas de DNA/administração & dosagem
5.
Int J Cancer ; 148(2): 277-284, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-32638362

RESUMO

The age-standardised incidence of cervical cancer in Europe varies widely by country (between 3 and 25/100000 women-years) in 2018. Human papillomavirus (HPV) vaccine coverage is low in countries with the highest incidence and screening performance is heterogeneous among European countries. A broad group of delegates of scientific professional societies and cancer organisations endorse the principles of the WHO call to eliminate cervical cancer as a public health problem, also in Europe. All European nations should, by 2030, reach at least 90% HPV vaccine coverage among girls by the age of 15 years and also boys, if cost-effective; they should introduce organised population-based HPV-based screening and achieve 70% of screening coverage in the target age group, providing also HPV testing on self-samples for nonscreened or underscreened women; and to manage 90% of screen-positive women. To guide member states, a group of scientific professional societies and cancer organisations engage to assist in the rollout of a series of concerted evidence-based actions. European health authorities are requested to mandate a group of experts to develop the third edition of European Guidelines for Quality Assurance of Cervical Cancer prevention based on integrated HPV vaccination and screening and to monitor the progress towards the elimination goal. The occurrence of the COVID-19 pandemic, having interrupted prevention activities temporarily, should not deviate stakeholders from this ambition. In the immediate postepidemic phase, health professionals should focus on high-risk women and adhere to cost-effective policies including self-sampling.


Assuntos
Alphapapillomavirus/imunologia , Infecções por Papillomavirus/imunologia , Vacinas contra Papillomavirus/imunologia , Saúde Pública/métodos , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Alphapapillomavirus/fisiologia , /prevenção & controle , Detecção Precoce de Câncer , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/administração & dosagem , Saúde Pública/normas , Saúde Pública/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/imunologia , Vacinação/métodos , Organização Mundial da Saúde , Adulto Jovem
6.
Sports Health ; 13(1): 91-94, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32662740

RESUMO

BACKGROUND: The preparticipation physical evaluation (PPE) is a requirement for high school sport participation in most states, but its location and role in preventive health care for adolescents is often questioned. HYPOTHESIS: Athletes who had their PPE performed in an office setting, in particular) by their primary care physician (PCP), will have higher human papillomavirus (HPV) immunization rates than those who had their PPE done in a group setting at a mass-participation PPE. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: The PPE forms and immunization records for athletes at a single high school were reviewed to determine the location of PPE, the signing practitioner, and HPV immunization status. RESULTS: A total of 488 athletes (286 males, 202 females) were included; 51% had received at least 1 dose of the HPV vaccine while 39% had completed the series. There was no significant difference in vaccination rates between examination in an office setting versus a group setting. Athletes receiving their PPE at an urgent care facility had significantly lower rates of HPV series completion than all other settings (29% vs 43%; P = 0.004). PPE completion by the athlete's PCP was associated with higher rates of vaccine series completion (46% vs 34%; P = 0.014). CONCLUSION: Athletes who completed their PPE in mass event and office-based settings had similar rates of HPV vaccine series initiation and completion. PPEs done at urgent care facilities were associated with low rates of vaccine series completion, while those done by a PCP were associated with higher rates. CLINICAL RELEVANCE: HPV immunization rates in athletes are low, and the PPE represents a potential opportunity to improve immunization rates.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Exame Físico , Atenção Primária à Saúde/estatística & dados numéricos , Esportes , Vacinação/estatística & dados numéricos , Adolescente , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Michigan , Estudos Retrospectivos , Instituições Acadêmicas
7.
Rev Bras Epidemiol ; 24: e210001, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33331411

RESUMO

OBJECTIVE: To estimate the coverage of the first and second dose of the human papillomavirus (HPV) vaccine in Brazil according to microregion, comparing cohorts of girls aged 14, 15, and 16 years in 2017, and investigate the association between spatial heterogeneity in vaccination coverage and sociodemographic variables. METHODS: Information about the doses administered from 2013 to 2017 by age was gathered from the National Immunization Program. The number of girls aged seven, eight, and nine years living in each microregion in 2010 was obtained from the 2010 Brazilian Census. For the analysis, the cumulated vaccination coverage per microregion (n = 558) was categorized as low (< 80%) and adequate (≥ 80%), and a random intercept logistic model was adjusted, with adequate vaccination coverage as the outcome. The random effect (federative unit) was included to identify the correlation between microregions that belong to the same state. RESULTS: The percentage of microregions with adequate vaccination coverage was significantly higher in the first dose (between 91.8 and 159.2%), regardless of the cohort. The coverage of the second dose was lower (between 7 and 79.9%), with heterogeneity associated with the degree of urbanization and households with private bathrooms in the municipality. The random effect showed a strong explanatory power, suggesting important differences among Brazilian states as to the outreach of vaccination coverage. CONCLUSION: Although the HPV vaccine is available through the Immunization Program, the findings of the present study point to a difficulty in achieving adequate vaccination coverage.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Brasil , Criança , Feminino , Humanos , Imunização , Vacinas contra Papillomavirus/efeitos adversos
8.
PLoS One ; 15(12): e0244242, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373380

RESUMO

In context of the ongoing multi-centric HPV vaccine study in India, unvaccinated married women (N = 1484) aged 18-23 years were recruited in 2012-2015 as age-matched controls to the vaccinated women and followed up yearly. We assess type-specific prevalence, natural history and potential determinants of human papillomavirus (HPV) infection in these unvaccinated women. Cervical samples were collected yearly for at least four consecutive years. A Multiplex Type-Specific E7-Based polymerase chain reaction assay was used to detect 21 HPV types. HPV prevalence was 36.4% during 6 years. Most common HPV types were 16 (6.5%) and 31 (6.1%). Highest persistence were observed for HPV 35 (62.5%) and 52 (25%). New HPV acquisition rate was 5.6/1000 person-months of observation (PMO), highest for HPV 16 (1.1/1000 PMO). Type-specific clearance rates ranged between 2.9-5.5/100 PMO. HPV 16 and/or 18 infections were 41% (95% CI 4-63%) lower among women with 2-<3 years between marriage and first cervical sample collection compared to those with <2 years. HPV prevalence and acquisition rates in young Indian women were lower than their Western counterparts. HPV 16 infections being most common shows the importance and potential impact of HPV vaccination in India. Women with 2-3 years exposure had reduced risk possibly due to higher infections clearance.


Assuntos
Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Comportamento Sexual , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Índia/epidemiologia , Estudos Longitudinais , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Prevalência , Adulto Jovem
9.
BMC Infect Dis ; 20(1): 808, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33153446

RESUMO

BACKGROUND: Although more than 10 years have passed since HPV vaccination was implemented, first as an interim programme (Emergent vaccine promotion programme) in November 2010, followed by incorporating into the National Immunization Programme in April, 2013 and suspended in June 2013, limited studies have investigated the HPV vaccine effectiveness against high-grade cervical lesions in Japan. METHODS: We collected the matched data of the results of cervical biopsy and history of vaccination from the Japan Cancer Society database. The subjects were women aged 20 to 29 years screened for cervical cancer between April, 2015 and March, 2017, and with information on HPV vaccination status. We estimated the relative risk of developing high-grade cervical lesions in vaccinated subjects using Poisson regression as compared to unvaccinated subjects. RESULTS: Among the 34,281 women screened, 3770 (11.0%) were vaccinated. The prevalence of CIN2+ was statistically significantly lower in the vaccinated women as compared to the unvaccinated women (Vaccine Effectiveness (VE) =76%; RR = 0.24, 95% CI:0.10-0.60). High VE against CIN3+ was also observed (91%; RR = 0.09, 95% CI:0.00-0.42). CONCLUSION: Women aged 20-29 years who received at least one dose of HPV vaccine had a significantly lower risk of high-grade cervical lesions than those not vaccinated. In Japan, HPV vaccination should be resumed in order to reduce the incidence of cervical cancer.


Assuntos
Neoplasia Intraepitelial Cervical/prevenção & controle , Papillomaviridae/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/imunologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação , Adulto , Neoplasia Intraepitelial Cervical/classificação , Neoplasia Intraepitelial Cervical/virologia , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Incidência , Japão/epidemiologia , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Prevalência , Resultado do Tratamento , Neoplasias do Colo do Útero/classificação , Neoplasias do Colo do Útero/virologia , Adulto Jovem
10.
Am J Public Health ; 110(S3): S305-S311, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33001720

RESUMO

Objectives. To compare how human papillomavirus (HPV) vaccination was portrayed on Pinterest before and after the platform acted to moderate vaccine-related search results to understand (1) what the information environment looked like previously and (2) whether Pinterest's policy decisions improved this environment in terms of sources and content.Methods. In this quantitative content analysis, we compared 2 samples of 500 HPV vaccine-focused Pinterest posts ("pins") collected before and after Pinterest's actions to provide more reliable vaccine-related information. Pins were based on search results and were analyzed using the Health Belief Model.Results. The majority of preaction search results leaned toward vaccine skepticism, specifically focused on perceived vaccine barriers. Few pins were published by public health-related Pinterest accounts. Postaction search results showed a significant shift to HPV vaccination benefits, and the number of pins by government or medical accounts increased. However, the proportion of pins in search results containing HPV content of any type was significantly lower.Conclusions. Pinterest's efforts to moderate vaccination discussions were largely successful. However, the ban also appeared to limit HPV vaccination search results overall, which may contribute to confusion or an information vacuum.


Assuntos
Comunicação , Infecções por Papillomavirus , Mídias Sociais , Vacinação/tendências , Adulto , Movimento contra Vacinação , Feminino , Humanos , Masculino , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/terapia , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/normas
11.
Obstet Gynecol ; 136(5): 1006-1015, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030866

RESUMO

OBJECTIVE: To evaluate the result of an inpatient postpartum human papillomavirus (HPV) immunization pilot program in a diverse, low-income patient population from an urban, hospital-based obstetrics and gynecology clinic. METHODS: In this cohort study, we present results from the first 2 years of the inpatient postpartum HPV immunization program, in which vaccine-eligible postpartum women were identified and immunized during their hospital stays. The program was implemented after educational outreach with prenatal and postpartum clinicians and nurses. Associations between receipt of the HPV vaccine as an inpatient and the characteristics of patients, and the likelihood of and missed opportunities for receiving a subsequent dose of the HPV vaccine as an outpatient were determined using logistic regression, time-to-event analyses, chi-squared tests and t-tests. RESULTS: From April 11, 2017, to April 10, 2019, 394 (59.2%) of 666 postpartum women were eligible for the inpatient postpartum HPV immunization program. The majority (265/394, 67.3%) received the immunization pilot program HPV dose; 36 of those 265 (13.6%) completed the series with that dose. Among women due for additional doses after hospital discharge, those who received the inpatient dose were more likely to receive a subsequent outpatient dose (138/229) than were those who did not receive an inpatient dose (39/129; hazard ratio 2.51, 95% CI 1.76-3.58). On average, there were 30.7 fewer (95% CI 5.8-55.6, P<.02) missed opportunities for subsequent outpatient doses for every 100 eligible visits among women who received the inpatient dose, compared with women who did not. By the end of the study, the proportion of women who had completed the vaccine series was higher among women who received the inpatient dose (95/265, 35.8%) than in those who did not (12 out 129, 9.3%; odds ratio 5.45, 95% CI 2.86-10.38). CONCLUSION: The inpatient postpartum HPV immunization program was associated with increased rates of immunization and addressed a previously missed opportunity. Inpatient immunization programs can serve as a critical way to address gaps in vaccine uptake.


Assuntos
Programas de Imunização/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cuidado Pós-Natal/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Feminino , Hospitais Urbanos , Humanos , Programas de Imunização/métodos , Programas de Imunização/normas , Modelos Logísticos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/normas , Pobreza/estatística & dados numéricos , Gravidez , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Adulto Jovem
12.
PLoS One ; 15(10): e0234693, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33091021

RESUMO

BACKGROUND: The pathogenic and oncogenic roles of papillomavirus (HPV) infections have been documented and shown to occur in women as well as in men. While other countries have already extended their vaccination guidelines to include boys, in 2019 the French National Authority for Health validated implementation of HPV vaccination in the 2020 vaccination schedule. There is, however, a climate of distrust in regard to vaccination in France, and there have been few studies to date regarding the acceptability of HPV vaccination in boys in France. The aim of this study was, therefore, to evaluate the acceptability of extending the recommendations for HPV vaccination in men, among middle and high school students and their parents. METHODS: Our study (HPVac) was a prospective, multicenter, departmental, and descriptive survey applied to a sample of male middle and high school students attending schools in the Loire-Atlantique department and their parents. It took place from January 2017 to January 2018. RESULTS: We analyzed the information obtained from 127 parent questionnaires and 145 children questionnaires. In terms of acceptability, 36.6% (n = 53) of the children and 37.8% (n = 48) of the parents were in favour of being vaccinated or of having their children vaccinated against HPV (51.7% (n = 75) and 50.4% (n = 64), respectively, were undecided). The perception of a risk stemming from HPV infection was positively associated with acceptability of the HPV vaccine. Being against vaccines in general, being discouraged by their parents, parents thinking that their child is not at risk, and the belief that the vaccine is not mandatory were arguments cited and significantly associated with a willingness to be vaccinated. CONCLUSION: This study revealed a lack of information among boys and their parents about HPV and its vaccination. It also clearly showed that taking time to discuss the consequences of an infection and the merits of being vaccinated can help parents overcome their reluctance. The children then generally go along with their parent's choice.


Assuntos
Papillomaviridae/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Estudantes/psicologia , Vacinação/psicologia , Adolescente , Adulto , Criança , Feminino , Seguimentos , França/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Prognóstico , Estudos Prospectivos , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
13.
J. negat. no posit. results ; 5(10): 1134-1144, oct. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-199387

RESUMO

INTRODUCCIÓN: El virus del papiloma humano (VPH) es el principal factor etiológico del cáncer cervicouterino (CaCu) el cual constituye un problema de salud pública mundial, especialmente en los países en desarrollo. Se han descrito más de 120 tipos de virus de VPH, sin embargo, los tipos 16 y 18 son los responsables del 70% de los casos del cáncer cervicouterino. La importancia del conocimiento acerca de la prevención y transmisión es fundamental para evitar la infección o lograr una detección oportuna. OBJETIVO: Determinar el nivel de conocimientos sobre la prevención del VPH de las alumnas de la Escuela Secundaria General No. 10 en Pachuca, Hidalgo. MATERIALES Y MÉTODOS: Estudio transversal, observacional, la información se obtuvo a partir de un cuestionario aplicado a las alumnas de una Secundaria General en el estado de Hidalgo. Se realizó análisis descriptivo, se calcularon medidas de tendencia central y de dispersión para variables continuas y para variables cualitativas se obtuvieron razones y proporciones. RESULTADOS: El 96.5% de las encuestadas refirió haber escuchado sobre el VPH, más del 90% cree que este padecimiento es curable. Con respecto a la vacunación el 50% expresó conocer la edad en que debe ser aplicada la vacuna. Solo el 76% refirió contar con la primera dosis de la vacuna, sin embargo, sólo el 17% se aplicó todas las dosis necesarias de la misma. CONCLUSIONES: Para mejorar el nivel de salud de la población mexicana es necesario implementar programa de acciones preventivas garantizando la cobertura en vacunación contra el VPH. De no implementarse este tipo de programas los resultados no serán del todo positivo


INTRODUCTION: The human papilloma virus (HPV) is the main etiologic factor of cervical cancer (CaCu) which constitutes a global public health problem, especially in developing countries. More than 120 types of HPV virus have been described, however, types 16 and 18 are responsible for 70% of cervical cancer cases. The importance of Knowledge about prevention and transmission is essential to avoid infection or achieve early detection. OBJECTIVE: To determine the level of knowledge about HPV prevention of the students at the General Secondary School No. 1 in Pachuca, Hidalgo. MATERIALS AND METHODS: Cross-sectional, observational study, the information was obtained from a questionnaire applied to the students at a General Secondary School in the state of Hidalgo. Descriptive analyses were performed, measures of central tendency and dispersion were calculated for continuous variables and ratios and proportions were obtained for qualitative variables. RESULTS: 96.5% of the respondents reported having heard about HPV, more tan 90% believe that this disease is curable. Regarding vaccination, 50% expressed knowing the age at which the vaccine should be applied. Only 76% reported having the first doce of the vaccine, however, only 17% applied all the necessary doses ofi t. Conlusions: To improve the health leve lof the mexican population, it is necessary to implement a preventive action program guarantteing coverage in HPV vaccination. If this type of program is not implemented, the results will not be entirely positive


Assuntos
Humanos , Feminino , Adolescente , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Neoplasias do Colo do Útero/prevenção & controle , Infecções por Papillomavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Resultado de Ações Preventivas , Fatores de Risco , Doenças Sexualmente Transmissíveis/prevenção & controle , Estudos Transversais , Inquéritos e Questionários/estatística & dados numéricos , México/epidemiologia
14.
Ann Agric Environ Med ; 27(3): 379-383, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955218

RESUMO

INTRODUCTION: Cervical cancer is the fourth neoplasm in women with respect to incidence. In Poland, both cervical cancer incidence and corresponding mortality are gradually decreasing. Despite these improvements, the epidemiological situation significantly deviates from European standards. Poland has one of Europe's lowest five-year survival rates at 54.1% for patients diagnosed in 2000-2002, compared to the European mean value of 62.1%. OBJECTIVE: The aim of this study is to present health policy programmes related to HPV vaccinations run by local self-government units in 2009-2016. MATERIAL AND METHODS: The research is based on analysis of already existing data developed by provincial governors and annual information reviews on health-policy programmes implemented by local self-government units presented to the Ministry of Health. All the programmes that included HPV vaccinations have been subjected to analysis. RESULTS: In 2009-2016, local government units implemented a total of 1,204 health policy programmes that covered HPV vaccinations. Under these programmes, 2.05% of girls aged 10-14 were vaccinated. Percentage-wise, these were communes that contributed the most financially to the HPV vaccination programmes, whereas the counties the least. CONCLUSIONS: Local self-government's programmes covering HPV vaccinations conform with the trends outlined in strategic documents on fighting neoplastic diseases. It is possible that the availability of HPV vaccination was limited for girls living in rural communes. Differences in the number of programmes, number of vaccinated girls and the financial outlays allocated for the implementation of HPV vaccination programmes in particular provinces, may be determined by the epidemiological situation in a given region, measured by the incidence rate of cervical cancer.


Assuntos
Política de Saúde , Governo Local , Papillomaviridae/imunologia , Infecções por Papillomavirus/terapia , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/legislação & jurisprudência , Adolescente , Criança , Feminino , Humanos , Polônia
15.
Cent Eur J Public Health ; 28(3): 178-186, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997472

RESUMO

OBJECTIVES: This study aims to identify the differences in the use of HPV vaccination between female medical students in the Czech and Slovak Republics and their possible causes. METHODS: We performed a cross-sectional survey among female students of general medicine in all faculties of medicine in the Czech and Slovak Republics. RESULTS: We obtained 630 questionnaires from the Czech Republic and 776 questionnaires from the Slovak Republic. In the Czech Republic, 65.4% of female medical students underwent HPV vaccination, while in the Slovak Republic, the figure was 21.1%. In the Czech Republic, residency and religion of students did not influence their rate of vaccination. However, in the Slovak Republic, village residency with less than 5,000 inhabitants lowered the probability of vaccination with OR = 0.56 (95% CI: 0.38-0.84), and the Catholic religion lowered the probability of vaccination with OR = 0.40 (95% CI: 0.28-0.57). Czech students were informed about the possibility of vaccination by a paediatrician in 55.7% of cases, while the figure for Slovak students was 26.8%. In the Czech Republic, 75.7% of students participated in regular cervical oncologic screening, while in the Slovak Republic, the figure was 57.7%. Vaccination of relatives would be recommended by 86.5% and 80.5% of Czech and Slovak students, respectively. CONCLUSIONS: The adoption of an oncologic prevention programme and the more extensive propagation by paediatricians are probably the medical reasons for the higher HPV vaccination among Czech students. Demographic factors - village residency and religion - are also important.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Estudantes de Medicina/psicologia , Vacinação/psicologia , Estudos Transversais , República Tcheca , Feminino , Humanos , Infecções por Papillomavirus/prevenção & controle , Eslováquia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Vacinação/estatística & dados numéricos
16.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32928985

RESUMO

OBJECTIVES: The human papillomavirus (HPV) vaccine was recommended in 2006 for girls and in 2011 for boys. The Healthy People 2020 goal for 2-dose HPV vaccination coverage is 80% by age 15 for girls and boys. We used nationwide population-based data to describe trends in HPV vaccination in children. METHODS: We conducted a cohort study nested within the MarketScan health care database between January 2003 and December 2017. Children were followed from the year they turned 9 until HPV vaccination, insurance disenrollment, or the end of the year when they turned 17, whichever came first. We estimated the cumulative incidence of at least 1- and 2-dose HPV vaccination, stratified by birth year, sex, and state. In secondary analyses, we evaluated the association between state-level vaccination policies and HPV vaccination coverage. RESULTS: This study included 7 837 480 children and 19.8 million person-years. The proportion of 15-year-old girls and boys with at least a 1-dose HPV vaccination increased from 38% and 5% in 2011 to 57% and 51% in 2017, respectively; the proportion with at least a 2-dose vaccination went from 30% and 2% in 2011 to 46% and 39% in 2017, respectively. By 2017, 2-dose HPV vaccination coverage varied from 80% in Washington, District of Columbia, among girls to 15% in Mississippi among boys and was positively correlated with legislation for HPV vaccine education and pediatrician availability. CONCLUSIONS: Despite the increasing trends in uptake, HPV vaccine coverage among commercially insured children in the United States remains behind target levels, with substantial disparities by state.


Assuntos
Planos de Seguro com Fins Lucrativos/tendências , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/tendências , Adolescente , Estudos de Casos e Controles , Criança , Estudos de Coortes , Feminino , Planos de Seguro com Fins Lucrativos/estatística & dados numéricos , Humanos , Estimativa de Kaplan-Meier , Masculino , Fatores Sexuais , Estados Unidos , Cobertura Vacinal/estatística & dados numéricos
17.
S Afr Med J ; 110(6): 525-531, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32880566

RESUMO

BACKGROUND: Infection with human papillomavirus (HPV) significantly increases the risk of developing cervical cancer later in life. Therefore, globally, HPV vaccines targeted to pre-adolescent and adolescent girls have been on the rise since the licensure in 2006. However, the introduction of HPV vaccines has been relatively slow in Africa. At the end of 2016, only 8 of the 54 countries in Africa were reported to have introduced HPV vaccination at a national level. By 2019, the number of countries had grown marginally to 11. OBJECTIVES: To investigate stakeholders' perspectives on the experiences, challenges and lessons learnt during national HPV vaccine introduction in Africa. METHODS: A questionnaire was administered to selected participants from 8 African countries. These countries had successfully introduced HPV vaccination at a national level by the end of 2016. We used in-depth interviews and self-administered online questionnaires for data collection and analysis. Data are presented without naming the country or participants; therefore, readers will not be able to identify the results that are specific to individual countries. Narrative and thematic reporting were used to describe the results. RESULTS: We obtained results from 6 of the 8 targeted countries. The challenges reported during HPV vaccination programmes were: identifying the target population, using a school-based vaccine-delivery strategy, obtaining political support, the need to integrate HPV vaccination with existing school health programmes and engaging multiple stakeholders. These challenges were similar in all 6 countries. The lessons learnt were that a school-based delivery strategy is a successful approach for national HPV vaccination, and that identifying girls for vaccination at schools was less challenging if implemented through a class-based instead of an age-based approach. CONCLUSIONS: Most African countries do not have established platforms to deliver vaccines to pre-adolescent and adolescent populations. The successful introduction of the HPV vaccine through school-based vaccination strategies in African countries may have created a platform to deliver other adolescent vaccines. The similarity of the study findings across the 6 participating countries further strengthens the need to document and disseminate the challenges and lessons learnt during HPV vaccine introduction in Africa. Documentation and dissemination of the challenges and lessons learnt are useful to other countries in Africa that plan to introduce an HPV vaccination programme, and possibly other adolescent vaccines.


Assuntos
Programas de Imunização/organização & administração , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Serviços de Saúde Escolar , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , África , Criança , Feminino , Humanos , Inquéritos e Questionários
18.
MMWR Morb Mortal Wkly Rep ; 69(33): 1109-1116, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32817598

RESUMO

Three vaccines are recommended by the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of adolescents aged 11-12 years to protect against 1) pertussis; 2) meningococcal disease caused by types A, C, W, and Y; and 3) human papillomavirus (HPV)-associated cancers (1). At age 16 years, a booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended. Persons aged 16-23 years can receive serogroup B meningococcal vaccine (MenB), if determined to be appropriate through shared clinical decision-making. CDC analyzed data from the 2019 National Immunization Survey-Teen (NIS-Teen) to estimate vaccination coverage among adolescents aged 13-17 years in the United States.* Coverage with ≥1 dose of HPV vaccine increased from 68.1% in 2018 to 71.5% in 2019, and the percentage of adolescents who were up to date† with the HPV vaccination series (HPV UTD) increased from 51.1% in 2018 to 54.2% in 2019. Both HPV vaccination coverage measures improved among females and males. An increase in adolescent coverage with ≥1 dose of MenACWY (from 86.6% in 2018 to 88.9% in 2019) also was observed. Among adolescents aged 17 years, 53.7% received the booster dose of MenACWY in 2019, not statistically different from 50.8% in 2018; 21.8% received ≥1 dose of MenB, a 4.6 percentage point increase from 17.2% in 2018. Among adolescents living at or above the poverty level,§ those living outside a metropolitan statistical area (MSA)¶ had lower coverage with ≥1 dose of MenACWY and with ≥1 HPV vaccine dose, and a lower percentage were HPV UTD, compared with those living in MSA principal cities. In early 2020, the coronavirus disease 2019 (COVID-19) pandemic changed the way health care providers operate and provide routine and essential services. An examination of Vaccines for Children (VFC) provider ordering data showed that vaccine orders for HPV vaccine; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap); and MenACWY decreased in mid-March when COVID-19 was declared a national emergency (Supplementary Figure 1, https://stacks.cdc.gov/view/cdc/91795). Ensuring that routine immunization services for adolescents are maintained or reinitiated is essential to continuing progress in protecting persons and communities from vaccine-preventable diseases and outbreaks.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Humanos , Esquemas de Imunização , Masculino , Estados Unidos , Vacinas Conjugadas/administração & dosagem
19.
Cancer Causes Control ; 31(10): 905-914, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32748100

RESUMO

PURPOSE: Research on HPV vaccine coverage in the United States has typically aggregated Hispanic/Latinx individuals into a single group for analyses, an approach that has potentially masked variation between Hispanic/Latinx subgroups. To address this limitation, we examined HPV vaccine coverage across Hispanic/Latinx subgroups. METHODS: We analyzed data on Hispanic/Latinx adolescents ages 13-17 (n = 16,335) from the 2012-2016 National Immunization Survey-Teen. Each adolescent was categorized into a subgroup: Mexican, Cuban, Puerto Rican, Central American, South American, other Spanish origin, or multi-subgroup. We examined HPV vaccine initiation (receipt of one or more doses) and completion (receipt of three doses) for males and females separately. Analyses used weighted logistic regression. RESULTS: Vaccine coverage among males was highest among Central Americans (initiation: 57.5%; completion: 31.1%) and lowest among multi-subgroup males (initiation: 46.3%; completion: 19.9%). Among females, initiation ranged from 63.4% among Cubans to 71.2% among Puerto Ricans, and completion ranged from 33.6% among multi-subgroup females to 48.7% among South Americans. Hispanic/Latinx subgroups were similar on these outcomes in regression models. However, within several subgroups, vaccine coverage was higher among adolescents whose parents' preferred language was Spanish (i.e., potentially less acculturated) compared to those whose parents' preferred language was English. CONCLUSIONS: Modest variation in HPV vaccine coverage exists across Hispanic/Latinx subgroups, with differences found by preferred language within several subgroups. Findings provide insight into HPV vaccine coverage among Hispanic/Latinx subgroups and can help guide future surveillance efforts and vaccination interventions.


Assuntos
Hispano-Americanos/estatística & dados numéricos , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/estatística & dados numéricos , Adolescente , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Infecções por Papillomavirus/prevenção & controle , Estados Unidos/etnologia
20.
Obstet Gynecol ; 136(2): 435-436, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32732765

RESUMO

Human papillomavirus (HPV) causes significant morbidity and mortality in women and men. The HPV vaccine significantly reduces the incidence of anogenital cancer and genital warts in women and in men. Human papillomavirus vaccines are among the most effective vaccines available worldwide, with unequivocal data demonstrating greater than 99% efficacy when administered to women who have not been exposed to that particular type of HPV. Obstetrician-gynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine. Further, obstetrician-gynecologists are encouraged to stock and administer HPV vaccines in their offices when feasible. Ideally, the HPV vaccine should be given in early adolescence because vaccination is most effective before exposure to HPV through sexual activity. Unvaccinated women age 26 years and younger should receive the HPV vaccine series regardless of sexual activity, prior exposure to HPV or sexual orientation. The HPV vaccine is now licensed in the United States for women and men through age 45 years. For some women aged 27-45 years who are previously unvaccinated, obstetrician-gynecologists and other health care professionals may use shared clinical decision making regarding HPV vaccination, considering the patient's risk for acquisition of a new HPV infection and whether the HPV vaccine may provide benefit.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/normas , Adolescente , Adulto , Comitês Consultivos , Criança , DNA Viral , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/imunologia , Guias de Prática Clínica como Assunto , Sociedades Médicas , Estados Unidos , Adulto Jovem
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