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1.
Expert Opin Drug Saf ; 19(1): 107-112, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31674255

RESUMO

Objectives: Complex regional pain syndrome (CRPS) cases have followed human papillomavirus (HPV) vaccination, but no causal link has been established.Methods: Using insurance claims, the authors observed unvaccinated 11-year-old girls for CRPS diagnoses. The authors used time-dependent Cox regression to identify health-related CRPS predictors using diagnosis codes. Next, the authors identified HPV vaccinations using procedural codes. HPV vaccination and CRPS predictors were considered time-dependent covariates to estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) for CRPS, 30, 90, and 180-days post-vaccination.Results: 1,232,572 girls received 563 unique CRPS diagnoses. In a 10% sub-cohort of 123,981 girls accounting for potential confounders and predisposing risk factors (i.e. injury, infection, mental illness, primary care use), CRPS hazard was not significantly elevated 30 days (HR: 0.90, 95% CI: 0.46, 1.73), 90 days (HR: 1.17, 95% CI: 0.83, 1.65), or 180-days post-vaccination (HR: 1.11, 95% CI: 0.83, 1.47).Conclusion: The results support the safety and continued administration of HPV vaccines to adolescents.


Assuntos
Síndromes da Dor Regional Complexa/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Adolescente , Criança , Estudos de Coortes , Síndromes da Dor Regional Complexa/diagnóstico , Feminino , Humanos , Vacinas contra Papillomavirus/efeitos adversos , Fatores de Risco , Fatores de Tempo , Estados Unidos
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1218-1235, 2019 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-31795578

RESUMO

Human papillomavirus (HPV)-related diseases such as cervical cancer are public health problems that threaten human health. In response to an action plan for the elimination of cervical cancer, we review the etiology, clinical features, and epidemiology of HPV-related diseases and HPV vaccinology. Our consensus statement is based on the World Health Organization position paper on HPV vaccines (2017) and on recent advances in Chinese and international HPV research. Its purpose is to strengthen HPV-related disease prevention and control by providing systematic, comprehensive evidence to enable health professionals use of HPV vaccine in a scientifically-appropriate manner that maximizes impact on disease.


Assuntos
Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Neoplasias do Colo do Útero/prevenção & controle , China/epidemiologia , Consenso , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Vacinação
3.
S D Med ; 72(10): 438-441, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31816202

RESUMO

Human papillomavirus (HPV) is a sexually transmitted virus that is the leading cause of cervical cancer world- wide. It is vaccine-preventable. According to the Centers for Disease Control, only 60 percent of girls have started the HPV vaccination series countrywide and only 50 percent of boys have started. South Dakota is below this national average. In an effort to assess - and improve - HPV vaccination rates in our practice a quality improvement effort was undertaken. Two interventions were implemented a month apart: the first was a mailing to the parent(s) of all patients 11-12 years of age during the time period of the intervention; the second was an in-office reminder system for both patients and physicians at the time of an office encounter. After each of the interventions, the immunization rate for one injection was significantly greater than baseline; while slightly higher than baseline, that for those receiving both injections was not statistically different for either intervention.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Vacinação/estatística & dados numéricos , Adolescente , Criança , Medicina de Família e Comunidade , Feminino , Humanos , Imunização , Masculino , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , South Dakota , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-31859847

RESUMO

This study aimed to explore how medical students differ regarding the HPV vaccination status according to their demographics, sexuality, medical school year and sources of information regarding the vaccine. The cross-sectional survey included 379 participants from medical school year 1 to 6, in a medical school in Brasilia. Statistical analyses of the data obtained from a questionnaire analyzed contingency tables and highlighted odds ratios effect sizes. The results showed that among all the participants, 80 (21.1%) were vaccinated against HPV, 215 (58.7%) were not vaccinated but wanted to be and 84 (22.2%) were neither vaccinated nor wanted to be vaccinated. . Female gender (OR= 5.88, 95% CI 3.36-10.30), parental advice (OR= 6.95, 95% CI= 3.97-12.16), and absence of sexual initiation before 16 years of age (OR= 3.04, 95% CI= 1.05-8.77) were positively associated with HPV-vaccinated students. In parallel, female gender (OR= 4.74, 95% CI= 2.38-9.44), parental advice (OR= 3.50, 95% CI=1.20-10.22), and reporting two or more recent sexual partners (OR= 2.03, 95% CI= 1.06-3.88) were positively associated with the intention to be vaccinated among unvaccinated students. The high cost of the vaccine was perceived as a barrier among those respondents who wished to be vaccinated. Additionally, among the 84 (81.3% male) students who admitted unwillingness to be vaccinated, approximately two-thirds cited the feeling to be safe, lack of counseling, or low efficacy of the vaccine as the reasons for their reluctance. In conclusion, vaccination coverage was low among these medical students. Nevertheless, female gender, personal advice, and safe sex were the main factors associated with higher levels of vaccination and vaccine acceptance.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Estudantes de Medicina/estatística & dados numéricos , Adulto , Fatores Etários , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Cobertura Vacinal/estatística & dados numéricos , Adulto Jovem
5.
BMC Public Health ; 19(1): 1454, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690296

RESUMO

BACKGROUND: Cervical cancer is the third most common cancer affecting women around the world in which the Human Papillomavirus (HPV) is the one of the recognized causative agent affecting women health. In response to this health issue, the Malaysian government had officially implemented the HPV immunisation programme for secondary schoolchildren in 2010 at the age of 13 years old and above. The purpose of this study is to investigate the sociodemographic determinants of knowledge and attitude among students of Universiti Tunku Abdul Rahman (UTAR) towards the HPV vaccination programme. METHODS: A cross-sectional study was conducted using self-administered questionnaires, recruiting 374 UTAR's students as the respondents by using convenience sampling method. Respondents were categorized as having good/poor level of knowledge and positive/negative attitude towards HPV vaccination. RESULTS: Over half of the respondents were females (64.5%) and the majority were aged 20 years old and below (55.8%). Generally, 54.7% of the total respondents had a high level of knowledge towards HPV vaccine while 57.5% of the total respondents showed a negative attitude towards HPV vaccine. Female respondents aged 20 years old and below showed good knowledge (56.4%) and a more positive attitude (55.8%) towards HPV vaccine. Students from the Faculty of Medicine and Health Sciences (FMHS) exhibited higher knowledge (67.3%) and positive attitude (62.4%) as compared to the Faculty of Accountancy and Management (FAM) which showed only 32.7% of knowledge and 37.6% of positive attitude towards the HPV vaccination. CONCLUSION: The majority of UTAR students possess good knowledge regarding HPV vaccination. Nonetheless, they demonstrated a negative attitude towards HPV vaccination, depicting the necessity to impart and further intensify the sense of health awareness among all students, especially among male students. The judicious use of social media apart from the conventional mass media should be an advantage as to enhance the practice of HPV vaccination among them and thereafter minimize the health and economic burdens of cervical cancer.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Papillomavirus , Estudantes/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Malásia , Masculino , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Prevenção Primária , Fatores Socioeconômicos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
6.
Rev Med Suisse ; 15(673): 2202-2204, 2019 Nov 27.
Artigo em Francês | MEDLINE | ID: mdl-31778050

RESUMO

Human papillomavirus (HPV) vaccine has been covered under basic health insurance in Switzerland since July 1, 2016, in accordance with the OFSP immunization plan and with the support of the Federal Vaccine Commission (CFV). The decision to include the vaccine in young adult vaccination plans came as a response to mounting evidence showing its efficiency in reducing HPV infections and associated diseases, especially cervical cancer, ano-genital and oro-pharyngeal cancers. General practitioners, pediatricians, urologists and gynecologists are the first in line to diagnose this sexually transmitted infection and are essential actors in its treatment and prevention.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinação , Neoplasias do Ânus/prevenção & controle , Feminino , Humanos , Masculino , Neoplasias Orofaríngeas/prevenção & controle , Fatores Sexuais , Suíça , Neoplasias do Colo do Útero/prevenção & controle
7.
Artigo em Inglês | MEDLINE | ID: mdl-31738865

RESUMO

This eleventh national annual immunisation coverage report focuses on data for the calendar year 2017 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. This is the first report to include data on HPV vaccine course completion in Aboriginal and Torres Strait Islander (Indigenous) adolescents. 'Fully immunised' vaccination coverage in 2017 increased at the 12-month assessment age reaching 93.8% in December 2017, and at the 60-month assessment age reaching 94.5%. 'Fully immunised' coverage at the 24-month assessment age decreased slightly to 89.8% in December 2017, following amendment in December 2016 to require the fourth DTPa vaccine dose at 18 months. 'Fully immunised' coverage at 12 and 60 months of age in Indigenous children reached the highest ever recorded levels of 93.2% and 96.9% in December 2017. Catch-up vaccination activity for the second dose of measles-mumps-rubella-containing vaccine was considerably higher in 2017 for Indigenous compared to non-Indigenous adolescents aged 10-19 years (20.3% vs. 6.4%, respectively, of those who had not previously received that dose). In 2017, 80.2% of females and 75.9% of males aged 15 years had received a full course of three doses of human papillomavirus (HPV) vaccine. Of those who received dose one, 79% and 77% respectively of Indigenous girls and boys aged 15 years in 2017 completed three doses, compared to 91% and 90% of non-Indigenous girls and boys, respectively. A separate future report is planned to present adult AIR data and to assess completeness of reporting.


Assuntos
Programas de Imunização , Imunização , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Papillomaviridae/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal , Adolescente , Algoritmos , Relatórios Anuais como Assunto , Austrália/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Serviços de Saúde do Indígena , Humanos , Lactente , Masculino , Infecções por Papillomavirus/virologia , Sistema de Registros
8.
Urologe A ; 58(11): 1353-1360, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31659370

RESUMO

Effective vaccines against various urologically important diseases have been established for a long time, nevertheless, vaccination activities are generally underperformed in urology. Consistently low vaccination rates, e.g. for human papillomavirus (HPV) vaccines and a widespread vaccination hesitancy characterize the situation especially in men. This article highlights the importance of various aspects of vaccinations in urology and focuses on the improvement of consultation techniques for vaccinations to increase the vaccination rate and acceptance in the future.


Assuntos
Hepatite/prevenção & controle , Programas de Imunização , Vacinas contra Papillomavirus , Urologia/métodos , Cobertura Vacinal , Vacinação/estatística & dados numéricos , Vacinas Anticâncer/administração & dosagem , Humanos , Masculino , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Encaminhamento e Consulta , Infecções Urinárias/prevenção & controle
9.
Rev Prat ; 69(5): 529-534, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31626462

RESUMO

In France, every year, HPVs cause approximately 6,300 cancers -cervix, anus, oropharynx, penis, vulva, vagina, oral cavity, larynx- representing 2% of all incident cancers, 35,000 precancerous le-sions of the cervix, and at least 50,000 condylomas in the under- 30s. All 3,000 new cases of cervical cancers are attributable to HPV infections. Cervical cancer prevention is based on the combination of two complementary strategies: vaccination of 11 to 14-years-old girls against HPV and organized screening of cervical cancer for women between 25 and 65 years old. In France, the vaccination coverage rate -VCR- against HPV for 2 vaccine doses is less than 25% while it reaches more than 80% in the United Kingdom, Portugal, Australia, etc. This low level of VCR can be explained by the mistrust in these vaccines especially regarding their effectiveness and safety. However, more than 10 years after their commercialization, HPV vaccines have already demonstrated, in many countries, their effectiveness against HPV infections, genital warts and precancerous cervical lesions. In addition, no association between vaccines and autoimmune diseases has been demonstrated, either by national or international surveillance authorities, or by scientific publications, after the commercialization of 200 million doses worldwide. As the International Papillomavirus Society has declared that the combination of a high VCR against HPV and a high participation in cervical cancer screening, combined with appropriate treatment, can lead to the elimination of cervical cancer as a public health problem, it is important to better communicate the scientific findings in order to better understand vaccination's benefits.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Adulto , Idoso , Criança , Detecção Precoce de Câncer , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Reino Unido , Neoplasias do Colo do Útero/prevenção & controle , Vacinação
10.
BMC Public Health ; 19(1): 1406, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664976

RESUMO

BACKGROUND: Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique's school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. METHODS: We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods-identification and measurement of resource quantities and valuation by application of unit costs, and gross costing-for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. RESULTS: The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15-$23) in year two, and $24 (CI: $22-$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. CONCLUSION: National adaptation and scale-up of Mozambique's school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/economia , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/organização & administração , Criança , Custos e Análise de Custo , Feminino , Humanos , Esquemas de Imunização , Moçambique/epidemiologia , Infecções por Papillomavirus/epidemiologia , Avaliação de Programas e Projetos de Saúde
11.
Int J Equity Health ; 18(1): 159, 2019 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623613

RESUMO

BACKGROUND: The human papillomavirus (HPV) is the most common sexually transmitted infection (STI) worldwide. Gay, bisexual, and other men who have sex with men (GBM), and GBM living with HIV in particular, are disproportionately impacted by HPV-associated cancers. The HPV vaccine, given early enough in life, may markedly reduce the likelihood of such cancers. In Canada, most provincial insurance programs only cover HPV vaccination for GBM up to the age of 26. Our objective was to understand physicians' everyday experiences and challenges in recommending HPV vaccination to older GBM patients. METHODS: As part of the HPV Screening and Vaccine Evaluation (HPV-SAVE) Study, we conducted semi-structured interviews with 25 HIV-positive GBM patients who had received anal cancer screening and 15 service providers, including 13 physicians, who had arranged for anal cancer screening in the Canadian provinces of Ontario and British Columbia. In this analysis, we draw upon the 13 physician interviews, which were coded following Grounded Theory. RESULTS: Physicians strongly supported the HPV vaccine for all GBM and considered it to be important for the management of HIV-related care. However, the overall support for HPV vaccination among physicians did not translate into consistent recommendation practices. There were two overarching factors that limited the strength/frequency of physicians' vaccine recommendation practices. First, cost/insurance coverage for some older patients impacted if and how the HPV vaccine was discussed. Second, physicians had diverse perspectives on both the prevention and therapeutic benefits of vaccinating older GBM and the reality that national guidelines are incongruent with publicly funded vaccine programs for vaccinating patients over 26 years old. These two interrelated factors have co-produced an apparent economic-evidentiary conundrum for many physicians regarding how and for whom to offer HPV vaccination. CONCLUSION: Economic barriers coupled with evidentiary and guideline gaps have created clinical practice challenges for physicians and has resulted in different messages being communicated to some older GBM patients about how important HPV vaccination is for their health.


Assuntos
Homossexualidade Masculina , Vacinas contra Papillomavirus/administração & dosagem , Médicos/psicologia , Padrões de Prática Médica , Minorias Sexuais e de Gênero , Adulto , Canadá , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Vacinas contra Papillomavirus/economia , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/economia , Padrões de Prática Médica/ética , Pesquisa Qualitativa , Minorias Sexuais e de Gênero/estatística & dados numéricos , Fatores Socioeconômicos
12.
Bull Cancer ; 106(11): 1008-1022, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31606139

RESUMO

With more than 3300 new cases and almost 2500 deaths each year, cervical cancer (CC) ranks second among female cancers in Moroccan women. The majority of cases occurs in women aged 50 and over. In absence of a national cancer registry, data published in Morocco are limited to the number of cases recorded in some oncology centers, so the incidence of this cancer is likely much higher than estimated. A Moroccan national program against CC based on the practice of visual inspection after application of acetic acid was set up in 2010, allowing both screening and possibly immediate treatment of (pre)cancerous lesions. However, this program has not been implemented in all regions of the country. The CC develops slowly and most often without any symptoms, and so it is diagnosed at an advanced stage of the disease. Virtually, all CC are associated with persistent infection of high risk human papillomavirus (HPV), particularly HPV16 and 18. For more than ten years, two prophylactic vaccines targeting these two HPV genotypes have been marketed. They have proved their excellent immunogenicity and efficacy and they are well tolerated. However, HPV vaccine is not yet recommended by health authorities in Morocco. In this literature review, we focused on the current situation of CC, the prevalence of HPV infection and the prevention strategies against CC in Morocco.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Lesões Pré-Cancerosas/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Ácido Acético/administração & dosagem , Adulto , Algoritmos , Coinfecção/epidemiologia , Detecção Precoce de Câncer/métodos , Feminino , Infecções por HIV/epidemiologia , Papillomavirus Humano 16/imunologia , Papillomavirus Humano 18/imunologia , Humanos , Incidência , Indicadores e Reagentes/administração & dosagem , Pessoa de Meia-Idade , Marrocos/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/virologia , Prevenção Primária , Sistema de Registros/estatística & dados numéricos , Gestão de Riscos , Prevenção Secundária , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia
13.
Int J Infect Dis ; 88: 110-112, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521851

RESUMO

Human papillomavirus virus-like particles (HPV VLPs) have distinctive immunogenic properties that generate a durable antibody response, producing high-quality neutralizing antibodies. By vaccination, i.e., intramuscular injection of these HPV VLPs, the viral survival strategy of avoiding exposure to the systemic immune system is completely overruled, and large amounts of vaccine-induced systemic antibodies are generated. These systemic circulating antibodies are easily transuded to the genital mucosa and are detectable in female genital secretions. It is well accepted that these antibodies interact with the virions presented by an infected partner and inhibit infection. However, much less attention has been paid to the role of anti-HPV vaccine-induced antibodies in an HPV-infected individual where infectious virions are encountered by neutralizing antibodies in mucosal secretions. There is a clear need to further investigate and document this role. Indeed, if HPV vaccination of HPV-infected women has an effect on HPV transmission, auto-inoculation, and relapse after treatment, this may influence how we model, assess, and implement HPV vaccination programmes.


Assuntos
Papillomaviridae/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Feminino , Humanos , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/transmissão , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/imunologia , Vacinação
14.
Int J Equity Health ; 18(1): 147, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533722

RESUMO

BACKGROUND: HPV vaccine is a prophylactic vaccine to prevent HPV infections. Recommended by the World Health Organization, this vaccine is clinically proven to be one of the most effective preventive measures against the prevalence of cervical cancer and other HPV-associated cancers and chronic genital conditions. However, its uptake rate among women in Hong Kong is insignificant-only approximately 2.9% adolescent girls and 9.7% female university students received HPV vaccination in 2014. With the notion of Critical Medical Anthropology, we aimed to identify if different influential factors, ranging from individual, societal, and cultural, are involved in the decision-making process of whether to receive HPV vaccination. METHODS: We adopted a qualitative approach and conducted in-depth individual semistructured interviews with 40 women in Hong Kong between May and August 2017. RESULTS: We noted that the following factors intertwined to influence the decision-making process: perceptions of HPV and HPV vaccine; perceived worthiness of HPV vaccines, which was in turn influenced by vaccine cost, marriage plans, and experiences of sexual activities; history of experiencing gynecological conditions, stigma associated with HPV vaccination, acquisition of information on HPV vaccines, distrust on HPV vaccines, and absence of preventive care in the healthcare practice. CONCLUSIONS: HPV vaccination is promoted in a manner that is "feminized" and "moralized" under the patriarchal value system, further imposing the burden of disease on women, and leading to health inequality of women in pursuing the vaccination as a preventive health behaviour as a result. We believe that this ultimately results in an incomplete understanding of HPV, consequently influencing the decision-making process. The "mixed-economy" medical system adopting capitalist logic also molds a weak doctor-patient relationship, leading to distrust in private practice medical system, which affects the accessibility of information regarding HPV vaccination for participants to make the decision.


Assuntos
Tomada de Decisões , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/psicologia , Adolescente , Adulto , Características Culturais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hong Kong , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto Jovem
15.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31527175

RESUMO

BACKGROUND AND OBJECTIVES: To examine, among pediatricians and family physicians (FPs) (1) human papillomavirus (HPV) vaccine delivery practices, (2) delivery experiences, and (3) attitudes regarding new 2-dose HPV vaccination schedules. METHODS: We surveyed nationally representative networks of pediatricians and FPs by Internet or mail from July 2018 to September 2018. Multivariable regression was used to assess factors associated with refusal or deferral rates of ≥50% among 11- to 12-year-old patients. RESULTS: The response rate was 65% (302 pediatricians and 228 FPs included). Pediatricians who strongly recommended the HPV vaccine ranged from 99% for patients ≥15 years old (female) to 83% for those 11 to 12 years old (male); FPs ranged from 90% for patients ≥15 years old (female) to 66% for those 11 to 12 years old (male) (P < .0001 between specialties). Sixty-five percent of pediatricians and 42% of FPs always or almost always used presumptive style when discussing the HPV vaccine (P < .0001). Overall, 40% used standing orders and 42% had electronic alerts. Among pediatricians, the proportion reporting a refusal or deferral rate ≥50% was 19% for female patients and 23% for male patients 11 to 12 years old; FPs reported 27% and 36%, respectively. In the multivariable regression (both sexes), refusal or deferral was associated with physicians not strongly recommending the HPV vaccine to 11- to 12-year-old patients, not using a presumptive style, perceiving less resistance when introducing the HPV vaccine to a 13-year-old patient versus an 11- or 12-year-old patient, and anticipating an uncomfortable conversation when recommending the HPV vaccine to an 11- or 12-year-old patient. Eighty-nine percent of pediatricians and 79% of FPs reported that more adolescents <15 years old are completing the HPV series now that only 2 doses are recommended. CONCLUSIONS: Although most physicians strongly recommend the HPV vaccine to 11- to 12-year-old patients, our data reveal areas for improvement in recommendation and delivery methods. Most physicians perceive that the 2-dose schedule is resulting in higher HPV completion rates.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Pediatras/estatística & dados numéricos , Médicos de Família/estatística & dados numéricos , Padrões de Prática Médica , Recusa de Vacinação/estatística & dados numéricos , Adolescente , Fatores Etários , Atitude do Pessoal de Saúde , Criança , Comunicação , Feminino , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Médicos de Atenção Primária/estatística & dados numéricos , Análise de Regressão , Fatores Sexuais
16.
Artigo em Inglês | MEDLINE | ID: mdl-31522666

RESUMO

This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, 'fully immunised' coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the 'No Jab No Pay' policy may have contributed to these increases. While 'fully immunised' coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, 'fully immunised' coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government's 'No Jab No Pay' policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8-82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal , Adolescente , Adulto , Idoso , Austrália , Criança , Pré-Escolar , Feminino , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Niger J Clin Pract ; 22(9): 1286-1291, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489868

RESUMO

Background: By the end of 2017, human papillomavirus (HPV) vaccine had been introduced in 80 countries, but Nigeria proposes introducing the vaccine into her routine immunization program from late 2020 or early 2021. The current mode of HPV access in the country is through out-of-pocket purchase with only 1.4% of adolescent girls being vaccinated. Cervical cancer has remained the second highest cancer among women in Nigeria, and the incidence rate is significantly higher than the global rate. This study assessed the factors associated with HPV awareness and willingness to vaccinate daughters among mothers of female secondary school students in Abakaliki. Materials and Methods: A cross-sectional study was carried out among 290 mothers of female students selected through multistage sampling technique using a pretested self-administered questionnaire. Data were analyzed with Epi Info™ version 7. Results: The mean age of the mothers was 42 ± 8 years, and 72.8% attained at least secondary education, while 37.2% were traders. Their awareness of HPV and uptake of cervical cancer screening were low, 42.8% and 9%, respectively. Although 89.1% were willing to vaccinate their daughters, only 6.9% of their daughters had ever received HPV vaccine. Lack of awareness on HPV vaccine and cost of purchase were the most cited reasons for low vaccine uptake. Education, screening status, mother-daughter vaccination status, and willingness to encourage others on HPV vaccine for daughters were significantly associated with HPV awareness. Conclusion: Most of the mothers were willing to vaccinate their daughters with HPV vaccine, but they lack awareness and the financial resources for the access. There is an urgent need for vigorous enlightenment campaigns on HPV vaccine and cervical cancer screening. Adding HPV vaccine in the routine immunization program will improve universal access and address financial concerns.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Núcleo Familiar/psicologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/psicologia , Adolescente , Adulto , Conscientização , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Humanos , Programas de Imunização , Programas de Rastreamento , Pessoa de Meia-Idade , Nigéria , Infecções por Papillomavirus/psicologia , Estudantes/psicologia , Inquéritos e Questionários
19.
BMJ Case Rep ; 12(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31401577

RESUMO

Essentially all cervical dysplasia is caused by human papilloma virus (HPV). Three HPV vaccines have been available, with Gardasil-9 being the most recently approved in the USA. Gardasil-9 covers high-risk HPV strains 16, 18, 31, 33, 45, 52 and 58 as well as low-risk strains 6 and 11. A 33-year-old woman (Gravida 2, Para 2) received Gardasil in 2006. Subsequently, her pap smear revealed low grade squamous intraepithelial lesion. Cervical biopsies performed in 2015 and 2016 revealed cervical intraepithelial neoplasia grade 1 (CIN 1). She underwent loop electrosurgical excision procedure for persistent CIN 1, which demonstrated CIN 3. Genotyping revealed HPV type 56 infection. The advancement of Gardasil-9 vaccine only offers 90% protection to patients against HPV-related disease. Lay literature may mislead patients to think they have no risk of HPV infection.


Assuntos
Neoplasia Intraepitelial Cervical/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Neoplasia Intraepitelial Cervical/cirurgia , Feminino , Humanos , Teste de Papanicolaou , Papillomaviridae/isolamento & purificação , Vacinas contra Papillomavirus/administração & dosagem , Neoplasias do Colo do Útero/cirurgia , Vacinação
20.
MMWR Morb Mortal Wkly Rep ; 68(32): 698-702, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31415491

RESUMO

Vaccination against human papillomavirus (HPV) is recommended to prevent new HPV infections and HPV-associated diseases, including some cancers. The Advisory Committee on Immunization Practices (ACIP)* routinely recommends HPV vaccination at age 11 or 12 years; vaccination can be given starting at age 9 years. Catch-up vaccination has been recommended since 2006 for females through age 26 years, and since 2011 for males through age 21 years and certain special populations through age 26 years. This report updates ACIP catch-up HPV vaccination recommendations and guidance published in 2014, 2015, and 2016 (1-3). Routine recommendations for vaccination of adolescents have not changed. In June 2019, ACIP recommended catch-up HPV vaccination for all persons through age 26 years. ACIP did not recommend catch-up vaccination for all adults aged 27 through 45 years, but recognized that some persons who are not adequately vaccinated might be at risk for new HPV infection and might benefit from vaccination in this age range; therefore, ACIP recommended shared clinical decision-making regarding potential HPV vaccination for these persons.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Vacinação/normas , Adulto , Comitês Consultivos , Feminino , Humanos , Esquemas de Imunização , Masculino , Infecções por Papillomavirus/prevenção & controle , Estados Unidos
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