Human Papillomavirus Vaccination Research Articles

One HPV Vaccination Message Does Not Fit All: Differences Between Young Adults Deciding to Be Vaccinated and Parents Deciding for Their Children

ABSTRACT Despite decades of research on HPV vaccination, the U.S. has still not achieved optimal vaccination rates. This study investigated two different message strategies (agency assignment and deviance regulation marking) for encouraging HPV vaccination in two different populations: parents considering vaccinating their children and young adults (18–26) considering vaccinating themselves. Using a 2 × 3 × 3 online experiment, this study examined the differences between the two message target groups and the effects of the different message strategies on psychological precursors to HPV vaccination and vaccination intention. The findings indicate that using both agency and deviance regulation marking message strategies provided a significant increase in HPV vaccination intentions. However, there were many differences in terms of the variables influencing HPV vaccination decision making in young adults (18–26) and parents making decisions for their children. Specifically, using human agency and a deviance message increased HPV vaccine confidence in young adults, but did not in parents. Implications of these findings for designing different messages directed to these target groups along with future directions are discussed.

Human papillomavirus vaccine to prevent CIN3 or worse (CIN3+): A nationwide case-control study in Japan.

An increase in cervical cancer incidence has been reported in Japan. The Ministry of Health, Labor, and Welfare of Japan has resumed the active recommendation of regular HPV vaccines in 2022. In Japan, the preventive effect of CIN3+ in the real world has not yet been demonstrated in age-adjusted cohort or case-control studies. This study aimed to estimate the effect of the HPV vaccine against CIN3+ in Japanese women. This nationwide case-control study from April 2013 to March 2020 targeted women aged 20-26 years old at the time of cervical screening. We compared HPV vaccination exposure between those with abnormal and those with normal cytology. Abnormal cytology was classified into cervical intraepithelial neoplasia (CIN)1+, CIN2+, and CIN3+. We calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 -OR) × 100. A total of 2790 cases and 13,990 controls (one-to-five matching) were eligible in 37 municipalities in Japan. In this study, 61 CIN3 (2.2%) and 10 squamous cell carcinomas (SCC) (0.4%) were found. The OR for CIN3+ versus controls was 0.14 (95% CI, 0.03-0.75), equating to a vaccine effectiveness of 86%. Of the 10 patients who had SCC none were vaccinated. This nationwide case-control study in Japan demonstrated a substantial risk reduction in CIN3+ among women who did versus those who did not receive HPV vaccination.

Cervical cancer screening among women: A systematic literature review

Background: Cervical cancer is one of the major concerns of public health importance in today's world. It is a leading cause of mortality in women of reproductive age group worldwide, mainly in developing countries. It is almost always associated with human papilloma virus (HPV) infection. Reduction in mortality and morbidity due to cervical cancer is possible through early detection as a first step. Purpose: To investigate about cervical cancer screening among women. Method: A systematic literature review approach was employed to gather and assess data from PubMed, Science Direct, and Google Scholar. The keywords "cervical cancer screening," "adult women," "pap smear," "HPV vaccination," "behavior," and/or "health belief" were utilized for this purpose. A total of 79 items were identified. In all, the study comprised 7 papers that satisfied the specified criteria. Following that, we carry out a methodical examination and evaluation of the chosen papers in the current literature. Results: Variables associated with cervical cancer screening including Pap smear, the impact of HPV vaccination, behavioral patterns, and health-related views. Health beliefs frequently act as the main driving force for persons to voluntarily get cervical cancer screening. Preventive cervical cancer screening enables early detection, so potentially averting the development of the illness or limiting its progression. Conclusion: To advance the objective of eliminating cervical cancer as a global public health concern, it is necessary to enhance the accessibility and involvement in screening interventions.

Update on HPV-associated head and neck cancers-highlights of the 2024 ASCO Annual Meeting

Human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is becoming increasingly important in head and neck oncology. At this year's conference of the American Society of Clinical Oncology (ASCO), alarge number of papers were presented on the topic of HPV-associated HNSCC, particularly with regard to neoadjuvant treatment approaches, radiation de-escalation strategies, therapeutic vaccines, and treatment monitoring. In this context, study results on the treatment of HPV-related recurrent respiratory papillomatosis (RRP) were also presented. Based on contributions to the 2024 ASCO Annual Meeting, an insight into the latest developments in HPV-associated diseases of the head and neck is provided. The papers were reviewed for clinical relevance and contextualized based on current therapeutic concepts. Alarge number of studies on liquid biopsies (LB) were presented. It was shown that although the methods for analyzing LBs for HPV-positive patients are well developed and can be used for diagnostics, risk classification, treatment management, or tumor follow-up, the methods vary considerably, and their clinical application has not yet been sufficiently validated. With regard to therapeutic HPV vaccination, three large studies were presented for the treatment of recurrent/metastatic HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). The only randomized study was on the vaccine ISA101b (peltopepimut-S) and did not reach its primary endpoint; however, the vaccine seemed to be highly effective in patients with a combined positive score (CPS) ≥ 20. Furthermore, data from aphaseIstudy on PRGN2012, an adenovirus-based immunotherapy used therapeutically for the treatment of recurrent respiratory papillomatosis (RRP), were presented. PRGN2012 led to areduction in surgical interventions for RRP, and the US Food and Drug Administration (FDA) designated PRGN2012 as abreakthrough therapy and orphan drug. However, the vaccine is not yet approved for the treatment of RRP.

Post-marketing study design to evaluate the effectiveness of the 9-valent and 4-valent HPV vaccines on serious HPV-related cervical disease in China.

The 4-valent (4 v) and 9-valent (9 v) human papillomavirus (HPV) vaccines are approved in China for females aged 9-45 years. However, the real-world impact of 4vHPV or 9vHPV vaccination for the prevention of high-grade cervical disease in Chinese women is lacking. Two post-marketing surveillance studies will be conducted to measure the occurrence of high-grade cervical lesions in Chinese women who had received ≥1 dose of the 4vHPV (aged 20-45 years) or 9vHPV (aged 16-26 years) vaccine in Ningbo, China. Vaccination data will be extracted from the Ningbo Regional Health Information Platform (NRHIP) from the date of the first 4vHPV (January 9, 2018) or the first 9vHPV (January 25, 2019) vaccination to March 31, 2021. The primary 4vHPV and 9vHPV vaccinated cohorts will include women vaccinated per protocol. The 4vHPV/9vHPV vaccinated test-negative (cervical HPV negative; ThinPrep cytology test negative) and corresponding matched unvaccinated HPV test-negative sub-cohorts will also be assessed. Outcomes will be the occurrence of new-onset cervical intraepithelial neoplasia grade 2/3, adenocarcinoma in situ, and invasive cervical cancer. This study aims to demonstrate that such a methodological approach is feasible and can be used to assess the impact of HPV vaccination in other regions across China.

Attitudes, healthcare interactions, and communication preferences for HPV vaccines among hesitant Hispanic/Latinx parents: how does this compare with influenza and COVID-19 vaccines?

ABSTRACT Objective We explored HPV vaccine concerns and healthcare provider communication among Hispanic/Latinx hesitant parents during the COVID-19 pandemic, and how those concerns and provider communications compared for influenza and COVID-19 vaccines. As a secondary aim, we explored communication needs and strategies for these recommended vaccines. Design We applied a concurrent, multi-method study design (survey and interview) with 23 Hispanic/Latinx American parents of adolescents aged 11–18 years. An inductive deductive thematic approach was used to interpret interview data. Descriptives were used to analyze survey data. Results Overall, most parents (77%) perceived that their child was receiving too many vaccines. Regarding hesitancy for the HPV vaccine, major parental concerns related to vaccine effectiveness (83%), vaccine necessity (83%), and vaccine safety (80%). For the COVID vaccine, major concerns were the newness of vaccine (83%), vaccine safety (77%), low perceived effectiveness (77%), and low perceived need (77%). For influenza vaccines, major parental concerns were vaccine safety (73%), low perceived need (73%), and preference for natural over vaccine-induced immunity (73%). Parents had overall positive views towards vaccination. Some parents prioritized school-required vaccines, and others ranked the recommended vaccines- HPV, COVID-19, and influenza vaccines- for their children. They saw the benefits of recommended vaccines; however, there were concerns. The majority received a provider’s recommendation for HPV vaccination for their child, while over half had not received a recommendation for COVID-19 and influenza vaccines. Recommended communication strategies were diverse with parents highlighting the need for providers to capitalize on waiting and clinic rooms to provide education. Conclusion Healthcare providers should take advantage of missed opportunities, improve healthcare interactions with a strong recommendation and persistent communication, and offer diverse communication strategies and messaging for vaccines. Future work should further explore multi-vaccine concerns and how addressing these concerns through healthcare-provider communication could improve HPV vaccination along with COVID-19 and influenza vaccination.

Effects of religion, politics and distance to providers on HPV vaccine attitudes and intentions of parents in rural Utah.

Human papillomavirus (HPV) causes an estimated 300,000 high grade cervical dysplasias and 36,000 preventable cancers each year in the United States alone. Despite having a safe, effective and long lasting vaccine since 2006, the rate of uptake has been suboptimal, particularly in rural areas. In 2020, Utah ranked near last in teenage HPV vaccination rates with rural areas trailing urban areas by about 18 percent. In this study, we identified factors that affect the intent of rural Utah parents to vaccinate their children against HPV. A survey was distributed electronically to Utah residents in rural areas. Recruitment was carried out through targeted advertising, community organizations, and professional survey panels. The survey was open from Nov. 15, 2022 to April 15, 2023. A total of 410 respondents were used for analysis. Survey results were analyzed using exploratory factor analysis, confirmatory factor analysis, and structural equation modeling. Distance to care was shown to negatively influence direct intent to vaccinate, while trust in government, general vaccine attitudes, and HPV knowledge positively influence intent to vaccinate. It was found that religious practice decreased vaccine hesitancy while cautious sexual attitudes, distance to care, and general negative vaccine attitudes increased vaccine hesitancy. Conservative political identity and high income were both shown to decrease vaccine hesitancy as covariates.

Knowledge, Attitudes, and Beliefs of Parents Toward the Human Papilloma Virus Vaccine

Knowledge, Attitudes, and Beliefs of Parents Toward the Human Papilloma Virus Vaccine

Trends in high-risk human papillomavirus infection and cervical cytology of women in Karamay City, 2012-2021.

Background To describe the changes in cervical lesions prevalence and high-risk human papillomavirus (HR-HPV) infections from 2012 to 2021, which have never been reported before, to provide direction for the effective implementation of cervical cancer prevention measures. Methods This retrospective study included women aged >25years who received either organised or opportunistic cervical HR-HPV screening from January 2012 to December 2021 in Karamay Central Hospital, Karamay, China. The patients were split into four groups according to age 25-35, 36-45, 46-55 and >55years, respectively. The Joinpoint Regression Program was used to analyse the trends of HR-HPV infection and the detection of cervical lesions. Results Data from 85,429 women revealed a decline in HR-HPV infection rates across all age groups from 2012 to 2021. Although HR-HPV infection rates decreased, cervical lesion detection rates increased, although the proportion of cervical cancer in these lesions declined, likely due to enhanced awareness and HPV vaccination in Karamay. From 2012 to 2021, the prevalence of low-grade squamous intraepithelial lesions was 9.70%, and high-grade squamous intraepithelial lesions was 5.85%. HR-HPV infections were highest in the ≥55years age group, with HPV52 (20.96%) being the most prevalent type. Conclusions In the past 10years, the prevalence of HR-HPV infection has shown a decreasing trend, whereas the detection prevalence of cervical lesions has shown an upward trend among women in Karamay City. Importantly, particular emphasis should be placed on cervical cancer screening in women aged >55years.

Awareness of the Link Between Human Papilloma Virus Infection and Head and Neck Cancer Among the General Population and Practitioners: A Literature Review

Background: Human papilloma virus (HPV) infection is responsible for 4.5% of cancers worldwide, i.e., for around 630,000 new cases per year. Around 38,000 cases per year of HPV-related cancers arise in the head and neck region, of which 21,000 cases are oropharyngeal squamous cell carcinomas (OPSCCs), with an increasing frequency in high-income countries. In our work, we aimed to collect the available evidence about the awareness of the relation between HPV infection and head and neck cancer among patients and practitioners. Methods: This review was based on all available prospective and retrospective studies, case reports, and review articles published up to May 2024 in PubMed. The search keywords used included “human papilloma virus” plus “head and neck cancer”, “awareness”, “infection”, “vaccination”, “awareness in patients and practitioners”, “oropharyngeal squamous cell carcinoma”, “HPV16-18”, “HPV awareness”, “cervical cancer”. Results: In the U.S.A., with more than 150.00 participants interviewed through different studies, the identification of HPV infection as a risk factor for head and neck cancer (HNC) was made by only 12–39% of the participants. Similar conclusions were drawn from European studies in which only 10–52% of the participants recognized HPV as a risk factor for HNC. HPV-related HNC awareness in health care providers and medical/dental students showed a high variability among studies, being otolaryngology and dental sciences specialists the most conscious in comparison to general practitioners, who demonstrated a low level of awareness. Conclusions: There is a dangerous lack of awareness about HPV infection and its potential role in HNC among both general populations and health care practitioners. A great effort should be made to increase awareness in both practitioners and the general population on this topic, also aiming to increase the HPV vaccination coverage.

Factors affecting human papillomavirus vaccine acceptance among parents of Primary 4 to 6 boys and girls in Hong Kong.

Human papillomavirus (HPV) poses a substantial but underestimated healthcare burden in Hong Kong. This study investigated factors affecting parental acceptance of HPV vaccination after the introduction of an immunisation programme for primary school girls. We assessed parental perceptions and related factors concerning HPV vaccination for both boys and girls. We conducted a cross-sectional survey between December 2021 and February 2022 among parents of Primary 4 to 6 students in Hong Kong. Our self-administered online survey collected data regarding socio-demographic characteristics, awareness and knowledge of HPV vaccination, attitudes towards HPV vaccination, and acceptance of HPV vaccination. Characteristics were compared between boys' parents and girls' parents. Factors associated with vaccine acceptance were analysed by multivariate logistic regression. We observed high awareness of HPV vaccination among boys' parents and girls' parents; however, they demonstrated relatively poor knowledge of HPV and the HPV vaccine. An alarming low HPV vaccination uptake rate was also observed. Attitudes towards the HPV vaccine were similar between parent groups. A majority of parents believed that the HPV vaccine was safe and effective in preventing infection. Parents of boys showed lower HPV vaccine acceptance. Factors associated with acceptance differed between parent groups. High awareness of HPV and HPV vaccine is predictive of vaccine acceptance. Boys' parents are less likely to accept HPV vaccination and emphasis should be placed on addressing potential HPV vaccine hesitancy in this group. Public education should also aim to raise awareness of government vaccination programme, and implementation of catch-up vaccination programme to school children beyond primary school should be considered.

Comparing the distribution of common human papillomavirus genotypes among the population of Fars province in southwest Iran with the genotypes included in the available HPV vaccines.

Given the strong association between high-risk HPV genotypes, such as HPV 16 and 18, and cervical cancer, this study aimed to compare the distribution of common HPV genotypes in the southwest Iranian population with those included in the available vaccines. Based on the sample quality, DNA was extracted from the biological samples of 8036 individuals included in the study using three different methods (automated instrument, column, and precipitation), and a total of 21 different HPV genotypes were detected using real-time PCR. The majority of participants were women (> 99%), with a positive rate of HPV infection of 29.9%, in which high-risk genotypes were dominant in 84.9% cases. The highest rate of HPV infections was observed in the age ≤ 30 years (35.9%). HPV 6 and 16 were the most frequent low- and high-risk genotypes, respectively. Multi HPV infections were observed in 35% of positive samples and the highest cross infections were observed between HPV6 and 16. Co-infection with HPV 16 and 18 was observed in 21 positive samples (1%). Although vaccination is essential to reduce the outcome of HPV infections, such as cervical cancer, other frequently occurring high-risk genotypes are not included in the 9-valent vaccine. Since the association between cervical cancer and other high-risk HPV types rather than 16 and 18 has been less studied, investigating their pathogenicity in cervical cancer is recommended. Furthermore, the new generation of HPV vaccines should contain other frequently occurring high-risk genotypes beyond those currently covered in approved vaccines.

Recurrent Respiratory Papillomatosis in the Post–Human Papillomavirus Vaccination Era

This cross-sectional study examines the incidence of juvenile-onset recurrent respiratory papillomatosis and HPV vaccination rates from 2007 to 2022 in the US.

Identifying System-Level Strategies to Engage in HPV Prevention Across Oral Health and Primary Care Settings

Introduction: HPV vaccination prevents most HPV-related cancers, yet uptake remains low. HPV is linked to an estimated 70% of oropharyngeal cancers (OPCs) in the US and outnumber cases of HPV-related cervical cancers. Not all OPCs can be detected through routine screening, making HPV vaccination a more effective primary prevention strategy. However, bridging primary and oral healthcare faces challenges due to a lack of referral networks between practices. The purpose of this study is to identify key infrastructure elements and policies, as well as HPV prevention strategies, among an academic practice network of dental clinics and partnering community health clinics in a southeastern state. Methods: Researchers held interviews with directors and focus groups with staff at six dental clinics and eight associated community clinics in a southeastern state. Interviews and focus groups at dental and community clinics were analyzed by two study team members using thematic analysis with Nvivo software. Results: A total of 90 participants participated in all focus groups and interviews (N = 14 interviews, 10 focus groups (5–13 participants per focus group). Most participants identified as white (58.9%) and female (70%), with an average age of 38.5 years. Researchers identified nine key study themes: three specific to the dental clinics’ HPV conversations with patients, two related to community clinics’ vaccine provision, and four involving the relationship between the dental and co-located community clinics. Dental clinic staff do not currently discuss HPV with patients. They are open to discussing HPV with patients but anticipate barriers that require preparation to overcome them. Community clinics have demonstrated previous success with HPV vaccination, but patients over the age of 18 face financial barriers to vaccination. Community clinics and dental clinics report that they do not currently have existing referral networks but are open to a referral system between practices if infrastructure is put into place to support it. Conclusions: Our findings indicate that there is interest in, and potential for, increased discussion of HPV with dental patients and collaboration between dental and community clinics for HPV vaccination referral. The results of this investigation can be used to develop intervention strategies to increase HPV vaccination through referrals between dental clinics and nearby community clinics. Ultimately, this work can reduce health inequities in HPV-related cancers, serve as a model for US dental practices, and possibly influence public health policy.

Knowledge and Attitudes of Female Students at Stikes Sehat Medan on Human Papillomavirus Infection and Vaccination

Cervical cancer is a malignancy that can occur in a woman's cervix and has a fairly high mortality rate. The virus that causes cervical cancer is Human Papillomavirus (HPV). One way to prevent HPV infection is to get the HPV vaccination. The purpose of this research is to analyze the relationship between knowledge and attitudes of STIKes Sehat Medan students regarding Human Papillomavirus infection and vaccination. The method used is descriptive analytical research with a cross-sectional approach, sampling using a total sampling method of 124 STIKes Sehat Medan students in 2024. Data analysis used the Spearman correlation test. The results of this study showed that of the 124 respondents, 95 students (76.6%) of STIKes Sehat Medan students had good knowledge about HPV infection and 102 people (82.3%) had a good attitude about HPV infection. Furthermore, as many as 118 people (95.2%) of STIKes Sehat Medan students had good knowledge about HPV vaccination and as many as 102 people (82.3%) had a good attitude about HPV vaccination. Based on the results of the Spearman correlation test, the relationship between knowledge and attitudes of STIKes Sehat Medan students regarding HPV infection in 2024, the value of p=0.010 was obtained, which means that there is a significant relationship between the knowledge and attitudes of STIKes Sehat Medan students regarding HPV infection and the value of p=0.015 was obtained, which is This means that there is a significant relationship between the knowledge and attitudes of STIKes Sehat Medan students regarding HPV vaccination.

Parental Perspectives on Human Papillomavirus (HPV) Vaccination in Gulf Cooperation Council Countries: A systematic review.

This systematic review aims to synthesize existing research on parental knowledge, attitudes, and barriers to human papillomavirus (HPV) vaccination in the Gulf Cooperation Council (GCC) countries. Following PRISMA guidelines, this systematic review analyzed parental knowledge, attitudes, and barriers to HPV vaccination in 6 GCC countries. A comprehensive search across multiple electronic databases (Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, Ovid MEDLINE, Web of Science, and PubMed) was conducted, focusing on studies published between January 2010 and December 2023. Inclusion criteria targeted studies in English or Arabic involving parents in GCC countries, excluding non-research publications and those not using survey techniques. The review included 7 studies from Saudi Arabia, the United Arab Emirates, and Qatar. No study was found in Oman, Bahrain, and Kuwait. The findings highlighted low knowledge and awareness of HPV and the vaccine, with significant variation across studies. According to our review findings, the level of awareness in the 7 studies was found to be low to high. These studies collectively illustrate a range of awareness levels, from as low as 11% awareness of the HPV-cervical cancer link to as high as 68% general awareness of HPV. Attitudes towards vaccination were poor in Saudi Arabia but more positive in the United Arab Emirates and Qatar. Major barriers included safety concerns, lack of information, and cultural beliefs. Despite moderate awareness in some GCC countries, substantial knowledge gaps and vaccine hesitancy persist. Targeted educational campaigns, effective communication strategies, and involvement of community leaders are essential to improve HPV vaccination uptake.

Gender Differences on the Awareness of Human Papillomavirus Infection and Vaccination.

Human papillomavirus (HPV) infection is implicated in causing several types of cancer, including cervical cancer. In Brazil, the quadrivalent HPV vaccine is provided free of charge for children between the ages of 9 and 14. Nevertheless, the vaccination coverage rate has remained below 60% since its implementation in 2014. This study aimed (i) to assess the knowledge of parents/guardians on HPV infection and vaccine prophylaxis and (ii) to test the association between having a "higher degree of knowledge" (HDK) and the sociodemographic characteristics. A total of 388 parents/guardians of children of vaccination age were enrolled. Questions assessing sociodemographic characteristics, knowledge, and attitudes toward HPV infection and vaccination were administered to participants via a self-answered questionnaire. Questionnaires of 343 participants were considered for analysis. Participants who answered at least 70% of the questions correctly were classified as presenting HDK. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations between population characteristics and HDK. This study occurred prior to the COVID-19 pandemic; thus, the pandemic was not considered in our analysis. A total of 212 (61.8%) participants showed HDK. Participants who were male (OR = 0.39; 95% CI = 0.22, 0.70) and lived in larger households (OR = 0.48; 95% CI = 0.25, 0.95) were less likely to present HDK. Participants who reported having an acquaintance with prior/concurrent HPV infection were more likely to have HDK (OR = 3.78; 95% CI = 2.02, 7.05). These findings suggest the importance of developing novel strategies for raising parental awareness of HPV, particularly targeting males.

Nationwide Discrete Choice Experiment on Chinese Guardians’ Preferences for HPV Vaccination for Mothers and Daughters

Background: HPV vaccination is the key measure to prevent cervical cancer, but uptake in China lags behind global targets. Understanding Chinese guardians’ preferences is key to improving vaccine acceptance and coverage. Methods: A nationwide online discrete choice experiment survey was conducted among 4933 Chinese guardians across seven provinces in 2022 to quantify preferences and willingness to pay. Attributes included effectiveness, safety, duration, valency, location, and out-of-pocket cost. Results: Out of the 4933 guardians who participated in the study, 4179 (84.72%) were mothers. More than 60% of the guardians belonged to the age group of 35–44 years. Additionally, over half of the respondents (53.15%) had daughters between the ages of 9 and 14 years. Respondents were open to accepting the HPV vaccine with 95% efficacy and exceptional safety. Guardians expressed a preference for longer protection duration (specifically 15 years (βa = 0.340, 95% CI: 0.31, 0.37)) and higher vaccine valency. As for willingness to pay, the respondents placed the highest value on vaccine efficacy, being willing to shell out more than USD 1100 for 95% protection as compared to 50%. Furthermore, very good safety commanded a premium of over USD 800 when compared to average safety. When it comes to willingness to uptake, a vaccine with 95% efficacy led to a more than 35% increase in acceptance as compared to one with 50% efficacy. Similarly, exceptional safety resulted in an increased willingness to uptake of over 25% when compared to average safety. Conclusions: The DCE highlighted effectiveness, safety, and durability as critical drivers of HPV vaccine acceptance, but substantial barriers persist regarding adolescent female coverage in China.

State-level disparities in cervical cancer prevention and outcomes in the U.S.: A modeling study.

Despite HPV vaccines' availability for over a decade, coverage across the US varies. While some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model. We developed a new mathematical model of HPV transmission and cervical cancer, creating US and state-level models, incorporating country- and state-specific vaccination coverage and cervical cancer incidence and mortality. We quantified the national and state-level impact of increasing HPV vaccination coverage to 80% by 2025 or 2030 on cervical cancer outcomes and the time to elimination defined as <4 per 100k women. Increasing vaccination coverage to 80% in Texas over ten years could reduce cervical cancer incidence by 50.9% (95% credible interval [CrI]:46.6-56.1%) by 2100, from 1.58 (CrI:1.19-2.09) to 0.78 (CrI:0.57-1.02) per 100,000 women. Similarly, New York could see a 27.3% (CrI:23.9-31.5%) reduction, from 1.43 (CrI:0.93-2.07) to 1.04 (Crl:0.66-1.53) per 100,000 women, and California a 24.4% (CrI:20.0-30.0%) reduction, from 1.01 (Crl:0.66-1.44) to 0.76 (Crl:0.50-1.09) per 100,000 women. Achieving 80% coverage in five years will provide slightly larger and sooner reductions. If the vaccination coverage levels in 2019 continue, cervical cancer elimination could occur nationally by 2051 (Crl:2034-2064), but state timelines may vary by decades. Targeting an HPV vaccination coverage of 80% by 2030 will disproportionately benefit states with low coverage and higher cervical cancer incidence. Geographically focused analyses can better inform priorities.

Human PapillomaVirus Vaccine Uptake: Attitudes and Practices Among Moroccan Physicians.

In Morocco, cervical cancer is a serious public health problem with an estimated number of 2165 new cases and 1199 deaths in 2020. The human papillomavirus (HPV) vaccine has been available in Morocco since 2008. Few data are available on physicians' practices and attitudes toward HPV vaccine. Hence, this study aims to evaluate physicians' awareness and practice towards HPV vaccine and to highlight the main factors affecting physicians' recommendation of this vaccine in Morocco. We have carried out a structured interviewer-administered questionnaire with 500 physicians in different Moroccan regions between March 2019 and March 2020. This study showed an insufficient level of awareness of the two most common types of HPV associated with cervical cancer (36.6%). The rate of HPV vaccine recommendation did not exceed 16.6%. However, more than 63% of participants who were aware of HPV vaccine were willing to recommend it for their future eligible patients. Age (p value < 0.01), sector of activity (p value < 0.01), awareness of the two most common types of HPV associated with genital warts (p value = 0.02), of the vaccine schedules (p value = 0.03), and of the commercial name of this vaccine (p value < 0.01), were significant factors influencing physicians' recommendation of HPV vaccine. Our results showed that, older age (above 51years old) was associated with negative attitude towards the recommendation of this vaccine (OR: 0.17, 0.06-0.46 CI 95%). Practice in public sector was positively associated with recommendation of HPV vaccine (OR: 7.54, 3.38-16.80 CI 95%). Who were aware of the two most common types of HPV associated with genital warts were more likely to recommend HPV vaccine (OR: 3.36, 1.31-8.65 CI 95%). In the same line, participants, who were also more likely to recommend the vaccine, were those who were aware of HPV vaccine schedules (OR: 6.07, 3.51-10.50 IC 95%); participants who were aware of the commercial name of the HPV vaccine were more likely to recommend the vaccine (OR: 10.04, 5.02-20.09 IC 95%). Indeed, raising physicians' awareness is urgently needed to improve HPV vaccine coverage within Moroccan population.