Human Papillomavirus Vaccination Research Articles

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.

The Effect of Cervical Cancer and Human Papillomavirus Vaccine Education on Vaccination Perception in University Students: A Quasi-Experimental Controlled Educational Intervention.

Purpose: The study investigated the impact of cervical cancer and human papillomavirus (HPV) vaccine education on university students' vaccination perceptions. Methods: This research was conducted with pre- posttest and quasi-experimental design with students enrolled in the department of health services of a university. The sample of the study consisted of 87 students (n = 43 in the intervention group, n = 44 in the control group). Research data were collected between June 29 and July 22, 2022, using the Introductory Information Form and HPV Information Scale. An informative training program about cervical cancer and HPV was applied to the intervention group. This training program was carried out in two separate sessions. In the first session, information was given about the prevalence, pathology, and risk factors of cervical cancer. In the second session, general information about HPV, details about the vaccine, and vaccination programs were given. Training sessions are organized as small group discussions and seminars covering relevant topics. Results: In our study, the average age of our students was 20.7 ± 2.5 years, and in both groups, the proportion of students who did not know about HPV, which can cause cervical cancer, was quite high (74.4%, 68.2%). The majority of the control and intervention groups needed health education about STDs. There were statistically significant differences between the control and intervention groups in terms of the pre-test and posttest Knowledge of HPV Scale scores (p < 0.05). Conclusion: It was found that the education on cervical cancer and HPV positively affected the perspectives of the students on vaccination. Interactive and group-oriented education increases knowledge sharing by encouraging interaction among students. In this way, a broader knowledge base about cervical cancer and HPV can be created, and misinformation can be corrected.

The Effect of Cervical Cancer Education Given to Women in Turkey on Knowledge, Attitudes, and Health Beliefs: A Randomized Controlled Study.

The objective of this study was to ascertain the impact of cervical cancer education provided to women in Turkey on their knowledge, attitudes, and health beliefs. The study was conducted in accordance with the pretest-posttest randomized controlled trial model. The participants were randomly assigned to either the experimental or the control groups. The study was completed with a total of 105 women, 51 of whom were in the experimental group and 54 of whom were in the control group. The personal information form, the human papillomavirus (HPV) knowledge scale, and the health belief model scale for cervical cancer and Pap smear test were employed as data collection instruments. The data were analyzed using the SPSS 25.0 package program, and the number, percentage, independent samples t-test, and paired t-test were utilized for data analysis. Upon completion of the training program, the mean scores of the experimental group demonstrated a statistically significant increase in knowledge related to general HPV information, HPV screening tests, general HPV vaccines, and HPV vaccine programs when compared to the control group (p<0.001). Upon conclusion of the educational intervention, it was determined that the mean scores of cervical cancer sensitivity, caring, health motivation, Pap smear utility, and motivation of women in the experimental group exhibited an increase, while their general perception of Pap smear demonstrated a decrease (p<0.05). The findings of this study indicate that educational initiatives targeting women regarding cervical cancer have a beneficial impact on their knowledge, attitudes, and health beliefs. NCT05990270 registered on https://clinicaltrials.gov/.

Susceptibility of HPV-18 Cancer Cells to HIV Protease Inhibitors.

Cervical cancer cases continue to rise despite all the advanced screening and preventative measures put in place, which include human papillomavirus (HPV) vaccination. These soaring numbers can be attributed to the lack of effective anticancer drugs against cervical cancer; thus, repurposing the human immunodeficiency virus protease inhibitors is an attractive innovation. Therefore, this work was aimed at evaluating the potential anticancer activities of HIV-PIs against cervical cancer cells. The MTT viability assay was used to evaluate the effect of HIV protease inhibitors on the viability of cervical cancer cells (HeLa) and non-cancerous cells (HEK-293). Further confirmation of the MTT assay was performed by confirming the IC50s of these HIV protease inhibitors on cervical cancer cells and non-cancerous cells using the Muse™ Count and Viability assay. To confirm the mode of death induced by HIV protease inhibitors in the HPV-associated cervical cancer cell line, apoptosis was performed using Annexin V assay. In addition, the Muse™ Cell Cycle assay was used to check whether the HIV protease inhibitors promote or halt cell cycle progression in cervical cancer cells. HIV protease inhibitors did not affect the viability of non-cancerous cells (HEK-293), but they decreased the viability of HeLa cervical cancer cells in a dose-dependent manner. HIV protease inhibitors induced apoptosis in HPV-related cervical cancer cells. Furthermore, they also induced cell cycle arrest, thus halting cell cycle progression. Therefore, the use of HIV drugs, particularly HIV-1 protease inhibitors, as potential cancer therapeutics represents a promising strategy. This is supported by our study demonstrating their anticancer properties, notably in HPV-associated cervical cancer cell line.

Identifying measures for understanding and addressing county-level disparities in adolescent HPV vaccination coverage in North Carolina.

HPV vaccination coverage is characterized by geographic disparities in the US, with national studies finding lower coverage in rural versus nonrural areas. To direct quality improvement efforts in North Carolina, we sought to understand how different rurality measures characterize these disparities. We used separate negative binomial regression models to test associations between 5 dichotomized county-level rurality measures and HPV vaccination coverage (≥1 dose) among North Carolina adolescents, ages 11-12 (n=326,345). Rurality measures were derived from: Office of Management and Budget's Metropolitan Statistical Areas, Rural-Urban Continuum Codes, Index of Relative Rurality, US Census Bureau classifications, and North Carolina Rural Center classifications. Models controlled for Social Vulnerability Index (SVI) percentile and rate of pediatricians per county. Vaccination data came from the North Carolina Immunization Registry. HPV vaccination coverage was 29% across North Carolina's 100 counties (range: 13%, 46%). Agreement between rurality measures ranged from 54% to 93% of counties. In adjusted analyses, none of the 5 rurality measures correlated with HPV vaccination coverage, but higher SVI and higher rate of pediatricians were positively associated with coverage (p< 0.01). Exploratory moderation analyses suggested regional variation in the relationship between rurality and coverage, with a positive association in one region, a negative association in one region, and no association in four regions. County-level rurality measures did not identify disparities in HPV vaccination coverage in North Carolina. Measures related to social vulnerability and access to pediatricians may be better suited for understanding and addressing the state's substantial county-level vaccination disparities.

Machine Learning and Hyperspectral Imaging for Analysis of Human Papillomaviruses (HPV) Vaccine Self-Healing Particles.

Human papillomaviruses (HPV) are known to cause a variety of diseases, including cervical cancer and genital warts. HPV is a highly prevalent virus and is considered the most common sexually transmitted disease. Because of the risks associated with HPV, Gardasil, a quadrivalent recombinant vaccine, was developed by Merck & Co., Inc., Rahway, NJ, USA, and approved by the Food and Drug Administration (FDA) in 2006. The second generation of the vaccine, Gardasil9, was subsequently approved by the FDA in 2014, providing significant protection against HPV. The HPV vaccine may be given as 2 or 3 doses; however, vaccine administration as a single dose with a sustained release mechanism may potentially offer benefits to meet emerging health needs. To explore this, HPV vaccines were formulated within microporous self-healing particles (SHPs) to enable potential controlled release of HPV virus-like particle (VLP) antigen. Machine learning, in the form of multivariate curve resolution-alternating least-squares (MCR-ALS), with Raman hyperspectral imaging was used to determine the molecular identity and spatial distribution of all relevant species within this HPV vaccine formulation. The results indicate that machine learning with Raman hyperspectral imaging was able to spatially resolve HPV VLP antigens within SHP vaccines for the first time, providing crucial information necessary for vaccine development.

Factors influencing human papillomavirus vaccine uptake among parents and teachers of schoolgirls in Saudi Arabia: a cross-sectional study

IntroductionCervical cancer is a highly prevalent disease among women worldwide. However, the advent of a vaccine against HPV, the main cause of the disease, has prevented its spread. The acceptability of the HPV vaccine to different sectors of the Saudi community has yet to be clarified. Since parents and teachers are major influencers in the decision-making process of vaccination for HPV, this study aimed to assess the knowledge and attitudes of teachers and parents toward cervical cancer, HPV, and the HPV vaccine, and unraveled the factors that would influence recommending the vaccine.MethodsA cross sectional study was done among 927 individuals (373 teachers and 356 parents). A newly developed validated questionnaire was used to collect data on knowledge, attitude, and factors influencing cervical cancer, HPV, HPV vaccine. The relationship between different factors with knowledge and attitude were assessed using univariate and multivariate analysis.ResultsOf the study participants, 94% were females, with a median (Interquartile range) age of 38(31–44) years, 12.2% were teachers, 38.7% were parents and 49.1% were parents and teachers. The majority (78.5%) were married, and 75.6% had at least one child. Among those with children, 88.6% had at least one girl, and among those with girls, 72.2% had at least one girl aged between 10 and 18 years. The total median (IQR) knowledge score was 9 [(−5)–(−26)] and the total median (IQR) attitude score was 49 (43–56). The knowledge score significantly increased by receiving postgraduate education, working in the health or education sectors, if a person knew someone diagnosed with cervical cancer, having girls in the age group of 10–18 years, reading about medical issues or having previously heard about the HPV vaccine. The attitude score significantly increased by high knowledge score and decreased if the person has previously diagnosed with cervical cancer.ConclusionPhysician’s recommendation and the amount of information on the HPV vaccine, opinions about vaccines in general, and government decrees are the main factors influencing decision on HPV vaccine Uptake. This study emphasizes the role of healthcare providers, awareness of cervical cancer, HPV and its vaccine, and social status, in favoring vaccine uptake in Saudi Arabia.

Overcoming barriers to cervical cancer prevention in Afghanistan: The imperative for an HPV vaccination and screening program.

SynopsisUrgent action is required to implement cervical cancer screening and HPV vaccination programs in Afghanistan to address rising incidence and fatalities amidst political and humanitarian crises.

Exploring the Impact of Social Media, Health Communication, and Social Influences on College Students’ Perceived Effectiveness of the HPV Vaccine

Exploring the Impact of Social Media, Health Communication, and Social Influences on College Students’ Perceived Effectiveness of the HPV Vaccine

Human Papillomavirus (HPV) Vaccination Rates Among U.S. Military Veteran Females and Males and Non-Veterans in the National Health Interview Survey.

Human papillomavirus (HPV) infection is a major risk factor for the development of multiple cancers. Active duty service members have higher rates of HPV infection than civilians, while Veterans are diagnosed with a disproportionately high burden of HPV-associated cancers compared to civilians without prior service. While a highly effective HPV vaccine has been available for over a decade, vaccination rates in the United States remain suboptimal. The objective of this study was to investigate HPV vaccination rates among male and female Veterans compared with their non-Veteran counterparts. We performed a secondary analysis of cross-sectional National Health Interview Survey (NHIS) data pooled from 2015 to 2018 to analyze HPV vaccination rates for respondents aged 18-45 years. We used multivariable logistic regression to compare HPV vaccination rates between Veterans and non-Veterans stratified by sex while controlling for sociodemographic factors, including age, race/ethnicity, education level, income, insurance coverage, and VA coverage. All analyses used NHIS survey weights to produce national estimates. Among 45,493 respondents aged 18 to 45 years, vaccination rates were low across all groups: 9.6% of male Veterans and 8.4% of male non-Veterans (P = .21) had received at least one HPV immunization, whereas 32.0% of female Veterans and 25.1% of female non-Veterans (P = .02) were immunized. After controlling for sociodemographics, both male Veterans (AOR 1.79; 95%CI 1.31, 2.44) and female Veterans (AOR 1.56; 95%CI 1.1, 2.21) exhibited higher odds of HPV vaccination compared to their non-Veteran counterparts. VA coverage was also independently associated with higher odds of HPV vaccination among female Veterans (AOR 2.39; 95%CI 1.10, 5.21). Veterans of both sexes are more likely to be vaccinated than their non-Veteran civilian counterparts. However, vaccination rates overall remain low. To our knowledge, ours is the first study of its kind to establish HPV vaccination rates among female Veterans. These findings underscore the important role of DoD and VA health care systems in improving HPV vaccine uptake and mitigating HPV-associated cancer risk among Veterans.

HPV Vaccination Stages and Associated Factors Among Children of Immigrant Women.

This study aimed to identify key determinants by stage of implementation of human papillomavirus (HPV) vaccination among children of immigrant women in South Korea. Cross-sectional descriptive study. The sample comprised 262 Chinese, Vietnamese, and Korean-Chinese women with children living in South Korea. The survey was conducted using self-report questionnaires. The HPV vaccination levels in children were classified into four transition stages. Sequential logistic regression analysis was conducted to identify the factors affecting the transition of HPV vaccination status. Social norms had the greatest influence on the intention to vaccinate. Perceived barriers were a significant factor associated with intention or initiation of vaccination, whereas perceived severity and susceptibility were associated with the intention and initiation stages, respectively. Upon the initiation of HPV vaccination, low perception of discrimination in healthcare was associated with continued vaccination. Given the importance of completing multiple doses of the HPV vaccine within a given timeframe, it is important to provide culturally appropriate interventions in stages to prevent dropouts.

Effectiveness of bivalent HPV vaccination against genital HPV DNA-positivity of a catch-up campaign at age 13–16 years compared to routine vaccination at age 12 years: a biennial repeated cross-sectional study

BackgroundThe Netherlands is one of few countries worldwide which has used the bivalent HPV vaccine for girls-only for over a decade. This allows assessment of vaccine effectiveness (VE) against female genital HPV DNA-positivity of this vaccine in an observational post-licencing real-world setting. Additionally, it is unclear whether catch-up vaccination campaigns result in similar VE as routine vaccination. Therefore, type-specific and grouped VE were assessed and compared for women who had been eligible for catch-up vaccination at 13–16 years with those who had been eligible for routine vaccination at 12 years.MethodsPASSYON is a Dutch biennial repeated cross-sectional (2011–2021) study among sexual health clinic clients aged 16–24 years old. Women provided self-collected vaginal samples, questionnaires on demographics and sexual behaviour were administered, and women self-reported HPV vaccination status. Samples were analysed using a PCR-based assay (SPF10-LiPA25). Type-specific and grouped VE estimates, adjusted with propensity score stratification, were assessed against genital positivity for 14 HPV types. VE for targeted and non-targeted genotypes were compared between women who had been eligible for the catch-up and those who had been eligible for routine vaccination.ResultsThe study included 4488 female participants who had been eligible for HPV vaccination and provided genital swabs (1561 eligible for catch-up, 2927 for routine vaccination). Very high VE against genital HPV-16 and HPV-18 was observed (resp. 93.5% and 89.5%) and significant cross-protection against six other genotypes (HPV-31/33/35/45/52/58), varying from 18.0% (HPV-52) to 79.6% (HPV-45). VE estimates were comparable between women who had been eligible for the catch-up campaign and those eligible for routine vaccination: VE HPV-16/HPV-18: 92.2% (95%CI: 87.9–94.9) vs. 91.8% (95%CI: 86.0–95.2).ConclusionsIn real-world settings, the VE of bivalent vaccine is high against targeted genotypes, with cross-protection against 6 other genotypes. Catch-up campaigns up to age 16 years can be as effective as routine vaccination at age 12, although it is recommendable to provide HPV vaccination at an age at which most are likely not sexually active yet. This may inform countries considering catch-up campaigns when introducing or extending the use of HPV vaccination within their national immunisation programmes.

High-risk human papillomavirus diversity among indigenous women of western Botswana with normal cervical cytology and dysplasia

BackgroundCervical cancer remains a public health problem despite heavy global investment in health systems especially in low-and-middle-income countries (LMIC). Prophylactic vaccines against the most commonly detected human papillomavirus (HPV) types in cervical cancers are available and decisions on the selection of vaccine design depends on the prevalence of high-risk (hr) HPV genotypes for a particular region. In 2015, Botswana adopted the use of a quadrivalent HPV vaccine as a primary prevention strategy. Secondary prevention includes cervical smear screening whose uptake remains notably low among indigenous and marginalized communities despite efforts to improve access.AimTo determine the prevalence of hrHPV genotypes and cervical lesions’ burden in women from the indigenous and marginalized communities of Botswana.MethodsThis prospective survey enrolled 171 non-HPV vaccinated women aged 21 years and older. Face-to-face interviews, Pap smear screening, hr-HPV and Human Immuno-deficiency virus (HIV) testing were carried out. Conventional Papanicolau smears were analyzed and cervical brushes were preserved for hrHPV testing using the Ampfire Multiplex HR-HPV protocol which detects the following genotypes: HPV 16, 18, 31, 35, 39, 45, 51, 52, 53, 56, 58, 59 and 68.ResultsIn this study, 168/171 (98.6%) of the women consented to HIV testing; 53/171 (31%) were living with HIV and self-reported enrolment on antiretroviral therapy. Among the women examined, 23/171 (13.5%) had cervical dysplasia with most presenting with Atypical Squamous Cells of Undetermined Significance 8/23 (35%), Low-Grade Squamous Intraepithelial Lesions 8/23 (35%), Atypical Squamous Cells-High Grade 4/23 (17%), Atypical Endocervical Cells 2/23 (9%) and Atypical Endocervical Cell favoring neoplasia 1/23(4%). However, no High-Grade Squamous Intraepithelial Lesions (HSIL) or squamous cell carcinoma (SCC) were detected. Overall hrHPV prevalence in this study was at 56/171 (32.7%). The most commonly detected hrHPV genotypes in women with cervical dysplasia were HPV39 (6.25%), HPV51 (14.5%), HPV52 (12.5%) and HPV56 (4%). Notably, HPV 16 and 18 were not found in women with cervical dysplasia.ConclusionsOur study provides valuable insights into the prevalence and distribution of hrHPV genotypes in indigenous and marginalized communities in Botswana, and the need for further investigation of their potential role in cervical carcinogenesis in this population. These results may also serve as baseline data to facilitate future evaluation of the HPV vaccine needs.

Long-term outcomes of high-risk human papillomavirus in anal infection support HPV men vaccination

Abstract Introduction/Objective The clinical laboratory in a local hospital has an important role in population surveillance. The clinical laboratory performs analyses on patients admitted to the hospital as inpatients or critical patients and it is also a reference point for people’s health check-ups and health surveillance. Infectious diseases normally have severe symptoms. To ensure benefits from therapeutic treatment, a timely diagnosis is necessary. The human papillomavirus (HPV) virus is among the most diagnosed sexually transmitted infections worldwide, and the male gender is not exempt from it. In fact, 1 out of 3 male individuals is infected with HPV and 1 out of 5 male individuals is infected with a high-risk strain (1). In Italy, vaccination is underway for women only. Vaccine prevention extended to male individuals could lead to a halving of HPV cases. Methods/Case Report From 2018 to 2022, we performed 7362 HPV tests using DNA extraction technique (QiaSimphony) and real-time Multiplex PCR (SeeGene 28 strains). Results (if a Case Study enter NA) 3762 out of 7362 HPV tests performed were positive for one (2059 patients) or more (1969 patients) HPV strains. Women, who are more aware of prevention, are more represented in our sample of subjects. The tests performed on women are 6499 and half (3331) are positive for at least one strain of HPV. Regarding men, 863 tests were performed. About half (431 patients) were positive for at least one HPV strain. Noteworthy, out of 175 anal HPV tests, 48% were positive and 1 patient had squamous cell carcinoma. Furthermore, in our male patients tested 2 - 12% had low or medium-risk injuries. In total, out of 7529 tests carried out from 2018 to 2022, over than 50% were found to be high-risk viral strains (5231). Of these, however, approximately half (2781) are now preventable with the monovalent HPV vaccine (strains covered: 6, 11, 16, 18, 31, 33, 45, 52, 58). Conclusion The Ospedale Isola Tiberina – Gemelli Isola is an Institution in the center of Rome, Italy. It is also a reference center for birthrates and women’s prevention. Therefore, our Institution is very efficient in raising awareness of the prevention of HPV-related cancer. Current data indicate that male cases are not negligible, being positive in almost 50% of anal tests, and associated with an increased risk of the related cancers. These data can have an important impact on the Italian population, both in terms of the spread of HPV and healthcare burden and in terms of high healthcare costs.