Human Papillomavirus Information Research Articles

Identifying the intersection of parental HPV and COVID-19 vaccine hesitancy to inform health messaging interventions in community-based settings

PurposeParental human papillomavirus (HPV) vaccine hesitancy contributes to delays or refusals in adolescent uptake. It is unclear if COVID-19 vaccine hesitancy has further impacted the low HPV vaccine uptake trends among underrepresented minorities. This study examines the relationship between COVID-19 vaccine intent and HPV vaccine hesitancy among parents for their adolescents in communities with low vaccine uptake in Los Angeles County. MethodsParents from a school-based academic enrichment program serving low-income, first-generation immigrant families completed an online cross-sectional survey to understand parental HPV vaccine hesitancy, adolescent HPV vaccine behavior, and attitudes towards other vaccines, including intent to receive COVID-19 vaccines. In March 2021, parents with children ages 9–17 years completed online surveys. Using multivariate logistic regression models, we examined whether low parent intent to vaccinate their adolescent against COVID-19 was associated with hesitancy to vaccinate against HPV. ResultsA total of 291 surveys were completed. Among parents with high HPV vaccine hesitancy for their adolescent, 33 % did not intend to vaccinate their adolescent against COVID-19 compared to 7 % among parents with low HPV vaccine hesitancy. Low parent intention to vaccinate adolescent against COVID-19 was associated with higher HPV vaccine hesitancy (p < 0.01) after controlling for parent nativity status, medical mistrust, receiving the flu vaccination and negative HPV information. DiscussionOur findings indicate associations between low parental COVID-19 vaccine intent and higher HPV vaccine hesitancy for their adolescent. Identifying community-relevant health interventions to address parental vaccine hesitancy across multiple child and adolescent vaccines may help to achieve equitable vaccine uptake.

Effectiveness of a School- and Primary Care–Based HPV Vaccination Intervention

The human papillomavirus (HPV) vaccine is safe and effective, yet vaccination coverage remains below public health objectives in many countries. To examine the effectiveness of a 3-component intervention on HPV vaccination coverage among adolescents aged 11 to 14 years 2 months after the intervention ended, each component being applied alone or in combination. A cluster randomized trial with incomplete factorial design (PrevHPV) was conducted between July 1, 2021, and April 30, 2022, in French municipalities receiving 0, 1, 2, or 3 components of the intervention. Randomization was stratified by school district and municipalities' socioeconomic level. Analyses were carried out on 11- to 14-year-old adolescents living in all participating municipalities, regardless of what had been implemented. The PrevHPV intervention had 3 components: (1) educating and motivating 11- to 14-year-old adolescents in middle schools, along with their parents; (2) training general practitioners (GPs) on up-to-date HPV information and motivational interviewing techniques; and (3) free HPV vaccination at school. The primary outcome was HPV vaccination coverage (≥1 dose) 2 months after the intervention ended among 11- to 14-year-old adolescents living in participating municipalities, based on the French national reimbursement database and data collected during the trial in groups randomized to implement at-school vaccination. A total of 91 municipalities comprising 30 739 adolescents aged 11 to 14 years (15 876 boys and 14 863 girls) were included and analyzed. Half the municipalities were in the 2 lowest socioeconomic quintiles and access to GPs was poor in more than two-thirds of the municipalities. Thirty-eight of 61 schools (62.3%) implemented actions and 26 of 45 municipalities (57.8%) had at least 1 trained GP. The median vaccination coverage increased by 4.0 percentage points (IQR, 2.0-7.3 percentage points) to 14.2 percentage points (IQR, 9.1-17.3 percentage points) at 2 months. At-school vaccination significantly increased vaccination coverage (5.50 percentage points [95% CI, 3.13-7.88 percentage points]) while no effect was observed for adolescents' education and motivation (-0.08 percentage points [95% CI, -2.54 to 2.39 percentage points]) and GPs' training (-1.46 percentage points [95% CI, -3.44 to 0.53 percentage points]). Subgroup analyses found a significant interaction between at-school vaccination and access to GPs, with a higher effect when access was poor (8.62 percentage points [95% CI, 5.37-11.86 percentage points] vs 2.13 percentage points [95% CI, -1.25 to 5.50 percentage points]; P = .007 for interaction). In this cluster randomized trial, within the context of the late COVID-19 pandemic period and limited school and GP participation, at-school HPV vaccination significantly increased vaccination coverage. The trial did not show a significant effect for training GPs and education and motivation, although it may be observed after more time has elapsed after the intervention. ClinicalTrials.gov Identifier: NCT04945655.

Knowledge and Awareness of Human Papillomavirus Infection and Vaccination in Thai Male Youth, Including Men Who Have Sex With Men

OBJECTIVE There is currently a lack of human papillomavirus (HPV) vaccination policy and education for male youth in Thailand. This study aimed to evaluate Thai male youth’s knowledge and awareness of HPV infection and vaccination, determine their HPV vaccination rate, and factors related to the vaccination rate and the level of awareness of HPV. METHODS A questionnaire survey on HPV vaccination was distributed to educational institutions across different regions of Thailand. Inclusion criteria included Thai male youth aged between 15 and 24 years, regardless of sexual orientation. Exclusion criteria were inability to access the internet, individuals whose responses were unintelligible, and those who did not complete the questionnaire. The trends of the association between participant characteristics and their HPV knowledge/awareness scores was analyzed using linear regression. RESULTS A total of 594 individuals responded to the questionnaire. The median score for knowledge was 11 out of 18 and the awareness level was 80%. Higher education level, higher family income, bisexuality, and prior receipt of HPV information were statistically significantly linked to higher HPV knowledge scores. However, only previous receipt of HPV information was associated with an increased awareness level. CONCLUSIONS Although the level of HPV knowledge and awareness among Thai males was acceptable, less than 50% of participants expressed an intention to get vaccinated. This indicates there is a need to improve the promotion of the HPV vaccine in order to achieve herd immunity.

Cognition, willingness, and behavior towards human papillomavirus vaccination in Chinese university students: Planned behavior, health beliefs, and media influence

This study assessed Human papillomavirus (HPV) vaccination knowledge, willingness, and status among University of Nottingham Ningbo undergraduate students, utilizing the Theory of Planned Behaviour (TPB) and Health Belief Model (HBM). Self-administered questionnaires covered demographics, sexual behavior, and factors influencing vaccination intentions. Quantitative and qualitative analyses included t-tests, ANOVA, Pearson correlation, logistic regression, and linear regression. Of 373 surveyed students, the HPV vaccination rate was notably higher than in previous studies (45.84%). While participants demonstrated good HPV knowledge, male students were less aware. Intentions to vaccinate were high, influenced by gender, profession, parental education, family/friend cancer history, and health status. The study confirmed TPB and HBM’s efficacy in predicting vaccination intentions, enhancing media-related aspects and perceived barriers. Gender differences in HPV information exposure, media use, and representations were identified, offering insights for optimized health communication strategies.

The effect of theoretical and student-centered interactive education on intern nursing students' knowledge and consideration regarding human papillomavirus and its vaccine in Turkey: A repeated measures design.

Intern nursing students not only belong to the high-risk group for human papillomavirus (HPV) infection and its associated complications but also represent the future healthcare workforce. Therefore, they constitute a significant group that should comprehensively understand HPV and its vaccine. This study aimed to assess the impact of educational interventions on intern nursing students' knowledge and considerations related to HPV and its vaccine. A repeated measures design with pretest/posttest measures was employed. The study involved 88 students at a university in Turkey and was conducted between November 2021 and February 2022. Data were collected using a Personal Information Form and the HPV Information Scale. All participants received theoretical and student-centered interactive education, and data were analyzed using numerical data, percentage distributions, Bonferroni correction, and one-way repeated measures ANOVA. The total score of the scale and the scores of all four sub-dimensions obtained in the first and third months after the education were significantly higher than those obtained before the education (p <0.001). Additionally, the proportion of students considering getting an HPV vaccine increased following the education (p <0.001).Conclusions: The education on HPV and its vaccine potentially improved students' knowledge levels and increased consideration for vaccination. Implementing interventions that equip nursing students with sufficient knowledge about HPV and its vaccine can contribute to reducing HPV-related cancer rates. Therefore, it is recommended to implement educational programs focused on the prevention of HPV-related cancers.

Communication Interactions, Needs, and Preferences During Clinical Encounters of African American Parent-Child Dyads.

Human papillomavirus (HPV) vaccination rates remain suboptimal among African American adolescents. Although provider recommendations during clinical encounters are believed to be highly effective in increasing uptake and series completion, little has been reported about parent-child perspectives on the counseling received during these encounters. Among African American parent-child dyads, we sought to explore and compare interactions, needs, and preferences during clinical encounters by child's HPV vaccination status. We applied a qualitative, phenomenological study design to conduct semi-structured interviews with African American parent-child dyads representing children who were unvaccinated (n = 10), had initiated but not completed (n = 11), or had completed the HPV vaccine series (n = 9). Using iterative, inductive-deductive thematic analysis, five themes were generated: (1) parents' attitudes varied about the HPV vaccine but were mostly positive for vaccines in general; (2) patient-parent-provider clinical encounters from the parent perspective; (3) patient-parent-provider clinical encounters from the child perspective; (4) methods of distribution of supplemental HPV information; and (5) communication desired on HPV vaccination by parents and children. Parents stating they received a provider's recommendation increased by vaccination status (unvaccinated: 6 out of 10; initiated: 7 out of 11; completed: 9 out of 9). Most parents and children were not satisfied with provider communication on the HPV vaccine and used supplemental materials to inform decision-making. Ongoing communication on the HPV vaccine was requested even post-vaccination of the child. During clinical encounters, children and parental messaging needs are similar yet dissimilar. We offer communication strategies and messaging that can be used for African American parent-child dyads by child HPV vaccination status during a clinical encounter.

Prophylactic Human Papillomavirus Vaccination: From the Origin to the Current State.

Immunization is the most successful method in preventing and controlling infectious diseases, which has helped saving millions of lives worldwide. The discovery of the human papillomavirus (HPV) infection being associated with a variety of benign conditions and cancers has driven the development of prophylactic HPV vaccines. Currently, four HPV vaccines are available on the pharmaceutical market: Cervarix, Gardasil, Gardasil-9, and the recently developed Cecolin. Multiple studies have proven the HPV vaccines' safety and efficacy in preventing HPV-related diseases. Since 2006, when the first HPV vaccine was approved, more than 100 World Health Organization member countries reported the implementation of HPV immunization. However, HPV vaccination dread, concerns about its safety, and associated adverse outcomes have a significant impact on the HPV vaccine implementation campaigns all over the world. Many developed countries have successfully implemented HPV immunization and achieved tremendous progress in preventing HPV-related conditions. However, there are still many countries worldwide which have not created, or have not yet implemented, HPV vaccination campaigns, or have failed due to deficient realization plans associated with establishing successful HPV vaccination programs. Lack of proper HPV information campaigns, negative media reflection, and numerous myths and fake information have led to HPV vaccine rejection in many states. Thus, context-specific health educational interventions on HPV vaccination safety, effectiveness, and benefits are important to increase the vaccines' acceptance for efficacious prevention of HPV-associated conditions.

HPV Vaccine Hesitancy Among Medical Students in China: A Multicenter Survey.

Human papillomavirus (HPV) is the most common genital tract virus infection and can cause genital warts and cervical cancer. This multicenter study examined HPV information sources, vaccine hesitancy, and the association between the two variables. An online survey of HPV information sources and vaccine hesitancy was conducted among Chinese medical students. The World Health Organization (WHO) Vaccine Hesitancy 3Cs model was used to evaluate reasons for respondents' vaccine hesitancy. A probit model was used to investigate the association between vaccine information sources and vaccine hesitancy. The reported rate of vaccine hesitancy was 62.36%. Convenience was the primary factor for vaccine hesitancy in medical students, and 19% used a single source to obtain vaccine information. A multivariate analysis revealed that master degree and above were 33% less likely to be hesitant about the HPV vaccine than first grade students. Respondents receiving HPV information through doctor were 8% less likely to report vaccine hesitancy than those receiving information from other information channels. HPV vaccine hesitancy requires more attention. Future studies could examine whether increasing vaccination locations and dissemination of information about the safety and effectiveness of HPV vaccines as well as using Internet media would help reduce medical students' vaccine hesitancy and expand HPV vaccine coverage.

Disentangling the Role of Religiosity in Human Papillomavirus Vaccination Amidst COVID-19 Pandemic.

Religion is a complex and sociocultural driver of human papillomavirus (HPV) vaccination decisions, but its exact role has been mixed/unclear. We used a cross-sectional study of 342 Christian parents to examine the associations between the three domains of religiosity (organizational, non-organizational, and intrinsic) and the intention to (i) seek HPV information and (ii) receive the HPV vaccine. Organizational religiosity was the only domain that was positively associated with information-seeking intention regardless of the type of covariates included. Mixed findings in the association between religiosity and HPV vaccination decisions may depend on the religiosity domain being assessed.

Health Literacy Correlates to HPV Vaccination Among US Adults Ages 27-45.

Human papillomavirus (HPV) vaccination is now available for adults aged 27–45 as a shared clinical decision. Health literacy skills (i.e., accessing, understanding, appraising, applying information) may facilitate vaccine decision-making for adults with a provider recommendation. This study assessed associations between health literacy skills and willingness to get a provider-recommended HPV vaccine among newly eligible US adults. In 2020, US participants (51% women), aged 27–45 years, were surveyed online (n = 691). The outcome was willingness (willing/not willing) to get the HPV vaccine with provider recommendation. Measures were adapted from Sørensen’s multidimensional European Health Literacy Scale, which assesses health literacy among four domains (i.e., access, understanding, appraisal, application). Adjusted odds ratios were calculated for the outcome and each health literacy domain, adjusting for personal health determinants (e.g., age, sex). The sample consisted of primarily non-Hispanic (91.2%), White (74.4%), and married (60.7%) adults. Approximately 65% of participants were willing to get a provider-recommended HPV vaccine. Higher willingness to vaccinate with provider recommendation was significantly associated with increased HPV knowledge (understanding; aOR = 1.13, 95% CI 1.04, 1.24), ability to understand HPV information (understanding; aOR = 1.96, 95% CI 1.09, 3.52), increased perceived vulnerability to HPV-related cancer (appraising; aOR = 3.22, 95% CI 1.83, 5.69), and the need for more information on vaccine safety to seek vaccination (applying; aOR = 3.25; 95% CI 2.05, 5.16). Utilizing a multidimensional health literacy framework to evaluate facilitators to HPV vaccination uptake among adults aged 27–45 can help guide future interventions by targeting accurate, easy-to-understand HPV information that connects vaccination efficacy to reduction in HPV cancer risk.

Sources of Information and Communication About HPV Among Chinese Students Attending U.S. Colleges: Implications for Culturally Appropriate Strategies.

Little is known about human papillomavirus (HPV) information sources and communication among Chinese students attending U.S. colleges. We assessed information sources and communication about HPV and HPV vaccines among this population. A cross-sectional design with 449 participants was conducted by using a questionnaire and snowball sampling. Summary statistics and multiple logistic regression were used. The most common sources of HPV information included the internet and friends. Communication about HPV occurred most frequently among friends, family, and health professionals. Those who had better HPV knowledge and attitudes and were vaccinated against HPV were more likely to use internet, friends, family, and health professionals as their information sources. Because the internet, friends, and families are likely sources for HPV information and communication, future internet-based culturally appropriate education should offer information not only to Chinese students but also to their social circles. Cultural beliefs may affect HPV prevention and should be examined.

HPV vaccine awareness, knowledge and information sources among youth in Switzerland: a mixed methods study

ObjectivesWe aimed to provide a detailed characterisation of human papillomavirus (HPV) vaccine awareness, knowledge and information sources in the HPV vaccine decision-making process of youth, both male and female, in...

National trends and survival outcomes of penile squamous cell carcinoma based on human papillomavirus status.

BackgroundThere are no series evaluating penile squamous cell carcinoma (pSCC) based on human papillomavirus (HPV) infection. Herein, we present national registry data on clinical and survival outcomes for pSCC based on HPV status.MethodsWe performed a retrospective review of 1224 pSCC patients with known HPV staining from the National Cancer Database. Patients with cM1 disease, those who did not receive treatment, or had missing follow‐up data were excluded. Logistic regression identified factors associated with locally aggressive disease. Univariable, multivariable, and inverse probability of treatment weighting (IPTW)‐Cox proportional hazard modeling were used to assess hazard ratios (HR) associated with overall survival (OS).ResultsAfter exclusion criteria, we identified 825 cases of which 321 (38.9%) were HPV positive. The HPV‐positivity rate did not significantly change by year. HPV‐positive patients were younger, had lower Charlson‐Deyo performance score, and resided in areas with both lower median household income and lower school education completion. HPV‐positive tumors presented with lower American Joint Committee on Cancer clinical T‐stage (cT), poorer differentiation, lower rates of lymphovascular invasion (LVI), but more node‐positive disease (cN+). For those who underwent lymph node surgery, there were no differences in final pathologic stage, upstaging, or presence of extranodal extension. Only tumor differentiation, LVI, and performance score were independent predictors for locally aggressive disease. HPV status was not a predictor of OS (IPTW‐HR:0.89, p = 0.13).ConclusionsIn the largest series evaluating pSCC based on HPV status, HPV‐positive tumors were associated with lower cT stages, less LVI, but more cN + disease. More studies on prognostic factors are needed, and time may still be immature to use HPV information for risk stratification.

HPV vaccination, information sources, and acculturation among Chinese college students aged 18-26 in the United States.

Human papillomavirus (HPV) vaccination behaviors among Chinese college students (CCS) in the United States are affected by social determinants of health. Using a self-report questionnaire and a snowball sampling technique, this cross-sectional study investigated (a) HPV vaccination practices; (b) primary social networking platforms and preferred means of receiving HPV information; and (c) the influence of acculturation on HPV vaccination, HPV information sources, and social networking use among 213 CCS aged 18-26 in the United States. About half (50.7%) had received one to three doses of an HPV vaccine, and 91.7% had received their first dose. The most popular social networking platforms were WeChat (69.5%), Instagram (58.7%), text messaging (55.4%), and Facebook (47.4%). Preferred means of receiving future HPV information included the internet, online social networking, and health professionals. Participants with high Asian identification (AI) were less likely to receive the HPV vaccine than those with high Western identification. Participants with high AI were more likely to use WeChat for their social networking but less likely to use US-based social media platforms. Acculturation, preferred social networking platforms, and sources and communication of HPV (i.e., health professionals, family members, schoolteachers, friends) influenced participants' HPV vaccination. To promote equity of access to health messages and increase HPV vaccination, future efforts should pay attention to CCS with high AI and incorporate their cultural beliefs and practices. Given that nonprofessionals (e.g., family, friends) were influential factors in HPV vaccination, it is critical to tailor interventions for CCS to the recipients and their social circles.

Creditable Health Information? An Analysis of Human Papillomavirus Vaccine Messages on YouTube

Aims: Human papillomavirus (HPV) infection is the most common sexually transmitted infection globally. Vaccination is effective in preventing HPV-associated cancers and is recommended for children at ages 11-12; however, the vaccination rate is suboptimal. Credible information about HPV vaccine in social media will help the public make effective healthcare decisions. This study analyzed YouTube videos about HPV vaccine.&#x0D; Study Design: Descriptive study. &#x0D; Place and Duration of Study: Videos in English posted on YouTube during 2006-2020.&#x0D; Methodology: We used purposive sampling to select and conduct a quantitative content analysis of 151 YouTube videos that met the criteria. An instrument including video characteristics and theoretical constructs of the Health Belief Model was used to code the videos. Three researchers independently coded the data; another three verified the accuracy. The team discussed discrepancies until reaching a consensus. We conducted descriptive and inferential statistics.&#x0D; Results: The major source of videos were medical centers/hospitals (26%), government (22%), media (20%), and consumers (15%). About 80% of the videos were positive in tone. Information covered included vaccine knowledge (85.4%), benefits (81.5%), severity if infected (79.5%), susceptibility (60.9%), and barriers (37.7%). The primary vaccination barriers were lack of knowledge of HPV and vaccine (12.6%), worries about adverse events/safety of vaccine (14.6%) and its side effects (9.3%). Videos in neutral tone had the highest number of views, likes and dislikes. Negative tone was mostly found in videos made by consumers and media while positive tone was found in videos made by governmental agencies and medical center/hospital. &#x0D; Conclusion: Despite YouTube being a popular avenue to disseminate health information and influence care, the HPV-related information on YouTube is mixed. Anecdotal health information without scientific support can mislead individuals’ decision in vaccination. Educational videos with comprehensive and accurate HPV information addressing barriers are imperative to promote vaccination and prevent HPV-related cancers.

Do Health-Seeking Populations Know the Link Between Human Papillomavirus and Oropharyngeal Cancer? A Cross-Sectional Study in a Nigerian Population.

The human papillomavirus (HPV) has been causally linked to oropharyngeal cancers. The extent to which the population is aware of this link has not been explored in Nigeria. We aim to investigate the knowledge of the link between HPV and oropharyngeal cancers in a health-seeking population in Nigeria.Methodology: We used a cross-sectional study design, with a multi-stage sampling method comprising a cluster of four health facilities and first-time adult patients attending the general outpatient clinics of the selected health facilities. An interviewer-administered questionnaire was be used to obtain demographic information, social history, HPV awareness, HPV vaccination and the link between HPV and oropharyngeal cancer. A total of 1,000 respondents completed the survey from four health facilities in Lagos, Nigeria. Majority of respondents were below 40 years (61.5%), and female (53.4%). About 13.4% of the study population were aware of HPV, and 7.9% of HPV vaccines. The most common source of HPV information for respondents who were aware of HPV was the internet (65.4%). Only 7.7% of respondents knew the link between HPV and oropharyngeal cancer. Significant predictors of knowledge of the link between HPV and oropharyngeal cancer were higher education [p: 0.012], higher overall knowledge of HPV risk factors and complications [p: 0.000]; and awareness of HPV vaccine [p: 0.020]. Our findings suggest a lack of public knowledge of the link between HPV and oropharyngeal cancer. These findings could inform health promotion measures for oropharyngeal cancer, particularly for groups where knowledge is lowest.

Investigating HPV- and HPV Vaccine-Related Knowledge, Perceptions, and Information Sources among Health Care Providers in Three Big Cities in China.

The limited access to vaccination and vaccine hesitancy are prevalent even among health care providers in less developed countries. This study assessed the relationships between (i) health care providers’ knowledge on human papillomavirus (HPV) and vaccination for HPV and (ii) their perceptions, demographic characteristics, and the use of information sources. In this large-scale online survey, participants (n = 1394) were recruited from hospitals of three big cities in China (Shanghai, Guangzhou, and Shenzhen). Descriptive analysis, the chi-square test, and logistic regression analysis were used to answer different research questions. Health care providers’ overall knowledge scores are consistent with their perceptions about HPV and HPV vaccine. Occupation, specialty, the type of hospitals, and the frequency of participants’ search for information using professional informational sources are the most significant characteristics that are closely associated with their knowledge of HPV and its vaccine. Targeted educational interventions are needed to improve health care providers’ engagement in the promotion of the HPV vaccine. Such interventions, besides increasing knowledge, should also emphasize the importance of appropriate information sources to acquire information.

Awareness and knowledge of human papilloma virus in UK women aged 25 years and over: Results from a cross-sectional internet-based survey.

The expanding use of human papilloma virus (HPV) testing within cervical screening requires an evaluation of public understanding of HPV. This study aimed to explore HPV awareness and knowledge using a previously psychometrically validated measure in a sample of UK women aged 25years and over. An anonymous web-based cross-sectional survey design was used, and responses were recorded for 246 women (mean age=37.59, SD=9.20). Findings indicated limits to women's understanding of HPV, its transmission, treatment and link with cancer. The mean HPV knowledge score was 9.35 (4.43), and the mean HPV testing score was 3.34 (1.91). Multivariate analyses revealed that information seeking following cervical screening and being a student is associated with higher HPV knowledge and that having a positive HPV test result and having university education is associated with higher HPV testing knowledge. These results highlight that there is a lack of knowledge and misunderstanding relating to HPV and its link with cancer in adult women in the UK. The findings suggest that public health HPV information campaigns are urgently needed, especially with a drop in UK cervical screening attendance rates, and with the upcoming change to HPV primary testing within the UK NHS cervical screening programme.

Risk stratification of cervical lesions using capture sequencing and machine learning method based on HPV and human integrated genomic profiles.

From initial human papillomavirus (HPV) infection and precursor stages, the development of cervical cancer takes decades. High-sensitivity HPV DNA testing is currently recommended as primary screening method for cervical cancer, whereas better triage methodologies are encouraged to provide accurate risk management for HPV-positive women. Given that virus-driven genomic variation accumulates during cervical carcinogenesis, we designed a 39 Mb custom capture panel targeting 17 HPV types and 522 mutant genes related to cervical cancer. Using capture-based next-generation sequencing, HPV integration status, somatic mutation and copy number variation were analyzed on 34 paired samples, including 10 cases of HPV infection (HPV+), 10 cases of cervical intraepithelial neoplasia (CIN) grade and 14 cases of CIN2+ (CIN2: n = 1; CIN2-3: n = 3; CIN3: n = 9; squamous cell carcinoma: n = 1). Finally, the machine learning algorithm (Random Forest) was applied to build the risk stratification model for cervical precursor lesions based on CIN2+ enriched biomarkers. Generally, HPV integration events (11 in HPV+, 25 in CIN1 and 56 in CIN2+), non-synonymous mutations (2 in CIN1, 12 in CIN2+) and copy number variations (19.1 in HPV+, 29.4 in CIN1 and 127 in CIN2+) increased from HPV+ to CIN2+. Interestingly, 'common' deletion of mitochondrial chromosome was significantly observed in CIN2+ (P = 0.009). Together, CIN2+ enriched biomarkers, classified as HPV information, mutation, amplification, deletion and mitochondrial change, successfully predicted CIN2+ with average accuracy probability score of 0.814, and amplification and deletion ranked as the most important features. Our custom capture sequencing combined with machine learning method effectively stratified the risk of cervical lesions and provided valuable integrated triage strategies.

Vaccine Safety International Monitoring

Vaccine safety is an important aspect of mass immunization of the population. Adverse reactions that occur following vaccination result in a decrease in public confidence. The aim of this research was to identify information on the development of adverse events after immunization with vaccines included into the national vaccination calendars of the USA, European Union (EU), Japan, China, South Korea and India. Particular attention was paid to vaccines that are not included in the vaccination calendar, but are presented in the Russian Federation. During monitoring of vaccination against human papillomavirus information in the European Union, Japan and the United States, according the possible connection with development of autoimmune diseases was refuted. Monitoring of adverse events after vaccination with rotavirus vaccine I generation in the USA, EU and India, allowed to establish a link with the development of intestine invagination and limit the use of this medicinal product in favor of vaccine II generation. After starting vaccination against influenza was detected narcolepsy as a complication of this procedure; and when analyzing the complications of meningococcal vaccination Guillain — Barre syndrome was detected. We also analyzed information on various complications associated with vaccination against Japanese viral encephalitis, which was included into the national vaccination calendar of countries in Asia and the Pacifi c region — China, India, Japan, and South Korea. The main complications registered in the PRC after the introduction of Japanese encephalitis vaccine into the national vaccination calendar included: febrile seizures, thrombocytopenic purpura, encephalitis and meningitis. The main safety concerns about vaccines included into the national vaccination calendars of EU countries, the USA and the Asia-Pacific region concern vaccines that have recently appeared on the pharmaceutical market.