Human Papillomavirus Vaccination Of Boys Research Articles

HPV‐related oropharyngeal cancer: preventable and treatable if recognised early

Oncogenic human papilloma virus (HPV) currently accounts for 50% of throat cancer cases in men in the UK. Due to the absence of conventional risk factors for head and neck cancer, many men are diagnosed late. Despite this, cure rates are high. Typically, the treatment is with surgery or chemoradiotherapy. The recently introduced programme of HPV vaccination in boys should, in the long‐term, see a dramatic reduction in this cancer type.

Acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana

BackgroundAlmost all cases of cervical and anal cancer have been linked to the human papillomavirus (HPV). However, in addition to women who develop HPV-related cervical cancer, both men and women can also develop cancers of the anus, oral cavity, and oropharynx that are attributed to HPV. However, literature on HPV vaccination among boys globally, in Africa, and most especially in Ghana is scarce. Thus, the main objective of this study was to explore the acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana.MethodsIn this study, a qualitative exploratory design was utilized to enlist 30 mothers who have male children aged between 9 and 12 years from the Greater Accra Region of Ghana. The recruitment of participants was carried out using a purposive sampling technique, and they were subsequently interviewed in-depth in a face-to-face setting, with the entire conversation being recorded for reference. After transcription, the recorded data were analyzed through content analysis.FindingsUpon analyzing the data, two (2) primary themes and 11 sub-themes emerged. The research showed that although the majority of the mothers were unaware of HPV in boys, they perceived it as a positive initiative and expressed a willingness to allow their sons to receive the vaccine. However, some participants mentioned certain factors that they believed could hinder the acceptance of HPV vaccination in boys among mothers. These included concerns about injection-related pain, high cost, and fears that the vaccine could make men immoral or infertile.ConclusionThe study revealed poor awareness of HPV vaccination in boys among mothers, and hence, suggested the need to increase the awareness on HPV vaccination in boys among mothers as well as the public to increase its acceptance.

The long view of vaccination to secure the future

The long view of vaccination to secure the future

The impact of publicly funded immunization programs on human papillomavirus vaccination in boys and girls: An observational study

Reaching and maintaining high global human papillomavirus (HPV) vaccine uptake has been challenging. The impact of publicly funded HPV immunization programs and the interplay of sociodemographic, psychosocial and policy factors in maximizing vaccination is poorly understood. This observational study examined the impact of introducing publicly funded school-based HPV vaccination programs for boys directly on uptake in boys and indirectly on uptake in girls, while concurrently examining other important sociodemographic and psychosocial factors. Data were collected from a national, longitudinal sample of Canadian parents of children aged 9-16 years during August-September 2016 (T1) and June-July 2017 (T2). Participants completed an online questionnaire measuring sociodemographic characteristics, vaccine knowledge and attitudes, health care provider recommendation, and HPV vaccine uptake. Analyses were conducted separately for parents of boys and girls using logistic regression analyses at T1 and T2. Jurisdictions with HPV vaccine funding for boys at both time-points were compared to those with funding at neither time-points and those that introduced funding between time-points. The sample included parents of boys (n=716) and girls (n=843). In multivariable analyses, jurisdictions with funding for boys at both time-points had higher odds of vaccination (adjusted odds ratio, T1 = 10.18, T2 = 11.42; 95% confidence interval, T1 = 3.08-33.58, T2 = 5.61-23.23) than jurisdictions without funding at both time-points; however, funded jurisdictions did not have higher odds of vaccination compared to jurisdictions that newly introduced funding for boys. Vaccination was associated with consistent determinants in boys and girls including child's age, health care provider recommendation, perceived vaccine harms, and perceived vaccine affordability. This gender-sensitive analysis highlights the interplay of sociodemographic, psychosocial, and policy factors that can improve HPV vaccination. Publicly funded school-based programs are an impactful strategy to increase vaccine uptake. This work was supported by the Canadian Cancer Society Research Institute (#704,036). GKS was supported by the Vanier Canada Graduate Scholarship and Queen Elizabeth II Diamond Jubilee Scholarship programs. The funders of this work had no role in the data collection, analysis, or interpretation, or any aspect pertinent to the study.

Adherence to HPV vaccine by responsible of boys in an elementary school Dr. Afrânio de Mello Franco

OBJECTIVE: Human Papillomavirus (HPV) is directly related to carcinoma of the cervix, oropharynx, anus, and penis. HPV infection can be prevented by vaccination and since 2017. Both boys and girls have free access to the vaccine by Public Health System. The present study aimed to carry out an epidemiological survey on HPV vaccination in boys, between 2017 and 2018 at the Dr. Afrânio de Mello Franco municipal elementary school. METHODS: A transversal, descriptive and analytical study was carried out. The data were collected through the application of a questionnaire to those responsible for the children. RESULTS: It was observed that the vast majority of those responsible for the boys were women (90.48%). In general, 36.84% did not adhere to the HPV vaccination campaign, although 97.37% of them considered vaccination important, regardless whether they adhered or not to the vaccination campaign. Among the main reasons for the non-adherence was the lack of knowledge that boys can get the vaccine (42.86%), the age that they could receive the vaccine (21.43%), and the lack of time (21.43%). CONCLUSION: Our results suggest that non-adherence to vaccination in boys is mainly due to the lack of information on the vaccine, the HPV infection, correlation of the infection with cancer of the penis and cervix. Dissemination of that knowledge, mainly by television might improve adherence to the HPV vaccination.

Human Papillomavirus Seroprevalence and Seroconversion Among Men Living With HIV: Cohort Study in South Africa.

Men living with HIV (MLHIV) have a high burden of human papillomavirus (HPV)-related cancer. Understanding serological dynamics of HPV in men can guide decisions on introducing HPV vaccination and monitoring impact. We determined HPV seroprevalence and evaluated factors associated with HPV seroconversion among MLHIV in Johannesburg, South Africa. We enrolled 304 sexually active MLHIV 18 years and older and collected sociobehavioral data, blood samples (CD4 counts, HIV-1 plasma viral load, and HPV serology), and genital and anal swabs [HPV DNA and HPV viral load (VL)] at enrollment and 6-monthly for up to 18 months. Antibodies to 15 HPV types were measured using HPV pseudovirions. Generalized estimating equations were used to evaluate correlates of HPV seroconversion. Median age at enrollment was 38 years (IQR: 22-59), 25% reported >1 sexual partner in the past 3 months, and 5% reported ever having sex with other men. Most participants (65%) were on antiretroviral therapy (ART), with median CD4 count of 445 cells/µL (IQR: 328-567). Seroprevalence for any HPV type was 66% (199/303). Baseline seropositivity for any bivalent (16/18), quadrivalent (6/11/16/18), and nonavalent (6/11/16/18/31/33/45/52/58) vaccine types was 19%, 37%, and 60%, respectively. At 18 months, type-specific seroconversion among 59 men whose genital samples were HPV DNA positive but seronegative for the same type at enrollment was 22% (13/59). Type-specific seroconversion was higher among men with detectable HIV plasma viral load (adjusted odds ratio = 2.78, 95% CI: 1.12 to 6.77) and high HPV VL (adjusted odds ratio = 3.32, 95% CI: 1.42 to 7.74). Seropositivity and exposure to nonavalent HPV types were high among MLHIV. HPV vaccination of boys before they become sexually active could reduce the burden of HPV infection among this at-risk population.

Epidemiology of head and neck cancers: an update.

This review attempts to give an update of epidemiological knowledge on head and neck cancers (HNC). Worldwide, from 1990 to 2017, incidence rates for larynx and nasopharyngeal cancers decreased, whereas they increased for oro/hypopharyngeal cancers and lip/oral cavity cancers. They are still markedly higher among men than women. South Asia has the highest HNC incidence rate, followed by Europe, North America, and Australasia.Tobacco and alcohol remain the major risk factors. Rate of cancers attributable to human papillomavirus (HPV) among HNCs is highly depending on world region and tobacco use prevalence. It increases in high-income countries. In the US population, the number of HPV-attributable oropharyngeal cancers now exceeds the number of cervix cancers. HPV vaccination for boys is recommended in an increasing number of countries. Many occupations are associated with an increased HNC risk. Fruits and vegetables intake have a protective effect against HNC. To decrease HNC incidence, measures to reduce tobacco use and alcohol consumption remain essential. Improvement of HPV vaccination coverage is also a major objective. Reduction of carcinogens at occupation, protection of workers from carcinogen exposures, education for better diet, and easy and affordable access to fruits and vegetables can contribute to incidence decrease.

A global epidemic increase of an HPV-induced tonsil and tongue base cancer - potential benefit from a pan-gender use of HPV vaccine.

In 2007, human papillomavirus (HPV) type 16 was finally recognized as a risk factor, besides smoking and alcohol, for oropharyngeal squamous cell carcinoma (OPSCC), including tonsillar squamous cell carcinoma (TSCC), by the International Agency for Research against Cancer. Just before, in 2006, the Food and Drug Administration had approved Gardasil, the first vaccine against HPV16, 18, 6 and 11, for preventive vaccination women against cervical cancer. Concurrently, some Western countries, where smoking was decreasing, disclosed an epidemic increase in the incidence of OPSCC, especially of TSCC and base of tongue cancer (BOTSCC), together accounting for 80-90% of all OPSCCs, and mainly affecting men. The epidemic was later revealed to be due to a rise in HPV-positive cases, and scientists in the field suggested HPV vaccination also of boys. Globally, there are roughly 96000 incident OPSCC cases/year of which 20-24% are caused by HPV, thereby accounting for around 22 000 OPSCC cases annually. Of these cases, 80-90% are due to HPV16 infection and would be prevented with the presently registered HPV vaccines. In Western countries, such as Sweden (with almost 400 TSCC and BOTSCC cases per year) and the United States, HPV prevalence in OPSCC is higher and around 70%. HPV vaccination of girls has been initiated in many countries, and the vaccines have been efficient and their side effects limited. HPV vaccination of boys has, however, been the exception, but should definitely not be delayed any further. It would benefit both girls and boys directly, and result in better and more robust herd immunity. Today, we have the possibility to eliminate several high-risk HPV types in the younger generations and avoid more than 600000 cancer cases annually worldwide, and this possibility should be embraced by offering global pan-gender HPV vaccination.

The World Could End Cervical Cancer if It Tried: Embracing the Power of Youth

Background and context: The human papillomavirus (HPV) is a ubiquitous virus that causes many cancers: cervical, oropharyngeal, anal, penile, vaginal and vulvar cancers, the most serious consequence being cervical cancer that takes the life of a woman between the ages of 35-60 every two minutes in this world. There are existing tools to prevent this cancer today: at the primary prevention level, the HPV vaccines that are up to 90%-97% preventive; at the secondary level, simple screening tests including Pap test, HPV DNA testing, and VIA; and at tertiary level, effective early treatment of precancerous conditions. Yet, cervical cancer is the second most common cancer among women in the developing world. One of the main reasons for this gap is the lack of awareness that cervical cancer is a preventable public health problem. Hence, education and innovative models are necessary for successful control of this disease. The HPV vaccines are recommended between 9-26 years in males and females. Hence, our organization, The Global Initiative Against HPV and Cervical Cancer (GIAHC), decided to empower the next generation to join the fight against HPV and cervical cancer. Aim: To empower the younger generation to play a proactive role to raise awareness and increase the uptake of HPV vaccination and cervical cancer screening through the use of arts in medicine and social media. Strategy/Tactics: An educational PowerPoint presentation was developed by medical and nursing students to present to middle and high school students and in other community settings. Program/Policy process: A 30-minute-long presentation was developed so that it could fit into a classroom period. A script for the presenter, a reference sheet, slides to highlight how HPV can affect both sexes, risk factors and effective ways to prevent it were developed. Emphasis was placed on the HPV vaccine for boys and girls. This was followed by a game, and a short inspirational and aspirational film and a few words to empower them. Outcomes: The program has met with good success: The presentation has been shown by our students in several states in the US and in other countries. Our student group has grown from 2 to 60 in one year. Middle and high school students also want to get involved to spread the message. Students are continually coming up with other creative ways through, dance, painting, poetry video clips and using social media to spread the message. Students of the American Medical Women's Association (AMWA) and Medical Women's International Association (MWIA) have now partnered with us. The Department of Education has expressed an interest to collaborate with us. What was learned: Empowering the younger generation and providing them with the tools to play a pro active role to interweave science with various creative art forms can have far-reaching and greater impact on communities and societies to raise awareness about HPV.

Quadrivalent human papillomavirus vaccination in boys and risk of autoimmune diseases, neurological diseases and venous thromboembolism

In recent years, human papillomavirus (HPV) vaccination of boys has been added to childhood vaccination programmes in several countries but, so far, no systematic population-based assessment with long-term follow-up has been undertaken of the relative incidence of adverse outcomes following HPV vaccination in this group. We investigated if quadrivalent HPV (qHPV) vaccination of 10-17-year-old boys is associated with any unusual risk of autoimmune diseases, neurological diseases or venous thromboembolism. We conducted a national cohort study of 568 410 boys born in Denmark 1988-2006 and followed for 4 million person-years during 2006-16, using nationwide registers to obtain individual-level information about received doses of the qHPV vaccine and hospital records for 39 autoimmune diseases, 12 neurological diseases and venous thromboembolism. For each outcome, we estimated incidence rate ratios (RRs) with 95% confidence intervals (CIs) according to qHPV vaccination status. Altogether 7384 boys received at least one dose of the qHPV vaccine at age 10-17 years. Overall, RRs were close to unity for the combined groups of autoimmune diseases (RR = 0.96; 95% CI: 0.71-1.28, n = 46 cases in qHPV-vaccinated boys) and neurological diseases (RR = 0.67; 0.41-1.10, n = 16), as well as for venous thromboembolism (RR = 0.88; 0.33-2.35, n = 4). After taking multiple testing into account, none of the 52 individual outcomes studied appeared to occur in excess among qHPV-vaccinated boys. Although additional large-scale epidemiological studies are warranted, our findings provide population-based reassurance that qHPV vaccination of 10-17-year-old boys is unlikely to be associated with an elevated risk of autoimmune diseases, neurological diseases or venous thromboembolism.

Human papillomavirus (HPV) infection and vaccination: knowledge and attitudes among healthcare professionals and the general public in Slovenia

This study evaluates knowledge of and attitudes toward human papillomavirus (HPV) infection and vaccination among healthcare professionals and the general public in Slovenia. Five statements were designed to evaluate participants' opinions regarding age at HPV vaccine administration and potential delay in vaccination, associations of HPV vaccination with riskier sexual behavior, HPV vaccine safety, the importance of the internet as a source of information, and the significance of HPV vaccination in boys. Participants were asked to express agreement or disagreement with each statement. A total of 605 surveys were completed by medical students (n = 259), parents of sixth-graders in 2016 (n = 103) and 2017 (n = 103), pediatricians and school medicine specialists (n = 21), gynecologists (n = 34), and women visiting gynecology outpatient clinics (n = 85). The highest level of knowledge and belief in the HPV vaccine and its safety was observed among pediatricians and school medicine specialists. Medical students tend to have a very positive attitude toward HPV vaccination, although they need additional education about HPV vaccine safety. Some healthcare professionals showed signs of HPV vaccine hesitancy, and their beliefs were somewhat similar to those of the general public. Although the overall attitude towards HPV vaccination is generally positive, additional education must be provided to both healthcare professionals and the general public in order to achieve higher HPV vaccination coverage rates in Slovenia.

Vacunación contra el virus del papiloma humano para niños en Brasil

Vacunación contra el virus del papiloma humano para niños en Brasil

Socioeconomic predictors of human papillomavirus vaccination in Danish men – A nationwide study

BackgroundThe quadrivalent human papillomavirus vaccine was licensed in Denmark in 2006. Unlike women, men are not offered human papillomavirus vaccination free of charge but can have it at their own expense. We investigated human papillomavirus vaccine uptake by men in Denmark and the socioeconomic factors that may predict human papillomavirus vaccination. MethodsUsing the Civil Registration System, we identified all boys and men aged 9–26 years in 2006–2013 and their mothers. By linkage to Statistics Denmark and the National Prescription Registry, we obtained information on socioeconomic variables and human papillomavirus vaccination during the study period. Using Cox regression, we examined the associations between socioeconomic variables and human papillomavirus vaccination. ResultsBetween 2006 and 2013, 6253 (0.8%) males aged 9–26 years were vaccinated against human papillomavirus. The strongest predictor identified was ethnicity. Males who were immigrants (hazard ratio, 0.12; 95% confidence interval, 0.08–0.180) or sons of immigrant parents (hazard ratio, 0.13; 95% confidence interval, 0.10–0.17) were less likely to be vaccinated than Danish males. Additionally, sons of mothers who were unemployed, unmarried, had a low income, and basic education initiated human papillomavirus vaccination less frequently. Finally, sons of mothers who were physicians or nurses were more likely to be vaccinated than sons of other highly educated mothers. ConclusionWe found low uptake, with social disparities in human papillomavirus vaccination of boys and young men in Denmark.

Health policy: HPV vaccination in boys - will the UK join the fight?

The UK Joint Committee on Vaccination and Immunization recently announced a further delay before considering the subject of widespread human papillomavirus (HPV) vaccination in teenage boys, thereby excluding an estimated 2.9 million boys from receiving an effective treatment in this interim period. Vaccination of boys can offer significant clinical, economic and ethical advantages.

Collateral Damage and Critical Turning Points: Public Health Implications of HPV Vaccine News Coverage for Boys and Men in 2011

ABSTRACTIn 2009, the Food and Drug Administration (FDA) officially expanded approval of the Gardasil vaccine to include human papillomavirus (HPV) vaccination for boys and men, and in 2011, the Centers for Disease Control and Prevention (CDC) issued a formal recommendation for routine vaccination for this population. Despite these efforts, HPV vaccination rates for boys and men continue to fall short of public health targets. While news was breaking about the benefits of the HPV vaccine for boys and men, public attention shifted as a result of political debates concerning the vaccine. This study examines a pivotal time period for public health in which the vaccine became officially recommended for boys and men and at the same time became the center of political controversies in the lead-up to the 2012 presidential campaign. The current study extends previous research and presents a content analysis of newspaper articles (N = 154) about the HPV vaccine for the year 2011. Results indicate that the lack of comprehensive coverage of HPV and the HPV vaccine found in previous studies continued in this year. Results shed light on key political events that may have functioned to overshadow the recommendation of the HPV vaccine for boys and men. The implications of this pattern of news coverage can inform public health efforts to address low rates of HPV vaccination uptake among boys and men in present day.

Vaccination of boys or catch-up of girls above 11years of age with the HPV-16/18 AS04-adjuvanted vaccine: where is the greatest benefit for cervical cancer prevention in Italy?

BackgroundSince 2007, a Human Papillomavirus (HPV) vaccination programme against cervical cancer (CC) is implemented in Italy in 11-year-old girls. The extension of HPV vaccination to young adult women, or to 11-year-old boys could further reduce the CC burden, in the latter case from indirect effect on HPV transmission. The objective of the study was to compare the potential CC cases prevention from HPV-16/18 AS04-adjuvanted vaccination of adding catch-up targeting 15- or 25-year-old girls to the addition of boys vaccination in Italy.The models assessing the impact of these alternative vaccination strategies are usually dynamic models requiring numerous input data. Simpler models could however provide some insight into this question, as reported in the current study.MethodsA published cohort model adapted to the Italian setting was used to estimate the potential CC reduction following different HPV vaccination strategies with a HPV-16/18 AS04-adjuvanted vaccine: vaccination of 11-year-old girls, female aged 15 or 25 years. The model assumed that the maximum benefit obtained from vaccinating boys equals the CC reduction that would result from immunisation of all non-vaccinated girls of the same age. Each cohort of 11-year-olds (either girls or boys) was assumed to include 281,000 individuals and a 70 % vaccination coverage was applied. Sensitivity analysis was performed by varying the vaccination coverage and the overlap in potential sexual contacts between vaccinated boys and girls of the same age-group.ResultsUnder base case, compared with the screening-only scenario, HPV vaccination of 11-year-old girls, 15-year-old females, 25-year-old females or 11-year-old boys, would prevent 1,146, 1,082, 788 or 491 CC cases respectively. HPV vaccination of boys could result in more CC cases prevented than adding a female catch-up only in scenarios with low vaccination coverage in the primary target cohort and when combined with small overlap between vaccinated boys and girls of the same age cohort.ConclusionsFor a fixed limited additional budget allowing the inclusion of a single catch-up cohort, the extension of HPV vaccination to girls or young women instead of boys was estimated to maximise the number of CC cases prevented.

The value of male human papillomavirus vaccination in preventing cervical cancer and genital warts in a low-resource setting.

To estimate health benefits and incremental cost-effectiveness of human papillomavirus (HPV) vaccination of pre-adolescent boys and girls compared with girls alone for preventing cervical cancer and genital warts. Model-based economic evaluation. Southern Vietnam. Males and females aged ≥9 years. We simulated dynamic HPV transmission to estimate cervical cancer and genital warts cases. Models were calibrated to epidemiological data from south Vietnam. Incremental cost-effectiveness ratios (ICERs): cost per quality-adjusted life-year (QALY). Vaccinating girls alone was associated with reductions in lifetime cervical cancer risk ranging from 20 to 56.9% as coverage varied from 25 to 90%. Adding boys to the vaccination programme yielded marginal incremental benefits (≤3.6% higher absolute cervical cancer risk reduction), compared with vaccinating girls alone at all coverages. At ≤25 international dollars (I$) per vaccinated adolescent (I$5 per dose), HPV vaccination of boys was below the threshold of Vietnam's per-capita GDP (I$2800), with ICERs ranging from I$734 per QALY at 25% coverage to I$2064 per QALY for 90% coverage. Including health benefits from averting genital warts yielded more favourable ICERs, and vaccination of boys at I$10/dose became cost-effective at or below 75% coverage. Using a lower cost-effectiveness threshold of 50% of Vietnam's GDP (I$1400), vaccinating boys was no longer attractive at costs above I$5 per dose regardless of coverage. Vaccination of boys may be cost-effective at low vaccine costs, but provides little benefit over vaccinating girls only. Focusing on achieving high vaccine coverage of girls may be more efficient for southern Vietnam and similar low-resource settings. Limited cervical cancer reduction from including boys in HPV vaccination of girls in low-resource settings.

Human Papillomavirus Vaccination of Boys and Extended Catch-up Vaccination: Effects on the Resilience of Programs.

Decreasing human papillomavirus (HPV) vaccine prices makes scaling up of vaccination programs attractive for countries that initially targeted 1 or a few birth cohorts of girls and/or achieved low coverage. This article aims to compare the impact of alternative HPV vaccination strategies, using data from Sweden, a high-income country that has experienced vaccine price changes. Using an HPV transmission model, we compared the existing vaccination program to alternatives, accounting for a 1-time catch-up vaccination of 22-26-year-old women, with or without routine vaccination of school-age boys, and for a 1-time catch-up vaccination of males aged 13-26 years. We also assessed the resilience of vaccination alternatives to coverage reduction. On the basis of an HPV16/18 prevalence of 12% before the HPV vaccine era, extended catch-up vaccination for females and males yielded relative reductions in the HPV prevalence of 49.4% and 55.6%, respectively, during the first 10 years after the start of each vaccination strategy, whereas the existing program yielded a relative reduction of 38.6% during the same period. The increased prevalence reduction due to catch-up vaccination continued for about 30 years. As compared to female-only routine and extended catch-up vaccination, routine vaccination of males with or without catch-up was, respectively, 12.6-fold and 7.2-fold more resilient to coverage reduction. Vaccination strategies based on catch-up vaccination of females and males are effective for accelerating HPV prevalence reduction. Inclusion of routine male vaccination improves the resilience of vaccination programs.

A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer.

Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis. After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a "lifetime" time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy. Assuming 99% vaccine efficacy and 70% uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime. On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada.

Intervention effects from a social marketing campaign to promote HPV vaccination in preteen boys

ObjectivesAdoption of human papillomavirus (HPV) vaccination in the US has been slow. In 2011, HPV vaccination of boys was recommended by CDC for routine use at ages 11–12. We conducted and evaluated a social marketing intervention with parents and providers to stimulate HPV vaccination among preteen boys. MethodsWe targeted parents and providers of 9–13 year old boys in a 13 county NC region. The 3-month intervention included distribution of HPV vaccination posters and brochures to all county health departments plus 194 enrolled providers; two radio PSAs; and an online CME training. A Cox proportional hazards model was fit using NC immunization registry data to examine whether vaccination rates in 9–13 year old boys increased during the intervention period in targeted counties compared to control counties (n=15) with similar demographics. To compare with other adolescent vaccines, similar models were fit for HPV vaccination in girls and meningococcal and Tdap vaccination of boys in the same age range. Moderating effects of age, race, and Vaccines for Children (VFC) eligibility on the intervention were considered. ResultsThe Cox model showed an intervention effect (β=0.29, HR=1.34, p=.0024), indicating that during the intervention the probability of vaccination increased by 34% in the intervention counties relative to the control counties. Comparisons with HPV vaccination in girls and Tdap and meningococcal vaccination in boys suggest a unique boost for HPV vaccination in boys during the intervention. Model covariates of age, race and VFC eligibility were all significantly associated with vaccination rates (p<.0001 for all). HPV vaccination rates were highest in the 11–12 year old boys. Overall, three of every four clinic visits for Tdap and meningococcal vaccines for preteen boys were missed opportunities to administer HPV vaccination simultaneously. ConclusionsSocial marketing techniques can encourage parents and health care providers to vaccinate preteen boys against HPV.