Human Papillomavirus Vaccine Recommendations Research Articles

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.

Cost-Effectiveness of 9-Valent HPV Vaccination for Patients Treated for High-Grade Cervical Intraepithelial Neoplasia in the UK

Patients who have been treated for high-grade cervical intraepithelial neoplasia (CIN grade ≥2) are at a high risk for subsequent CIN and other cancers and diseases related to human papillomavirus (HPV). HPV vaccination can reduce the risk of subsequent disease in patients surgically treated for grade 2 or greater CIN; however, there is no formal recommendation for prophylactic HPV vaccination in this high-risk population, and the cost-effectiveness is unknown. To assess the incremental lifetime outcomes, costs, and cost-effectiveness of integrating peritreatment 9-valent HPV (9vHPV) vaccination in combination with posttreatment surveillance for the prevention of cervical cancer and other HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN vs posttreatment surveillance alone from a UK payer perspective. This economic evaluation used 3 independent Markov model structures. Model inputs for vaccine efficacy, utilities, and costs were obtained from published sources, and cervical cancer screening data were obtained from the National Health Service Cervical Screening Program. Costs were adjusted to 2022 to 2023 reference years. Data were analyzed from October 2022 to September 2023. Peritreatment vaccination with 9vHPV in combination with posttreatment surveillance compared with posttreatment surveillance alone. Clinical outcomes included grade 1, 2, or 3 CIN; cervical cancer; vaginal cancer; vulvar cancer; anal cancer; head and neck cancer; genital warts; and recurrent respiratory papillomatosis. Incremental cost-effectiveness ratios (ICERs) using a willingness-to-pay threshold (WTP) of £20 000 (US $26 200) per quality-adjusted life-year (QALY) were estimated. Deterministic sensitivity analysis and probabilistic sensitivity analysis were performed. Vaccination with 9vHPV in conjunction with posttreatment surveillance was cost-effective, with a favorable ICER of £13 789.07 (US $18 064.68) per QALY gained (ie, below the WTP of £20 000 per QALY) vs posttreatment surveillance alone. The resulting ICER was £52 358.01 (US $68 588.99) per HPV-related cancer averted and £64 090 (US $83 958.18) per HPV-related cancer death averted. The ICER was most sensitive to discount rate, incidence of HPV infection, vaccine price, and age at initial treatment for grade 2 or greater CIN. Results of the probabilistic sensitivity analysis showed peritreatment 9vHPV vaccination was cost-effective at the WTP recommended by the UK's Joint Committee on Vaccination and Immunisation (90% of iterations <£30 000 [US $39 300] per QALY) in 100% of iterations. These findings suggest that peritreatment prophylactic 9vHPV vaccination is a cost-effective option for preventing subsequent HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN.

Abstract A123: Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States

Abstract Background: Human Papillomavirus (HPV) vaccination is essential to prevent occurrences of a variety of HPV associated cancers. The awareness of HPV and its vaccine could be associated with the use of telehealth. The aims of this study were to examine the association between awareness of HPV and HPV vaccine with receiving telehealth for health care within the past year. Methods: Data from the Health Information National Trends Survey (HINTS) 6 (N=5,887) were utilized. Dependent variable was awareness of HPV and HPV vaccine. The independent variable was those who received care from a doctor or health professional using telehealth. Weighted multivariable logistic regression was performed to determine association of awareness of HPV and its vaccine with receiving healthcare using telehealth while adjusting for age, gender, race, education, and census region. Results: The study sample consisted of 68.28% awareness of HPV and 63.47% awareness of HPV vaccine. After controlling for covariates, we found those who were aware of HPV and HPV vaccine have received telehealth care (aOR=1.40, 95%CI:1.11-1.78; aOR= 1.40, 95%CI:1.09 -1.80), respectively. In the adjusted model, the awareness of HPV for being female (aOR=2, 95%CI:1.60-2.48) and college graduates (aOR=3.80, 95%CI: 2.59-6.56). In the adjusted model, the awareness of HPV vaccine for being female (aOR= 2.68, 95%CI:2.13-3.36) and college graduates (aOR=4.68,95%CI:2.77-7.91). HPV and HPV vaccine awareness, Non Hispanic Whites had significantly higher adjusted odds compared to other race/ethnicity groups. Conclusion: Hence public health programs could be directed to promote use of telehealth to increase awareness of HPV causing cancers, reduce stigma associated with vaccination, boost healthcare recommendation and uptake of HPV vaccination considering socio demographic factors. Citation Format: Manali Desai, Iman Igab, Ogochukwu Ezeigwe, Devesh Malgave. Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A123.

Increasing Oral Health Team's Knowledge, Attitudes, and Intention to Recommend the HPV Vaccine.

This study aims to assess the impact of an educational intervention on the knowledge, attitudes, and intentions of oral health providers regarding the recommendation of the human papillomavirus (HPV) vaccine. A qualitative evaluation was conducted in 2021 with dental professionals who participated in a training program focused on HPV vaccination. Saturation was reached at 12. Results showed increased knowledge and awareness of the link between HPV infection and oropharyngeal cancers among participants. Intention to recommend was universally endorsed. The use of role-play with youth actors was highly regarded as an effective method for improving communication skills and confidence in recommending the vaccine. These findings emphasize the importance of targeted interventions to enhance oral health professional education and the intention to recommend HPV vaccine.

Knowledge about human papillomaviruses among students in Germany-a cross-sectional study with aneed for action

The human papillomavirus (HPV) is one of the most common viruses transmitted through intimate contact, causing many benign and malignant diseases. Vaccination protects against these diseases. Despite the HPV vaccination being recommended by the Standing Committee on Vaccination (STIKO), knowledge and vaccination rates in Germany are very low. Therefore, the aim of the study was to assess the HPV knowledge among German students. Between 06/2019 and 01/2024, anationwide online survey on HPV knowledge among students in Germany was distributed via the respective student councils. The survey included two aspects: 1)basic characteristics of the participants and 2)knowledge questions about HPV (e.g., transmission routes, effectiveness, and side effects of vaccination, knowledge about the HPV subtypes). Data collection was anonymous. Atotal of 459 students took part in the study. Of these, 335 (72.98%) were female, 122 (26.57%) were male, and2 (0.45%) did not specify their gender. The average age of the students was 24.02 years, and most of the participants were in their 6th (23.31%/107) semester. In all, 75.82% (348) of the participants were medical students followed by law students with 19.61% (90) participants. The most represented study location was Aachen, with 270 (58.82%) participants. Only about half (48.80%/223) of the students knew that approximately 8000 new cancer cases in Germany are HPV-associated annually. Regarding the HPV vaccination, more than athird (35.82%/163) of participants did not know that it also protects against genital warts, while 21.93% (100) did not know that boys can also benefit from the HPV vaccination and that it does not only improve HPV protection of girls against cervical cancer. Despite several years of HPV vaccination recommendation by the Standing Committee on Vaccination (STIKO), knowledge about HPV among college students still remains very low. Further prevention and educational efforts are needed to address HPV knowledge gaps, with the additional goal of improving HPV vaccination rates.

Human Papillomavirus Vaccination by Birth Fiscal Year in Japan

The Ministry of Health, Labour, and Welfare (MHLW) of Japan aggregates human papillomavirus (HPV) vaccination data across Japan for each fiscal year (FY) by age at vaccination. Birth FY (BFY)-specific vaccination coverage remains unknown. To calculate the BFY-specific vaccination coverage for each FY and the cumulative first-dose coverage for each BFY in Japan, to understand the generation-specific vaccination coverage, and to estimate the cumulative first-dose coverage of each BFY that would be achieved by FY 2028 vs World Health Organization (WHO) targets. In this cross-sectional study, MHLW-published national age-specific HPV vaccination numbers and demographic data for female individuals were used to calculate the BFY-specific first-dose coverage for each FY and the BFY-specific cumulative first-dose coverage. It was assumed that the BFYs 2007 to 2012 vaccination coverage in FY 2023 to 2028 would remain the same as the vaccination coverage of the same grade in FY 2022 to estimate the cumulative first-dose coverage that would be achieved by FY 2028. Data analysis was performed from December 2023 to January 2024. Two MHLW policy changes were the government's suspension of proactive recommendation for HPV vaccination in June 2013 and the government's resumption of proactive recommendation for HPV vaccination in April 2022. The primary outcome was generation-specific vaccination coverage among female individuals born in BFYs 1994 to 2010 in FYs 2010 to 2022, calculated using reconfigured published data. In this study of vaccination data for 9 414 620 female individuals, the generation-specific vaccination coverage was 71.96% for the vaccination generation (BFYs 1994-1999), 4.62% for the vaccine-suspension generation (BFYs 2000-2003), 16.16% for the generation that received information individually (BFYs 2004-2009), and 2.83% for the vaccine-resumed generation (BFY 2010). HPV routine vaccination coverage was extremely low in BFYs 2000 to 2010 (0.84%-25.21%) vs BFYs 1994 to 1999 (53.31%-79.47%). The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 plateaued at 43.16%. Even after the resumption of MHLW's proactive recommendations, HPV vaccination coverage has only minimally recovered in Japan. The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 is below the WHO target. These findings reveal that stronger cervical cancer control measures are required, particularly for the vaccine-resumed generation, which will plateau at approximately one-half the WHO target values.

Human papillomavirus (HPV) vaccination in Japan.

To review the status of human papillomavirus (HPV) vaccination in Japan from inception to the present, focusing on past and current challenges. Published articles and website content related to HPV vaccination were reviewed. The Ministry of Health, Labor and Welfare suspended proactive recommendations for HPV vaccination in June 2013 following repeated media reports of girls experiencing adverse events, including chronic pain and walking disturbances, after receiving the HPV vaccine. Despite later recognition of these symptoms as a functional somatic syndrome, HPV vaccine coverage of target girls aged 12 to 16 years in the National Immunization Program (NIP) rapidly decreased to near zero. This suspension of the proactive HPV vaccination recommendation ceased in fiscal year (f-year) 2022, initiating a 3-year catch-up free HPV vaccination period from April 2022 to March 2025 for women born from f-years 1997 to 2005. These drastic changes were driven by established evidence of the effectiveness and safety of HPV vaccines reported from both Japan and other countries, and a nine-valent HPV vaccine has been included in the NIP since f-year 2023. However, the estimated HPV vaccination rate in the NIP remains low at ≤30%. To regain high coverage of HPV vaccination in Japan, it is essential that government, industry, and academic society work together to raise awareness and educate Japanese people about cervical cancer prevention and HPV-related diseases.

Healthcare Professionals' Perspectives on HPV Recommendations: Themes of Interest to Different Population Groups and Strategies for Approaching Them.

As a flagship of the Europe's Beating Cancer Plan, the European Commission supports EU member states' efforts to strengthen and expand the routine vaccination of girls and boys against human papillomavirus (HPV). Populations across Europe have grown in diversity, and health systems must adapt to meet the specific needs of increasing diversity. Healthcare professionals (HCPs) must strive to communicate HPV vaccine information in a culturally sensitive manner and address specific concerns related to cultural beliefs, trust in health systems and perceived risks. The objectives of this exploratory study are to identify which themes are most frequently raised during the recommendation of vaccination to minors based on the characteristics of the population (religion, region of origin, gender, level of education and language proficiency) and to collect strategies to improve communication with a diverse population. A survey was distributed through various European public health institutions to HCPs in the region and their networks. The survey included multi-response questions (themes addressed during vaccination recommendation based on population characteristics) and open-ended questions (own qualitative comments and strategies). The most common issues that arise during vaccine recommendation are a lack of knowledge, followed by misinformation. Differences were detected according to the population characteristics. Suggested strategies to improve HPV vaccine recommendation focused on the following aspects: affordability; sexuality and gender; communication platforms; multilingualism; quality of care; school collaboration. HCPs report differences according to the characteristics of the population receiving the recommendation. Personalisation of the recommendations would help to optimise the decision-making process for some groups.

Content validation of a Facebook HPV vaccination promotion intervention (#HPVvaxtalks) created for young Black adults (18-26 years old).

Despite the expansion in human papillomavirus (HPV) vaccination recommendations, vaccine uptake and completion remain low among Black individuals. An 8-week Facebook intervention (#HPVvaxtalks) was developed to increase knowledge and awareness of HPV risk factors, risk perceptions, and vaccination intention and uptake. This article details the formative phase of experts' feedback and participants' satisfaction on the components of the #HPVvaxtalks for content useability, acceptability, relevance, and visual appeal to inform further refinements. A convenience sample of 5 experts and 13 young Black adults were invited to provide feedback on #HPVvaxtalks intervention content. The experts reviewed and provided feedback via a survey and open-ended questions. After incorporating suggestions from experts' feedback, 13 participants viewed #HPVvaxtalks posts, took part in a virtual focus group, and completed a survey. Qualitative data were thematically analyzed and integrated with survey results. Experts and participants mean age were 41.9±2.3 and 21.2±1.9 years, respectively. Experts and participants reported positive ratings for intervention posts, including useability, acceptability, relevance, and visual appeal. Data provided areas for improvements of #HPVvaxtalks. CONCLUSION: Experts indicated strong content validity and participants showed satisfaction with #HPVvaxtalks content. Ensuring acceptability, relevance, and appeal of the intervention for the target population is an integral part of intervention development.

Human Papilloma Virus Vaccination and Cervical Screening in the Italian Regions: An Overview of the Current State of the Art.

Human Papilloma Virus (HPV) infection and HPV-related cancers can be prevented through vaccinations and mass cervical screening programmes. The Ministry of Health in Italy provides recommendations on primary and secondary prevention of HPV-related diseases, but the 19 Italian regions and 2 autonomous provinces have organisational and decision-making autonomy, with differences in the strategies for offering prevention. The aim of this study is to describe the HPV vaccination and cervical screening offered in all Italian regions. Regional official documents up until 31 December 2021 were first identified. Subsequently, primary and secondary prevention experts from each region were interviewed to validate the previously collected data. The National Immunisation Plan (NIP) 2017-2019 recommends HPV vaccination from the age of 11 for both sexes, with a coverage target of 95%. HPV vaccination is offered free of charge or co-payment. All regions have screening programmes for cervical cancer, using PAP or HPV-DNA tests every three to five years. All regions have an electronic registry for vaccination and screening status. All regions have developed awareness-raising campaigns. It is important to harmonise regional policies with the implementation of information systems integration. The collected data could enhance both regional and national public health initiatives, bolstering the resilience of vaccination programs.

Impact of Educational Intervention on Cervical Cancer and HPV Vaccine Knowledge, Attitudes, and Acceptance among First-Year Medical Students of Birat Medical College

Introduction: Cervical cancer poses a significant health burden, particularly in developing nations, with notable incidence and mortality rates. However, there exists a notable gap in understanding the knowledge, attitudes, and acceptance surrounding cervical cancer and the Human Papillomavirus (HPV) Vaccine. This study aims to evaluate the current awareness, attitudes, and acceptance levels of HPV Vaccine among first-year medical students, alongside assessing the effectiveness of an educational intervention on these aspects. Objectives: To evaluate current knowledge, attitude and acceptance of cervical cancer and HPV Vaccine and evaluate the impact of educational intervention. Methodology: 2 An analytical cross-sectional study was conducted among 96 first-year medical students at a medical college in Nepal from December 24, 2023, to February 28, 2024, after receiving Ethical Approval. Total enumeration sampling technique was applied, and a structured self- administered questionnaire, validated for data collection, was employed. Data were collected at baseline and after an educational intervention class to assess the impact on the knowledge, attitude, and acceptance toward cervical cancer and the HPV Vaccine. Result: Pre-intervention scores (mean=5.90, SD=1.73) significantly increased after the intervention (mean=11.65, SD=1.44) with p&lt;0.001, indicating a 97.46% increase. Willingness to receive HPV vaccination increased from 47.9% to 88.5%, and willingness to recommend vaccination increased from 88.54% to 96.88%. No significant differences were found in vaccination willingness. Conclusion: Educational interventions significantly enhanced medical students' willingness to receive and recommend HPV vaccination, suggesting potential for future healthcare provider influence on vaccination behaviors.

HPV Vaccination Practices Among Medical Trainees in Pediatrics, Obstetrics and Gynecology, and Family Medicine.

The human papillomavirus (HPV) vaccine has been proven effective in preventing HPV-related cancer. However, vaccination uptake in the United States remains unacceptably low. The aim of this study is to determine whether residents' HPV vaccination status, demographics, or residency training setting are predictive of vaccination prescribing practices. This was an anonymous, IRB-approved, opt-in survey of OBGYN, Family Medicine, and Pediatric residents. Using the National Residency Match Program Web site, surveys were sent to program directors requesting their residents' participation. Demographics, practice settings, HPV vaccination status, reasons for being inappropriately vaccinated, and resident vaccination-prescribing practices were analyzed. A total of 853 residents participated. A total of 56.7% of respondents were fully vaccinated against HPV. The most common reasons for being unvaccinated were as follows: age (51.7%, n = 122), monogamous (30.9%, n = 73), do not believe it works (22.5%, n = 53), and affordability/insurance did not cover (14.4%, n = 34). Residents working in an urban setting were more likely to be vaccinated than those in suburban (odds ratio [OR] = 1.93, 95% confidence interval [CI], 1.364-3.229, p < .001) or rural (OR = 2.08, 95% CI 1.461-3.359, p 0.01) settings. Males were less likely than females (OR = 0.90, 95% CI 0.702-0.997, p < .001) to be vaccinated. Single residents were more likely to be vaccinated than married (OR = 2.56, 95% CI 2.444-2.704, p < .001) or divorced (OR = 2.15, 95% CI 1.822-3.264, p 0.21) residents. Vaccinated residents were more likely to recommend HPV vaccination to their patients than those who were unvaccinated (OR = 1.83, 95% CI 1.321-2.548, p .004). A significant portion of Family Medicine, Pediatrics, and OBGYN residents have not received appropriate vaccination against HPV. Vaccination is highest among residents who identify as female, single, or working in urban settings. Vaccinated residents were also found to be almost 2 times as likely to recommend vaccination to their patients. As such, our data suggest that targeted provider education is needed to increase vaccination rates for both trainees and their patients.

Evaluation of a human papillomavirus vaccination training implementation in clinical and community settings across different clinical roles.

Improving human papillomavirus (HPV) vaccination is a national priority but uptake declined following the coronavirus pandemic. A strong predictor of HPV vaccination in the USA is a strong provider recommendation. Therefore, we developed a brief, asynchronous training on HPV vaccine recommendations in clinical and community settings as part of a multisite quality improvement initiative. This paper aims to describe the implementation and initial outcomes of the training provided. A 20-minute training on HPV vaccine bundled recommendations, motivational interviewing, and brief responses to patient concerns (Communicating about HPV vaccination to Adults and Teens; HPV CHAT) was implemented at seven safety-net clinics, two practice-based research network clinics, and nine county immunization clinics. We integrated training with clinical care teams; thus, we assessed immediate training outcomes across their different clinical roles compared to pre-training. In April-May 2022, HPV CHAT training was launched. One hundred eighty-seven people participated in the training and completed the pre-/postevaluation surveys. Knowledge about the HPV vaccine guidelines improved with notable changes in correctly reporting vaccine eligibility (P < .05). A significant change in participants' confidence when addressing safety concerns and answering questions about the HPV vaccine (clinicians, 26.8% and 17.1%; nurses, 29.0% and 23.2%, and clinical staff, 18.2% and 37.7%) was observed. At post-test, more than 85% of clinicians and nurses reported their plan to routinely recommend the HPV vaccine. This quality improvement initiative demonstrated implementation feasibility of a brief HPV vaccine training that improved provider and clinical staff knowledge, confidence, and intention to routinely recommend HPV vaccination.

Safety and immunogenicity of Innovax bivalent human papillomavirus vaccine in girls 9–14 years of age: Interim analysis from a phase 3 clinical trial

BackgroundWorld Health Organization human papillomavirus (HPV) vaccination recommendations include a single- or two-dose schedule in individuals 9–20 years old and advice for generating data on single-dose efficacy or immunobridging. The ongoing Phase 3 trial of Innovax’s bivalent (types 16 and 18) HPV vaccine (Cecolin®) assesses in low- and middle-income countries alternative dosing schedules and generates data following one dose in girls 9–14 years old. Interim data for the 6-month dosing groups are presented. MethodsIn Bangladesh and Ghana, 1,025 girls were randomized to receive either two doses of Cecolin at 6-, 12-, or 24-month intervals; one dose of Gardasil® followed by one dose of Cecolin at month 24; or two doses of Gardasil 6 months apart (referent). Serology was measured by enzyme-linked immunosorbent assay (ELISA) and, in a subset, by neutralization assays. Primary objectives include immunological non-inferiority of the Cecolin schedules to referent one month after the second dose. Safety endpoints include reactogenicity and unsolicited adverse events for 7 and 30 days post-vaccination, respectively, as well as serious adverse events throughout the study. ResultsInterim analyses included data from the two groups on a 0, 6-month schedule with 205 participants per group. One month after Dose 2, 100% of participants were seropositive by ELISA and had seroconverted for both antigens. Non-inferiority of Cecolin to Gardasil was demonstrated. Six months following one dose, over 96% of participants were seropositive by ELISA for both HPV antigens, with a trend for higher geometric mean concentration following Cecolin administration. Reactogenicity and safety were comparable between both vaccines. ConclusionsCecolin in a 0, 6-month schedule elicits robust immunogenicity. Non-inferiority to Gardasil was demonstrated one month after a 0, 6-month schedule. Immunogenicity following one dose was comparable to Gardasil up to six months. Both vaccines were safe and well tolerated (ClinicalTrials.gov No. 04508309).

Knowledge regarding human papillomavirus and cervical cancer prevention among medical students from Chulalongkorn University in Thailand

BackgroundCervical cancer is one of the leading causes of death among women in Thailand. General practitioners, within their primary healthcare role, play a vital role in the cervical cancer screening program, as they are the healthcare professionals most easily accessible to the general population. This study aims to determine the level of knowledge of cervical cancer and human papillomavirus (HPV) infection, HPV vaccination, and cervical cancer screening among last-year medical students.MethodsA cross-sectional study was conducted among sixth-year medical students using an electronic self-administered questionnaire. The two-part questionnaire comprised demographic data and 12 true/false questions that assessed knowledge regarding HPV infection, HPV vaccination, and cervical cancer screening recommendations. Pilot testing revealed a high Cronbach’s alpha and test–retest reliability coefficient.ResultsA 67% response rate was achieved. Among the 198 respondents, only one (0.5%) student correctly answered over 80% of the questions while most respondents (172, 71.7%) correctly answered less than 60% of the questions. Less than half of the respondents correctly identified crucial aspects such as the primary cause of cervical cancer, recommended vaccination age, cytology sensitivity compared to HPV testing, and the recommended screening frequency for average-risk women.ConclusionsThis study highlights a significant lack of comprehension among Thai medical students concerning HPV infection, vaccination, and cervical cancer screening guidelines. Encouraging educational enhancement, effective communication, and heightened awareness of these crucial topics within the medical school curriculum are imperative.

Practices of French General Practitioners Regarding Vaccination of Boys Against Human Papillomavirus (HPV), One Year After the Application of Its Official Recommendation

In 2019, French health authorities extended the recommendation for human papillomavirus (HPV) vaccination to include boys aged 11 to 19 years. We describe HPV vaccination practices among French general practitioners (GPs) since this recommendation wasapplied. We also identified factors associated with the propensity to propose HPV vaccination to boys. Cross-sectional study, between May and August 2022, among French GPs using a questionnaire asking about the GPs, their practices, and opinions regarding HPV vaccination, including whether they systematically proposed HPV vaccination to eligible boys or not. We investigated factors associated with systematic proposal of HPV vaccination, using univariate and multivariate logistic regression. In total, 360 GPs participated (76.6% females; mean age 34.7 ± 7.8 years; 22.9% had additional training in gynecology or pediatrics); 5.5% reported that they systematically offered HPV vaccination to boys prior to the recommendation, whereas 61.2% do so systematically since the recommendation. Factors associated with systematic proposal to boys (post recommendation) were female GP sex (78.6% versus 66.2%; OR = 2.0 [95% confidence interval (CI) 1.2–3.3]; p = 0.007) and systematic proposal prior to the recommendation (8.5% versus 0.7%; OR = 13.3 [1.7–101.7]; p = 0.01). Protection against HPV-induced cancer was cited as an argument to vaccinate girls (98.3% versus 89.2%; p < 0.0001); while reducing the risk of transmission was more commonly an argument to vaccinate boys (78.1% versus 51.8%; p < 0.0001). This study underlines the positive impact of the official recommendation for HPV vaccination of boys on the attitude of GPs, with an increase in the systematic proposal of HPV vaccination to boys.

Uptake of human papilloma virus vaccination among adolescent girls living with HIV in Uganda: A mixed methods study.

Human Papilloma Virus (HPV) vaccination can prevent more than 90% of cancers caused by HPV. Although this vaccination is recommended and provided at no cost to all adolescent girls aged 9 to19 years in Uganda, its uptake remains low. We sought to determine the uptake of, and factors associated with HPV vaccination among adolescent girls living with HIV in Uganda. We conducted an explanatory sequential mixed methods study, among adolescent girls living with HIV, attending HIV care at the Mulago ISS HIV clinic in Kampala, Uganda. We administered a structured questionnaire to elicit data on HPV vaccination and its covariates to a systematic random sample of 264 adolescent girls with HIV. A participant who had received all the three recommended HPV vaccine doses was classified as fully vaccinated. We then conducted four focus group discussions among adolescent girls living with HIV (n = 32), eight in-depth interviews among their parents and five Key informant interviews among their healthcare providers. We conducted descriptive statistics and logistic regression analyses for the quantitative data before thematic analysis for the qualitative data. Of 264 adolescent girls, 31% (83/264) had at least one HPV vaccine dose; 22% (59/264) two doses, while 8.0% (21/264) were fully vaccinated (received three doses). While most participants received their first and second doses (48% (40/83)) and 57.6% (34/59), respectively) from school, the largest number of participants (47.1% (12/21)) received their third dose at community outreaches. Participants who received counseling from community members were three times more likely to get fully vaccinated compared to those who did not receive counseling (aOR 3.28, Cl:1.07-10.08, P = 0.038). From the qualitative follow-up, three major themes were identified: (1): Limited information about HPV vaccination, which gave room for misconceptions and doubts about the vaccine; (2) Parental influence on adolescent decisions was strong despite parents having limited knowledge about HPV vaccination and (3) Inadequacy of HPV vaccination services at the hospital and in the schools. Full HPV vaccination was low among adolescent girls living with HIV. Counseling of the adolescents by community members, alongside HPV vaccination community outreaches, provided a platform for vaccination. There should be strategies to provide adequate information about HPV vaccine to health workers, parents, and the adolescents. In addition to schools, community-based initiatives, including outreaches and lay-health workers can be utilized to improve HPV vaccine uptake among girls with HIV.

The receipt of the human papillomavirus vaccine’s influence on future human papillomavirus vaccine recommendations by medical and dental students

BackgroundWith a growing vaccine-hesitant population and with the increase in oral cancers, particularly in a younger population, there is a heightened need for dental and medical providers to advocate for vaccination, including the human papillomavirus (HPV) vaccine. This study aimed to assess HPV vaccine knowledge, personal immunization status, and attitudes and opinions of dental students (DSs) and medical students (MSs). MethodsStudents from 1 medical and 4 dental schools in the United States completed an anonymous online survey assessing knowledge and attitudes and opinions about the HPV vaccine, including personal HPV vaccine status and confidence in vaccine counseling. ResultsSeventy percent of the 453 students who completed the survey were vaccinated for HPV. Male students were significantly less likely to have received the HPV vaccine (odds ratio [OR], 0.37; 95% CI, 0.24 to 0.56). MSs were 1.75 times more likely to have received the HPV vaccine than DSs (95% CI, 1.16 to 2.63). Those who were vaccinated and those who were not vaccinated substantially differed in opinions and knowledge of the HPV vaccine. Vaccinated students were more than 5 times more likely to report they would recommend HPV vaccines to friends and family (OR, 5.22; 95% CI, 2.57 to 10.87), recommend HPV vaccines to patients (OR, 2.71; 95% CI, 1.39 to 5.26), and advocate for HPV vaccines (OR, 2.42; 95% CI, 1.24 to 4.70). In the linear regression model, age (P = .0204 and P < .00003), profession (P < .00001), and HPV vaccination status (P < .00001) predicted HPV knowledge. ConclusionsThese findings show that MSs are more likely to be vaccinated. In addition, HPV-vaccinated people had better knowledge, attitudes, and opinions than those who were not vaccinated. Receipt of the HPV vaccine increased advocacy for the vaccine. Educating these professionals about the efficacy and impact of the HPV vaccine could increase their advocacy for the vaccine.

Impact of visit characteristics on intention to recommend HPV vaccine: An experiment with US health care professionals

ObjectivePresumptive recommendations that assume parents want to vaccinate can increase human papillomavirus (HPV) vaccine uptake. We sought to examine how visit characteristics affect health care professionals' (HCPs) intention to use this evidence-based recommendation style. MethodsIn 2022, we conducted an online experiment with 2527 HCPs who had a role in adolescent vaccination in the United States. Participants read 1 of 8 randomly assigned vignettes about a well-child visit. Using a 2 × 2 × 2 between-subjects factorial design, the vignettes varied the following visit characteristics: patient age (9 vs. 12-year-old), prior parental vaccine refusal (yes vs. no), and time pressure on the HCP (low vs. high). HCPs reported on their intention to use a presumptive HPV vaccine recommendation, as well as on related attitudes, subjective norms, and self-efficacy. Analyses used 3-way analysis of variance and parallel mediation. ResultsParticipants were pediatricians (26%), family/general medicine physicians (22%), advanced practitioners (24%), and nursing staff (28%). Overall, about two-thirds of HCPs (64%) intended to use a presumptive recommendation. Intentions were higher for older children (b = 0.23) and parents without prior vaccine refusal (b = 0.39, both p < 0.001). Time pressure had no main effect or interactions. HCPs' attitudes and self-efficacy partially mediated effects of patient age and prior vaccine refusal (range of b = 0.04–0.28, all p < 0.05). ConclusionTo better support visits with younger children and parents who have refused vaccines, HCPs may need more training for making presumptive recommendations for HPV vaccine. Reinforcing positive attitudes and self-efficacy can help HCPs adopt this evidence-based recommendation style.

Abstract PR008: Human papillomavirus vaccination knowledge, health beliefs, recommendation receipt, and intentions among unvaccinated Spanish-speaking young adult Hispanic/Latino sexual minority men

Abstract Sexual minority men are at increased risk for human papillomavirus (HPV) infections and subsequent HPV-related health concerns, including anal cancer. HPV vaccination remains an underutilized prevention strategy among sexual minority men, including Hispanic/Latino (H/L) individuals. As part of a mixed methods project, we conducted a cross-sectional survey among Spanish-speaking H/L sexual minority men ages 18-26 to characterize awareness, knowledge, health beliefs, provider recommendation, and HPV vaccine intentions. Multiple in-person and social media strategies were used to recruit participants who self-identified as having had sex with a man and/or being attracted to men and were of H/L ethnicity; able to read, write, and understand Spanish; aged 18-26 years; living in either Florida or Puerto Rico; and with internet access. Data were collected between August 2021-August 2022 using an online survey. Following data cleaning, descriptive analyses using SAS focused on unvaccinated participants (n=102). Results indicated that most participants (86%) were living in Puerto Rico and self-identified as gay (84%). Fifty-six percent reported having heard of the HPV vaccine. Only 19% reported having received a provider recommendation for the HPV vaccine, and less than one-quarter (21%) reported strongly agreeing that people important to them would want them to receive the HPV vaccine. Most individuals (69%) correctly identified that HPV can cause genital warts. However, over half responded either incorrectly or ”do not know” to questions regarding the link between HPV and anal (54%), oral (61%), or penile (65%) cancers. Over half of participants (56%) responded incorrectly or “do not know” to an item about whether most sexually active individuals are at risk for being infected with HPV. Twenty percent responded incorrectly or “do not know” to an item assessing whether men can be infected with HPV. Regarding comparative risk, 28% reported believing themselves to be at average risk for HPV compared to people their age, whereas 14% and 27% reported being at below average risk and at much below average risk, respectively. Most participants (56%) reported they were either not at all or only a little concerned with the safety of the HPV vaccine; however, 25% responded they were very or extremely concerned. Participants reported positive attitudes toward the efficacy of the HPV vaccine in preventing genital warts, penile cancer, and anal cancer. Further, the majority (69%) indicated strongly agreeing or agreeing with an item that assessed their perceived ability to make an appointment to receive the HPV vaccine. Regarding intentions, only 12% reported being very likely to receive the HPV vaccine in the next year, whereas 30% reported being very likely to receive the vaccine at some point in the future. Findings suggest numerous potential malleable targets for future interventions to promote HPV vaccination among H/L young adult sexual minority men, including prompting provider recommendations and addressing patient education needs and health beliefs. Citation Format: Shannon M. Christy, Steven K. Sutton, Mariana Arevalo, Cyril Patra, Cathy D. Meade, Melisa Ramos, Juliana Borrego, Erin Park, Susan T. Vadaparampil, Julio C. Jimenez, Julian Sanchez, Melissa Marzan-Rodriguez. Human papillomavirus vaccination knowledge, health beliefs, recommendation receipt, and intentions among unvaccinated Spanish-speaking young adult Hispanic/Latino sexual minority men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR008.