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1.
Objective
Vaccines have the potential to reduce morbidity from HPV infections if age-eligible patients receive and parents know about them. Content analyses have demonstrated significant range in the quality of HPV information obtained from different sources. The purpose of this study was to determine the pattern of associations between information source and level of knowledge about HPV and vaccine receipt/intention.Methods
We analyzed the 2007 California Health Interview Survey, a population-based, statewide random digit dial survey, using data on adult females ages 18–65 who had heard about HPV (n = 16,806). One-way ANOVA and multivariate logistic regression assessed the associations between source of information (advertisement only, advertisement plus other sources, and non-advertisement sources) and knowledge of HPV (3 or greater correct on a 4-point scale). Multivariate logistic regressions were conducted on a subsample of vaccine-eligible women and parents to assess vaccine uptake or intention.Results
Less than half of respondents (43%) correctly answered 3 or more of the HPV knowledge questions. Mean knowledge scores were significantly different when comparing women who reported advertisement only, non-advertisement, and advertisement plus other sources of information (p < 0.001). In multivariate analysis, women who reported non-advertisement sources (OR 2.44, 95% CI 2.07–2.87) and advertisements plus other sources (OR 3.03, 95% CI 2.57–3.58) were more likely to have knowledge scores above the 75% level than women who relied on advertisements alone. In the subsample of vaccine-eligible women and parents, those who reported advertisements plus other sources (OR 1.85, 95% CI 1.30–2.62) were more likely to have received or intend to receive the vaccine than those who reported advertisements as their sole information source.Conclusion
Advertisements are the most commonly reported source of information about HPV, and while they inform women of the existence of the vaccine, they do not contribute to accurate knowledge about the virus, nor do they appear to influence vaccine uptake. Other sources may play a larger role in refining knowledge and/or improving uptake. 相似文献2.
目的了解广东省某医药院校大学生对人乳头瘤病毒(HPV)及HPV疫苗的认知情况、态度及HPV疫苗接种意愿,为HPV疫苗在国内推广接种提供建议。方法采用分层整群抽样法选取301名广东省某医药院校全日制本科在校学生,使用自填式网络问卷调查。对HPV及HPV疫苗认知度进行描述统计,采用X2检验和二分类非条件logistics回归分析影响HPV疫苗接种意愿的因素。结果 53.96%的调查对象知道HPV;46.97%的男生和53.77%的女生知道HPV疫苗;72.73%的男生和75.94%的女生有HPV疫苗接种意愿。婚姻状态(OR=2.143,P=0.009)、宫颈癌筛查知晓度(OR=1.805,P=0.018)、患宫颈癌可能性自我评价(OR=0.641,P=0.024)、是否同意HPV疫苗能有效预防宫颈癌(OR=1.919,P=0.027)以及是否同意疫苗能有效预防疾病(OR=1.686,P=0.022)影响HPV疫苗接种意愿。结论被调查大学生对HPV疫苗认知度高,接种HPV疫苗的意愿强。建议学校和社会加大对HPV及HPV疫苗宣传力度,政府加强疫苗监管。 相似文献
3.
目的 调查大同市妊娠期女性人乳头瘤病毒(HPV)感染及亚型分布情况.方法 采用PCR以及线形杂交法(LA)对177例妊娠期女性宫颈脱落细胞标本进行HPV检测和基因分型.结果 大同市妊娠期女性HPV感染率为38.42%,妊娠早期感染率最高(57.35%,P< 0.005),且以多型别为主(73.92%).HPV-16、HPV-58、HPV-18、HPV-11以及HPV-6的感染率最高,分别为15.82%,4.52%,3.95%,3.95%和3.39%.结论 大同市妊娠期女性HPV的感染较为普遍,HPV亚型分布具有明显的地域特征,妊娠早期女性为易感人群. 相似文献
4.
Peter Hillemanns Karl Ulrich Petry Nathalie Largeron Ruth McAllister Keith Tolley Katharina Büsch 《Zeitschrift fur Gesundheitswissenschaften》2009,17(2):77-86
Aim Clinical trials have demonstrated the efficacy of the tetravalent human papillomavirus (HPV) vaccination in the prevention
of cervical cancer and genital warts associated with HPV types 6, 11, 16 and 18. We used an empirically calibrated Markov
cohort model of the natural history of HPV to assess the cost-effectiveness of the vaccine administered to 12-year-old girls
alongside existing cervical screening programmes in Germany.
Subjects and methods The model estimated cervical cancer (CC), cervical intraepithelial neoplasia (CIN) and genital wart lifetime risks and total
lifetime health care costs, life years gained and quality-adjusted life years (QALY) gained. The analysis was conducted from
the perspective of the German health care payer.
Results In the base case (considering a lifetime duration of protection and 100% efficacy) it was estimated that 2,835 cervical cancer
cases and 679 deaths could be prevented among a cohort of 400,000, at an incremental cost per QALY gained of 10,530 €. A total
of 120 girls needed to be vaccinated to prevent 1 case of CC. Cost-effectiveness is sensitive to a duration of protection
of less than 20 years and to the discount rate for costs and benefits.
Conclusion A policy of vaccinating adolescent girls has been recommended by the German Standing Committee on Vaccinations. This study
has demonstrated that such a policy is cost-effective based on thresholds of cost-effectiveness that apply in Germany. 相似文献
5.
Holly Seale Linda Trung Fiona E. Mackie Sean E. Kennedy Christina Boros Helen Marshall Jane Tidswell Peter J. Shaw Kay Montgomery C. Raina MacIntyre 《Vaccine》2012
Barriers influencing the willingness of parents to vaccinate immunocompetent children include a lack of knowledge about human papillomavirus (HPV) and low perception of risk regarding their child's acquisition of HPV infection. However, it cannot be assumed that the facilitators and barriers of HPV vaccination are the same for parents/guardians of children who are immunocompromised, or who have chronic medical conditions. This study aimed to document the knowledge and attitudes of parents/guardians of immunosuppressed children and adolescents towards HPV infection and the vaccine. 相似文献
6.
Little is known about initiation and completion among males who received the HPV vaccine on an off-label basis before 2009. This study utilized administrative claims data from a private insurance company to examine completion of the 3 dose HPV series among 514 males who initiated the vaccine between 2006 and May of 2009. Frequencies of HPV vaccination were examined and multivariate logistic regression estimated the odds of completing the entire series within 365 days of initiation. We found that only 21% of male initiators completed all 3 vaccine doses within 12 months and completion decreased over time. Series completion did not vary significantly by provider type. These findings suggest that difficulties may be encountered in fully vaccinating enough males to achieve adequate herd immunity in the future. 相似文献
7.
《Vaccine》2018,36(10):1243-1247
Trends in HPV vaccine awareness among parents of adolescent girls and boys (ages 13–17) and HPV vaccine uptake (≥1 dose) among girls (ages 13–17) were evaluated in Los Angeles County, California. Between 2007 and 2011, parental HPV vaccine awareness increased from 72% to 77% overall, with significant increases among mothers, Latinos, and respondents with daughters and Medi-Cal insured children. In 2011, parents who were male, older, less educated, Asian/Pacific Islander, and had sons remained significantly less likely to be aware. HPV vaccine initiation among daughters nearly doubled from 25% in 2007 to 48% in 2011, and girls who were older, uninsured, and had access-related barriers showed the largest improvements. In 2011, daughters who were younger and who had older and African American parents were at risk for low uptake. Thus, initiatives targeting male and younger adolescents, culturally-relevant information, and access to vaccination may help to reduce identified disparities. 相似文献
8.
Purpose
A 3-dose human papillomavirus (HPV) vaccine is recommended for adolescents to protect against HPV-related cervical and other cancers. The purpose of this study was to provide an update on HPV vaccine uptake among 11–17 year old girls residing in the US.Methods
Data from the 2010 National Health Interview Survey (NHIS) were obtained to assess HPV vaccination status and its correlates. Multivariate logistic regression analyses were performed to examine HPV vaccine uptake of ≥1 dose and ≥3 doses among all girls, and completion of the 3-dose series among those who initiated (received ≥1 dose) the vaccine.Results
Overall, 28.9% and 14.2% received ≥1 dose and ≥3 doses of vaccine: 14.5% and 3.0% among 11–12 year old girls, and 34.8% and 18.7% among 13–17 year olds, respectively. Hispanics had higher uptake of ≥1 dose (odds ratio (OR) 1.63, 95% confidence interval (CI) 1.22–2.17) than whites. Having received an influenza shot in the past year and parents’ awareness of the vaccine were significantly associated with receiving ≥1 dose (OR 1.88, 95% CI 1.51–2.33 and OR 16.57, 95% CI 10.95–25.06) and ≥3 doses (OR 1.48, 95% CI 1.13–1.92 and OR 10.60, 95% CI 5.95–18.88). A separate multivariate model based on girls who initiated the vaccine did not identify any significant correlates of 3-dose series completion. Among parents of unvaccinated girls, 60% were not interested in vaccinating their daughters and mentioned three main reasons: “does not need vaccine” (25.5%), “worried about safety” (19.3%) and “does not know enough about vaccine” (16.6%). Of those who were interested, 53.7% would pay $360–$500 for the vaccination, while 41.7% preferred to receive it at a much lower cost or free.Conclusions
Only 1 out of 3 girls (11–17 years) have received ≥1 dose of HPV vaccine and much less have completed all 3 doses. Strategies should be taken to improve this vaccine uptake among girls, especially those 11–12 year olds, and to educate parents about the importance of vaccination. 相似文献9.
10.
Julie Garon In Vong Wuddhika Nandini Sreenivasan Kathleen Wannemuehler Yong Vutthikol Chhea Chhorvann Anagha Loharikar 《Vaccine》2019,37(9):1202-1208
Background
In 2017, the Cambodia Ministry of Health introduced human papillomavirus (HPV) vaccine through primarily school-based vaccination targeting 9-year-old girls. Vaccination with a two-dose series of HPV vaccine took place in six districts in two provinces as a demonstration program, to better understand HPV vaccine delivery in Cambodia.Methods
We conducted a community-based coverage survey using a one-stage sampling design to evaluate dose-specific vaccination coverage among eligible girls (those born in 2007 and residents in the areas targeted by the campaign). The household-level survey also assessed factors associated with vaccine acceptability and communication strategies. Trained data collectors interviewed caregivers and girls using a standard questionnaire; vaccination cards and health facility records were reviewed.Results
Of the 7594 households visited in the two provinces, 315 girls were enrolled in the survey (188 in Siem Reap; 127 in Svay Rieng). Documented two-dose HPV vaccination coverage was 84% (95% confidence interval [CI]: 78–88%) overall [85% (95% CI: 78–90%) in Siem Reap; 82% (95% CI: 73–88%) in Svay Rieng.] Almost all girls (>99%) were reported to be enrolled in school and over 90% of respondents reported receipt of vaccine in school. Knowledge of HPV infection and associated diseases was poor among caregivers and girls; however, 58% of caregivers reported “protection from cervical cancer” as the primary reason for the girl receiving vaccine. No serious adverse events after immunization were reported.Conclusions
The HPV vaccine demonstration program in Cambodia achieved high two-dose coverage among eligible girls in both provinces targeted for vaccination in 2017, through primarily school-based vaccination. High school enrollment and strong microplanning and coordination were seen throughout the campaign. Cambodia will use lessons learned from this demonstration program to prepare for national introduction of HPV vaccine. 相似文献11.
《Vaccine》2022,40(37):5413-5432
BackgroundHuman papillomavirus (HPV) vaccines were first licensed as a three-dose series. Two doses are now widely recommended in some age groups; there are data suggesting high efficacy with one dose. We updated a systematic literature review of HPV vaccine effectiveness by number of doses in observational studies.MethodsWe searched Medline and Embase databases from January 1, 2007, through September 29, 2021. Data were extracted and summarized in a narrative synthesis. We also conducted quality assessments for bias due to selection, information, and confounding.ResultsOverall, 35 studies were included; all except one were conducted within the context of a recommended three-dose schedule. Evaluations were in countries that used bivalent HPV vaccine (seven), quadrivalent HPV vaccine (27) or both (one). Nine evaluated effectiveness against HPV infection, ten anogenital warts, and 16 cervical abnormalities. All studies were judged to have moderate or serious risk of bias. The biases rated as serious would likely result in lower effectiveness with fewer doses. Investigators attempted to control for or stratify by potentially important variables, such as age at vaccination. Eight studies evaluated impact of buffer periods (lag time) for case counting and 10 evaluated different intervals between doses for two-dose vaccine recipients. Studies that stratified by vaccination age found higher effectiveness with younger age at vaccination, although differences were not all formally tested. Most studies found highest estimates of effectiveness with three doses; significant effectiveness was found among 28/29 studies that evaluated three doses, 19/29 that evaluated two doses, and 18/30 that evaluated one dose. Some studies that adjusted or stratified analyses by age at vaccination found similar effectiveness with three, two and one doses.ConclusionObservational studies of HPV vaccine effectiveness have many biases. Studies examining persons vaccinated prior to sexual activity and using methods to reduce sources of bias are needed for valid effectiveness estimates. 相似文献
12.
Objective
Minority populations in the United States are disproportionally affected by human papillomavirus (HPV) infection and HPV-related cancer. We sought to understand physician practices, knowledge and beliefs that affect utilization of the HPV vaccine in primary care settings serving large minority populations in areas with increased rates of HPV-related cancer.Study design
Cross-sectional survey of randomly selected primary care providers, including pediatricians, family practice physicians and internists, serving large minority populations in Brooklyn, N.Y. and in areas with higher than average cervical cancer rates.Results
Of 156 physicians randomly selected, 121 eligible providers responded to the survey; 64% were pediatricians, 19% were internists and 17% were family practitioners. Thirty-four percent of respondents reported that they routinely offered HPV vaccine to their eligible patients. Seventy percent of physicians reported that the lack of preventive care visits for patients in the eligible age group limited their ability to recommend the HPV vaccine and 70% of those who reported this barrier do not routinely recommend HPV vaccine. The lack of time to educate parents about the HPV vaccine and cost of the vaccine to their patients were two commonly reported barriers that affected whether providers offered the vaccine.Conclusions
Our study found that the majority of providers serving the highest risk populations for HPV infection and HPV-related cancers are not routinely recommending the HPV vaccine to their patients. Reasons for providers’ failure to recommend the HPV vaccine routinely are identified and possible areas for targeted interventions to increase HPV vaccination rates are discussed. 相似文献13.
Ashlesha Patel Lisa Stern Zoe Unger Elie Debevec Alicia Roston Rita Hanover Johanna Morfesis 《Vaccine》2014
Objectives
To evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series.Methods
Ten reproductive health centers enrolled 365 women aged 19–26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders – text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks.Results
The reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p = 0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR = 1.15, 95% CI 1.01–1.31), report having completed a four-year college degree or more (age-adjusted OR = 2.51, 95% CI 1.29–4.90), and report three or more lifetime sexual partners (age-adjusted OR = 3.45, 95% CI 1.20–9.92).Conclusions
The study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low. 相似文献14.
《Vaccine》2023,41(13):2224-2233
ObjectivesHuman papillomavirus (HPV) infection is the leading risk factor for the development of anogenital cancers. Most Arab countries lack both HPV education and national HPV vaccination programs. The objective of this study was to assess knowledge, attitudes, and acceptance toward HPV vaccination in men and women from Oman, a country in the Middle Eastern North Africa region.MethodsThis cross-sectional quantitative study used convenience sampling to recruit male and female participants, aged 18 years and above from all 11 governorates of Oman to complete a validated self-administered questionnaire online in the Arabic language. The questionnaire comprised five sections, with a total of 32 questions. The questionnaire, including Arabic and English versions, was content validated and piloted.ResultsA total of 1403 participants, including 952 parents and 369 healthcare providers, completed the survey. The results showed a lack of knowledge regarding HPV infection and vaccines, including among healthcare providers. Less than a quarter of the participants had heard of HPV infection, with digital sources of information being the most common. Factors such as being a woman or a healthcare provider or completing higher levels of education were independently and significantly positively association with HPV awareness (p < 0.001). The majority of the participants lacked vaccine safety knowledge, had concerns about the vaccine's side effects, and sought reassurance of its protection against HPV infection (62%, 71.5%, and 84.6%, respectively). Nevertheless, nearly two-thirds of the participants agreed to take the HPV vaccine, with support for both boys and girls being vaccinated. There was almost universal agreement among the participants regarding the need for parental and adolescent HPV educational programs.ConclusionOmani women and men showed a high level of acceptance and favorable attitude toward HPV vaccination. The study findings support future efforts to implement school and public-level HPV education and a national HPV vaccination program in Oman. 相似文献
15.
《Vaccine》2020,38(5):954-962
Vaccines for two viruses which cause cancer, human papillomavirus (HPV) and hepatitis B virus (HBV), are recommended for all children in the United States. Numerous parallels exist between the two vaccines in addition to their roles in cancer prevention, including transmission through sexual contact, multiple doses needed for series completion, and vaccine administration in adolescence for HPV and in the initial phase of the HBV vaccination program. All of these factors were viewed as potential barriers to achieving high rates of coverage, yet the ultimate success of the HBV vaccination program led to predictions that similarly high rates of coverage could be achieved for the HPV vaccine. However, currently, only the recommendation for HBV vaccination is supported by mandates for school entry in most states. Uptake of the HPV vaccine has lagged far behind U.S. goals for public health promotion. The aim of this paper is to examine factors which may account for the divergent pathways of the two vaccines. Four main factors are identified: logistical challenges of vaccine administration, attitudes of parents and healthcare providers, safety concerns, and cost. For each factor examined, recommendations are offered to confront similar barriers likely to arise for future vaccines. The authors conclude that gender-neutral state mandates coupled with school-located vaccination programs, stronger gender-neutral messaging from pharmaceutical companies and healthcare providers, and younger age of vaccine administration, if approved, present the most promising approaches to improving uptake of the HPV vaccine, and similar vaccines down the road. 相似文献
16.
《Vaccine》2020,38(27):4316-4324
BackgroundEmerging observational evidence suggests a single-dose of human papillomavirus (HPV) vaccine may be protective against vaccine-targeted HPV infection and associated cervical dysplasia. We aimed to demonstrate whether a single dose of quadrivalent HPV (4vHPV) vaccine was immunogenic and reduced HPV detection rates in young women in Mongolia. We also assessed knowledge and attitudes regarding HPV and the HPV vaccine.MethodsA retrospective paired cohort study was undertaken to evaluate the effect of a single dose of 4vHPV, given at age 11–17 years in 2012, on HPV detection rates, when compared with unvaccinated women. Real time PCR was performed on self-administered vaginal swabs for HPV detection. An immunological analysis detecting neutralising antibodies (NAb) to high-risk HPV (HRHPV) genotypes 16 and 18 was performed on sera from a subset of 58 participants. Questionnaires evaluated knowledge, attitudes and self-swab acceptability.FindingsA total of 475 women (mean age 20.4 years ± 1.6) were recruited; 118 vaccinated and 357 unvaccinated women. The prevalence of vaccine-targeted HRHPV16 and 18 was reduced by 92% (95%CI 44–99%) in the vaccinated (1·1%) compared with the unvaccinated (15.4%) group. The percentage of non-vaccine HPV genotypes was similar between vaccinated (26.5%) and unvaccinated (26.7%) groups. Approximately 90% and 58% of vaccinated women remained seropositive after six years for HRHPV16 and 18, respectively, with neutralising antibody levels 5- and 2-fold higher than unvaccinated women (p < 0.001).InterpretationOne dose of 4vHPV vaccine reduces vaccine-targeted HPV genotypes, six years following vaccination, with high levels of HR genotype seropositivity among young Mongolian women. 相似文献
17.
Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes 总被引:1,自引:0,他引:1
Jessica A. Kahn M.D. M.P.H. Gregory D. Zimet Ph.D. David I. Bernstein M.D. Jeremy M. Riedesel M.S. Dongmei Lan M.S. Bin Huang Ph.D. Susan L. Rosenthal Ph.D. 《The Journal of adolescent health》2005,37(6):502-510
18.
目的 了解健康教育对四川省医务人员HPV相关知识的认知情况及对HPV疫苗接种态度的影响,为HPV疫苗在四川省的进一步推广提供参考依据。方法 对2018 - 2019年在四川省参加全国宫颈癌预防医师培训项目的医务人员进行培训前后的问卷调查。调查对象培训前后对HPV相关知识认知情况及对HPV疫苗态度的差异性比较采用χ2检验。是否愿意主动推荐HPV疫苗人群中,HPV相关知识平均得分差异性比较采用t检验。结果 培训前、后有效问卷分别为485、459份。培训后,医务人员对HPV及其疫苗相关知识知晓率有不同程度提高。认为HPV疫苗安全(χ2 = 27.881,P<0.001)、有效(χ2 = 24.943,P<0.001)以及愿意主动推荐HPV疫苗(χ2 = 24.010,P<0.001)的医务人员占比与培训前相比均有提升。培训前(t = 5.328,P<0.001)及培训后(t = 3.090,P<0.05)愿意主动推荐疫苗组的HPV相关知识平均分均高于不愿意主动推荐疫苗组。医务人员不愿意主动推荐HPV疫苗的原因主要为对相关知识的了解不够(31.5%)、价格过高(22.6%)以及对疫苗的有效性及安全性存疑(22.6%)。结论 应在医务人员中开展形式多样的健康教育以提高其HPV相关知识水平及HPV疫苗推广态度,从而提高人们对HPV疫苗的接受度,为宫颈癌的一级预防提供人群基础。 相似文献
19.
Jing Li Lian-Kun Li Jun-Fei Ma Li-Hui Wei Mayinuer Niyazi Chang-Qing Li Ai-Di Xu Jian-Bin Wang Hao Liang Jerome Belinson You-Lin Qiao 《Vaccine》2009
Infection with the human papillomavirus (HPV) is one of the most common sexually transmitted infections and causes virtually all cervical cancer globally. The recent development of two safe and clinically effective vaccines against HPV is a promising step towards lowering cervical cancer rates in the future. What Chinese women think about HPV and the vaccines remains unknown. We undertook a population-based survey, which was embedded in a cervical cancer screening project and was designed to assess women's knowledge about HPV and their acceptability to the vaccines. We found that only 15.0% of women in our study reported to have ever heard of HPV, and this knowledge differs by rural (9.3%) and metropolitan areas (21.6%) and also by education. Most (84.6%) participants were willing to be vaccinated if HPV vaccine became available to them. The present study documents ways in which women learn about HPV and indicates the potential barriers and success of introducing HPV vaccine to China. 相似文献
20.
《Vaccine》2018,36(29):4311-4316
BackgroundCervical cancer occurrence and mortality are strongly correlated with socioeconomic disadvantage, largely due to unequal access to screening and treatment. Universal human papillomavirus (HPV) vaccination provides the opportunity to greatly reduce this global health disparity. Australian Indigenous women have substantially higher rates of cervical cancer than non-Indigenous women, primarily due to under-screening. We investigated HPV infection rates in Indigenous women 7 years after implementation of the national HPV vaccination program.MethodsWe used a repeat cross-sectional design, with the baseline being provided by an HPV prevalence survey among Indigenous women attending clinics for cervical cytology screening, prior to the start of the vaccination program in 2007. We returned to clinics in four locations during 2014–15, and invited women aged 18–26 years attending for screening to provide a cervical specimen for HPV testing, as well as to complete a short questionnaire and consent to allow access of their records in the National HPV Vaccination Program Register. We used well-established laboratory methods to test specimens for specific HPV genotypes.ResultsA total of 142 women were recruited at participating sites and compared to 155 who had been recruited at the same locations in the 2007 pre-vaccine survey. The two groups were identical in regard to age, with the more recent group having a higher proportion of hormonal contraception users, and a lower proportion of smokers. The proportion found to have any HPV type fell from 58 to 36% with the decline being entirely due to reductions in vaccine types, which fell by 94% from 24 to 1.4%.ConclusionAustralia’s national HPV vaccination program appears to be successfully protecting a very high proportion of Indigenous women against vaccine targeted HPV types, who have in the past been at elevated risk of cervical cancer. 相似文献