HPV vaccine and males: Issues and challenges
TL;DR: The attitudes of parents, young men, and HCPs toward HPV vaccination and other sexually transmitted infections (STI) appear that parents are interested in vaccinating their sons against HPV and other STI, and adolescent and adult males areinterested in receipt of HPV vaccine and other vaccines for prevention of STI.
About: This article is published in Gynecologic Oncology.The article was published on 2010-05-01. It has received 85 citations till now. The article focuses on the topics: Vaccination & Cost effectiveness.
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TL;DR: Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men.
Abstract: Objective To understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability. Design Meta-analyses of cross-sectional studies. Data sources We used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV. Review methods We calculated mean HPV vaccine acceptability across studies. We conducted meta-analysis using a random effects model on studies reporting correlates of HPV vaccine acceptability. All studies were assessed for risk of bias. Results Of 301 identified studies, 29 were included. Across 22 studies (n=8360), weighted mean HPV vaccine acceptability=50.4 (SD 21.5) (100-point scale). Among 16 studies (n=5048) included in meta-analyses, perceived HPV vaccine benefits, anticipatory regret, partner thinks one should get vaccine and healthcare provider recommendation had medium effect sizes, and the following factors had small effect sizes on HPV vaccine acceptability: perceived HPV vaccine effectiveness, need for multiple shots, fear of needles, fear of side effects, supportive/accepting social environment, perceived risk/susceptibility to HPV, perceived HPV severity, number of lifetime sexual partners, having a current sex partner, non-receipt of hepatitis B vaccine, smoking cigarettes, history of sexually transmitted infection, HPV awareness, HPV knowledge, cost, logistical barriers, being employed and non-white ethnicity. Conclusions Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men. Future investigations employing rigorous designs, including intervention studies, are needed to support effective HPV vaccine promotion among men.
139 citations
02 Oct 2004
TL;DR: Routine MCV-4 vaccination of US children would reduce the burden of disease in vaccinated cohorts but at a relatively high net societal cost, compared with recently adopted childhood vaccines under conditions of above-average meningococcal disease incidence or at a lower cost per vaccination.
Abstract: Context. The US Food and Drug Administration approved a meningococcal conjugate A/C/Y/W-135 vaccine (MCV-4) for use in persons aged 11 to 55 years in January, 2005; licensure for use in younger age groups is expected in 2 to 4 years. Objective. To evaluate and compare the projected health and economic impact of MCV-4 vaccination of US adolescents, toddlers, and infants. Design. Cost-effectiveness analysis from a societal perspective based on data from Active Bacterial Core Surveillance (ABCs) and other published and unpublished sources. Sensitivity analyses in which key input measures were varied over plausible ranges were performed. Setting and Patients. A hypothetical 2003 US population cohort of children 11 years of age and a 2003 US birth cohort. Interventions. Hypothetical routine vaccination of adolescents (1 dose at 11 years of age), toddlers (1 dose at 1 year of age), and infants (3 doses at 2, 4, and 6 months of age). Each vaccination scenario was compared with a “no-vaccination” scenario. Main Outcome Measures. Meningococcal cases and deaths prevented, cost per case prevented, cost per life-year saved, and cost per quality-adjusted life-year saved. Results. Routine MCV-4 vaccination of US adolescents (11 years of age) would prevent 270 meningococcal cases and 36 deaths in the vaccinated cohort over 22 years, a decrease of 46% in the expected burden of disease. Before program costs are counted, adolescent vaccination would reduce direct disease costs by $18 million and decrease productivity losses by $50 million. At a cost per vaccination (average public-private price per dose plus administration fees) of $82.50, adolescent vaccination would cost society $633000 per meningococcal case prevented and $121000 per life-year saved. Key variables influencing results were disease incidence, case-fatality ratio, and cost per vaccination. The cost-effectiveness of toddler vaccination is essentially equivalent to adolescent vaccination, whereas infant vaccination would be much less cost-effective. Conclusions. Routine MCV-4 vaccination of US children would reduce the burden of disease in vaccinated cohorts but at a relatively high net societal cost. The projected cost-effectiveness of adolescent vaccination approaches that of recently adopted childhood vaccines under conditions of above-average meningococcal disease incidence or at a lower cost per vaccination.
97 citations
TL;DR: This paper examined how young adults' attitudes toward human papillomavirus vaccination and their intentions to get the vaccine are influenced by the framing of health messages (gain vs. loss) and time orientation (i.e., the extent to which people value immediate vs. distant consequences of their decisions).
Abstract: This research examines how young adults' attitudes toward human papillomavirus (HPV) vaccination and their intentions to get the vaccine are influenced by the framing of health messages (gain vs. loss) and time orientation (i.e., the extent to which people value immediate vs. distant consequences of their decisions). Results of an experiment showed an overall persuasive advantage for loss-framed messages. Attitudes and behavioral intentions toward HPV vaccination were found to be more favorable among future-minded individuals. Moreover, an interaction between framing and time orientation was found to predict persuasive outcomes. Present-minded participants responded more favorably to the loss-framed message, whereas future-minded participants were equally persuaded by both frames. Implications of the findings for vaccine risk communication are discussed.
La Persuasion Relativa de los Encuadres de Ganancia - versus de Perdida:
Los Mensajes sobre la Vacunacion contra el Papiloma Virus Humano para las Personas con Mentalidad Presente y Futura
Xiaoli Nan
University of Maryland
Resumen
Esta investigacion examina como las actitudes de los jovenes adolescentes hacia la vacuna del Papiloma Virus Humano (HPV) y sus intenciones de obtener la vacunacion son influenciados por los encuadres de los mensajes de salud (de ganancia versus de perdida) y la orientacion del tiempo (a saber, hasta que punto la gente valora las consecuencias de sus decisiones inmediatas versus distantes). Los resultados de un experimento muestran en general una ventaja persuasiva de los mensajes de encuadres de perdida. Las actitudes y las intenciones de comportamiento hacia la vacuna del HPV fueron encontrados como mas favorables entre los individuos con mentalidad de futuro. Mas aun, una interaccion entre el encuadre y la orientacion del tiempo se encontro que predice los resultados persuasivos. Los participantes con mentalidad en el presente respondieron mas favorablemente a los encuadres de perdida del mensaje, mientras que los participantes con mentalidad de futuro fueron igualmente persuadidos por ambos encuadres. Las implicancias de estos hallazgos para la comunicacion de riesgo sobre la vacuna son discutidos.
Palabras claves: encuadre, orientacion del tiempo, persuasion, papiloma virus humano, vacuna, comunicacion de riesgo
La force de persuasion relative des messages de vaccination contre le virus du papillome humain cadres sur le gain ou la perte chez les personnes tournees vers le present ou vers le futur
Xiaoli Nan
University of Maryland
Cette etude examine comment les attitudes des jeunes adultes envers la vaccination contre le virus du papillome humain (VPH) et leurs intentions de se faire vacciner sont influencees par le cadrage des messages relatifs a la sante (gain ou perte) et par l’orientation temporelle (c.-a-d. dans quelle mesure les gens evaluent les consequences immediates ou distantes de leurs decisions). Les resultats d’une experience demontrent un avantage persuasif general en faveur des messages cadres sur la perte. Les attitudes et les intentions comportementales envers la vaccination contre le VPH se sont revelees etre plus favorables chez les individus tournes vers le futur. De plus, une interaction entre le cadrage et l’orientation temporelle a predit la force persuasive. Les participants tournes vers le present reagissaient plus favorablement aux messages cadres sur la perte, alors que les participants tournes vers le futur etaient convaincus de facon egale par les deux cadrages. Les implications des resultats pour la communication des risques lies au vaccin sont commentees.
Mots cles : cadrage, orientation temporelle, persuasion, virus du papillome humain, vaccin, communication des risques
72 citations
TL;DR: In this paper, the authors examined the association between parents' knowledge, beliefs, and acceptance of the HPV vaccination for their daughters, considering their socio-demographics and religious beliefs.
Abstract: Thailand has one of the world's highest prevalence of cervical cancer, mainly caused by the human papillomavirus (HPV) HPV infections can successfully be prevented by vaccination, which is available at a cost but not yet implemented in the national vaccination program Parents play a critical role in deciding whether to vaccinate their child against HPV Thus, the aim was to examine the association between parents' knowledge, beliefs, and acceptance of the HPV vaccination for their daughters, considering their socio-demographics and religious beliefs A cross-sectional design was used among three schools in Thailand: Nakorn Phatom province (suburban) and Bangkok (urban) Parents of 9-12-year-old daughters completed the questionnaires, guided by the Health Belief Model In total, 359 parents completed the questionnaires; of those, 301 were included in the final analyses The ordinary least squares (OLS) regression analysis showed that background knowledge of HPV and the HPV vaccine was positively related to knowledge of HPV and cervical cancer For beliefs, knowledge was positively associated with susceptibility (ie, parents' perceived risk of an HPV infection/ related disease), severity, and benefit However, knowledge was not significantly related to barriers For acceptance, higher susceptibility and benefit were related to higher acceptance, and greater knowledge was associated with higher acceptance Thus, we found associations between parents' knowledge, beliefs, and acceptance of the HPV vaccination for their daughters, considering their socio-demographics and religious beliefs Parents, who reported religion as important, as opposed to those who did not, were more favorable toward the HPV vaccination Four out of ten mothers had never undergone a cervical cancer screening, but most had accepted previous childhood vaccinations for their daughters The overall acceptance of the vaccine was high, and we believe our results are promising for future implementation of the HPV vaccination in the national childhood vaccination program in Thailand
65 citations
TL;DR: Given brief information about HPV in both genders, parental acceptance of HPV vaccination of sons is as high as acceptance levels for girls, and all parents should be informed about HPV to make informed decisions about HPV vaccination for their children.
Abstract: Human papillomavirus (HPV) is a common sexually transmitted virus that can lead to severe diseases in both women and men. Today, HPV vaccination is offered to females only across Europe. We aimed to examine parental attitudes to HPV vaccination of their sons given brief information about HPV in both genders. A literature study on acceptability of male HPV vaccination was carried out to inform the construction of a study questionnaire. Following up on a Danish study from 2012, this questionnaire was applied in 1837 computer assisted interviews with parents of sons in the UK, Germany, France and Italy. In each country, the parents were representative in terms of geographical dispersion, city size and age of sons in the household. The applied questionnaires took the varying vaccination policies and delivery systems into account. The data were analysed pooled and for each country using significant statistical tests (chi-2) with a 95 % confidence interval. Approximately ¾ of parents in the UK, Germany and Italy were in favour of HPV vaccination of their sons. In France, this applied to 49 % of respondents. Favourable parents wanted to protect their sons from disease and found gender equality important. Parents in doubt about male HPV vaccination needed more information about HPV diseases in men and male HPV vaccination; Rejecting parents were generally sceptical of vaccines and feared vaccination side-effects. Parents in countries with active vaccination policies (UK and Italy) tended to trust the importance of national vaccination programmes. Parents in countries with passive vaccination strategies (Germany and France) had greater need for information from health care professionals (HCP) and public health authorities. Given brief information about HPV in both genders, parental acceptance of HPV vaccination of sons is as high as acceptance levels for girls. All parents should be informed about HPV to make informed decisions about HPV vaccination for their children. There is a need for joint efforts from public health authorities and HCPs to provide parents with such information.
62 citations
Cites background from "HPV vaccine and males: Issues and c..."
...The education of HCPs about HPV and their direct recommendation to their patients is particularly crucial to parents in countries with opportunistic vaccination [54, 55]....
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References
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Journal Article•
TL;DR: The first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine was made by the U.S. Food and Drug Administration on June 8, 2006 as mentioned in this paper.
Abstract: These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States. Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women. The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types. The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.
1,545 citations
TL;DR: Noninferior immunogenic responses to all 4 human papillomavirus types in the quadrivalent vaccine permit the bridging of efficacy data that were generated in young women to girls, and the results in boys lend support for the implementation of gender-neutral human papillaavirus vaccination programs.
Abstract: OBJECTIVE. Prophylactic vaccination of 16- to 23-year-old females with a quadrivalent human papillomavirus (types 6, 11, 16, 18) L1 virus-like particle vaccine has been shown to prevent type-specific human papillomavirus infection and associated clinical disease. We conducted a noninferiority immunogenicity study to bridge the efficacy findings in young women to preadolescent and adolescent girls and boys, who represent a primary target for human papillomavirus vaccination. METHODS. We enrolled 506 girls and 510 boys (10–15 years of age) and 513 females (16–23 years of age). Participants were vaccinated on day 1, at month 2, and at month 6, and serology testing was performed on day 1 and at months 3 and 7 on blinded samples. Neutralizing antibody concentrations were determined using type-specific immunoassays and summarized as geometric mean titers and seroconversion rates. Vaccine tolerability also was assessed. RESULTS. By month 7, seroconversion rates were ≥99% for all 4 human papillomavirus types in each group. By month 7, compared with women, anti–human papilloma virus geometric mean titers in girls or boys were noninferior and were 1.7- to 2.7-fold higher. Most (>97%) injection-site adverse events were mild to moderate in intensity. Significantly more boys (13.8%) and girls (12.8%) than women (7.3%) reported fevers ≥37.8°C within 5 days of vaccination. Most (96.4%) fevers were mild ( CONCLUSIONS. Noninferior immunogenic responses to all 4 human papillomavirus types in the quadrivalent vaccine permit the bridging of efficacy data that were generated in young women to girls. The results in boys lend support for the implementation of gender-neutral human papillomavirus vaccination programs. This vaccine generally was well tolerated.
484 citations
TL;DR: Among insured women, aged 19-26 years, those who discussed the HPV vaccine with their physician and received a recommendation were overwhelmingly more likely to be vaccinated.
428 citations
Journal Article•
TL;DR: This report summarizes results from the 2008 NIS-Teen and, for the first time, includes estimates for each of the 50 states and selected local areas and by race/ethnicity and poverty status.
340 citations