P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S65-S65
Author(s):  
Ryan Suk ◽  
Heetae Suk ◽  
Keith Sigel ◽  
Kalyani Sonawane ◽  
Ashish Deshmukh

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

2018 ◽  
Vol 94 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Stephen Jean ◽  
Malak Elshafei ◽  
Alison Buttenheim

ObjectiveTo assess social patterns in human papillomavirus (HPV) vaccine coverage in a school-based, government-funded vaccination programme located within a single-payer universal healthcare system.DesignWe conducted a cross-sectional analysis of HPV vaccine uptake data for the 2013–2014 school year for 131 local authorities in England, and then evaluated the association between vaccine uptake and socioeconomic status at the aggregate level.Data sourcesHPV vaccination coverage data from Public Health England’s vaccine uptake guidance and the UK’s March 2011 Census.Main outcome measuresWe measured three-dose local authority-level vaccine series initiation to completion.ResultsWe found that in local authorities where there are more high-income families, the vaccination rate is lower than in local authorities with more low-income families. Local authorities with a higher percentage of whites, compared with non-whites, had higher HPV vaccination rates. Additionally, local authorities with more non-migrants had higher rates of vaccination. Local authorities with more education deprivation had higher rates of vaccination. Local authorities’ higher proportions of high-status occupations had worse vaccination coverage. In bivariate analyses across all the socioeconomic indicators, a 1 SD change in the indicators was associated with about a 2.25 percentage point decrease (for income, education and occupation) or increase (for race and migrant composition) in HPV dose coverage in the local authority. In multivariable analyses, only race remained as a significant predictor of HPV coverage at the local authority level.ConclusionsAcross all three doses, there are notable variations by socioeconomic status, with steep reverse gradients in three socioeconomic indicators. More quantitative and qualitative research needs to be conducted to determine the effects of the 2014 transition from a three-dose regimen to two-dose regimen on vaccination coverage, especially in groups that experience lower rates of vaccination.


2021 ◽  
Author(s):  
Ted Dolby ◽  
Katie Finning ◽  
Allan Baker ◽  
Leigh Dowd ◽  
Kamlesh Khunti ◽  
...  

Background: The UK began an ambitious COVID-19 vaccination programme on 8th December 2020. This study describes variation in vaccination coverage by sociodemographic characteristics between December 2020 and August 2021. Methods: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics amongst adults aged 18 years or over in England. We also present a tool to display the results interactively. Findings: Our study population included 35,223,466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged ≥80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socio-economic group, and had fewer qualifications. Interpretation: We found inequalities in COVID-19 vaccination rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socio-economic position, and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.


2018 ◽  
Vol 36 (3) ◽  
pp. 262-267 ◽  
Author(s):  
Anil K. Chaturvedi ◽  
Barry I. Graubard ◽  
Tatevik Broutian ◽  
Robert K.L. Pickard ◽  
Zhen-Yue Tong ◽  
...  

Purpose The incidence of human papilloma virus (HPV)–positive oropharyngeal cancers has risen rapidly in recent decades among men in the United States. We investigated the US population–level effect of prophylactic HPV vaccination on the burden of oral HPV infection, the principal cause of HPV-positive oropharyngeal cancers. Methods We conducted a cross-sectional study of men and women 18 to 33 years of age (N = 2,627) within the National Health and Nutrition Examination Survey 2011 to 2014, a representative sample of the US population. Oral HPV infection with vaccine types 16, 18, 6, or 11 was compared by HPV vaccination status, as measured by self-reported receipt of at least one dose of the HPV vaccine. Analyses accounted for the complex sampling design and were adjusted for age, sex, and race. Statistical significance was assessed using a quasi-score test. Results Between 2011 and 2014, 18.3% of the US population 18 to 33 years of age reported receipt of at least one dose of the HPV vaccine before the age of 26 years (29.2% in women and 6.9% in men; P < .001). The prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated individuals (0.11% v 1.61%; Padj = .008), corresponding to an estimated 88.2% (95% CI, 5.7% to 98.5%) reduction in prevalence after model adjustment for age, sex, and race. Notably, the prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated men (0.0% v 2.13%; Padj = .007). Accounting for vaccine uptake, the population-level effect of HPV vaccination on the burden of oral HPV16/18/6/11 infections was 17.0% overall, 25.0% in women, and 6.9% in men. Conclusion HPV vaccination was associated with reduction in vaccine-type oral HPV prevalence among young US adults. However, because of low vaccine uptake, the population-level effect was modest overall and particularly low in men.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6003-6003 ◽  
Author(s):  
Maura L. Gillison ◽  
Tatevik Broutian ◽  
Barry Graubard ◽  
Robert Pickard ◽  
Zhen-Yue Tong ◽  
...  

6003 Background: The incidence of HPV-positive oropharyngeal cancers has risen in recent decades among US men. The potential impact of HPV vaccines on oral HPV infections has yet to be evaluated in efficacy-trials or surveillance studies. Methods: To evaluate the impact of prophylactic HPV vaccination on oral HPV infections in the US population, we conducted a cross-sectional study among men and women aged 18-33 years (n = 2,627) in the National Health and Nutrition Examination Survey, 2011-2014. We examined the effect of self-reported receipt of ≥1 vaccine dose on oral HPV infection (vaccine-types 16/18/6/11) prevalence among vaccinated vs. unvaccinated individuals. Additional outcomes included percent reduction in infection-prevalence among vaccinated individuals and population-level effectiveness of vaccination. Analyses accounted for the complex sampling design. Comparisons between vaccinated and unvaccinated individuals were conducted using binary logistic regression, with adjustment for age, gender, and race. Statistical significance was assessed using a quasi-score test. Results: During 2011-2014, 18.3% of the US population aged 18-33 years reported receipt of ≥1 HPV vaccine-dose prior to age 26 (29.2% in women and 6.9% in men; P< 0.001). The prevalence (population-weighted) of oral HPV16/18/6/11 infections was significantly reduced in vaccinated vs. unvaccinated individuals (0.11% vs. 1.61%; P= 0.008), corresponding to an estimated 88.2% (95%CI = 5.7%-98.5%) reduction in prevalence. Notably, oral HPV16/18/6/11 prevalence was significantly reduced in vaccinated vs. unvaccinated men (0.0% vs. 2.13%; P= 0.007). In contrast, prevalence for 33 non-vaccine HPV types was similar (3.98% vs. 4.74%; P= 0.24). Accounting for HPV vaccine-uptake, the population-level effectiveness of HPV vaccination on the burden of oral HPV16/18/6/11 infections was 17.0% overall, 25.0% in women and 6.9% in men. Conclusions: HPV vaccination substantially reduced vaccine-type oral HPV infection prevalence among young adults (ages 18-33 years) in the US population during 2011-2014. However, due to low vaccine uptake, population-level effectiveness was modest overall and particularly low in men.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S31-S32
Author(s):  
Maria A Corcorran ◽  
Ethan Valinetz ◽  
Abir Hussein ◽  
Alyson J Littman ◽  
Stephen E Hawes

Abstract Background Human papillomavirus (HPV) is the main cause of cervical, anal and oro-pharyngeal cancer worldwide. The HPV vaccine can prevent over 90% of HPV-related malignancies but vaccination rates in the United State (US) vary significantly by region. In this study, we assessed whether state-level politics is associated with receipt of HPV vaccination in the US, and if the association is modified by sex and age. Methods This study analyzed data from the Center for Disease Control and Prevention’s (CDC) Behavioral Risk Factors Surveillance System (BRFSS) survey. Persons ages 18 to 36 years of age, who lived in 17 states that included the supplementary “Adult Human Papillomavirus (HPV)” module questionnaire in 2016, 2017 or 2018, were included. We compared self-reported receipt of HPV vaccination among persons living in Republican versus Democratic states, based on state electoral college votes in the 2016 US presidential election. Mantel-Haenszel stratified analysis was used to estimate prevalence ratios and to assess for effect modification and control for confounding. Results Overall, 36,334 survey respondents were included in the analysis, 22.7% of whom reported prior receipt of the HPV vaccine, 28.1% in Democratic states and 20.4% in Republican states. When adjusted for race, living in a Democratic state was associated with a higher prevalence of prior receipt of the HPV vaccine in comparison to living in a Republican state. This association was strongest for men less than 26 years of age (PR 1.77, 95% CI: 1.58, 1.98) but remained significant for men ages 26 – 36 years (PR 1.51, 95% CI: 1.24, 1.85), women less than 26 years of age (PR 1.20, 95% CI: 1.13, 1.27), and women ages 26 – 36 years (PR 1.69, 95% CI: 1.57, 1.83). Conclusion Overall HPV vaccine coverage was low in adults 18–36 years of age. The strong association between state-level voting patterns and prior receipt of the HPV vaccine suggests that HPV vaccine coverage is lower in Republican states when compared to Democratic states. Further public health efforts are needed to promote HPV vaccine uptake among young men and women, particularly in Republican voting states. Disclosures All Authors: No reported disclosures


2021 ◽  
Vol 26 (50) ◽  
Author(s):  
Giuseppina Ortu ◽  
Anne-Sophie Barret ◽  
Kostas Danis ◽  
Lucie Duchesne ◽  
Daniel Levy-Bruhl ◽  
...  

Background In France, human papillomavirus (HPV) vaccination has been recommended in 2016 for men who have sex with men (MSM) up to age 26 years. Aim We aimed to estimate HPV vaccine coverage in 18–28 year-old MSM and identify uptake determinants. Methods We collected data on socio-demographic characteristics, sexual behaviour, sexually transmitted diseases (STI) screening and vaccination uptake using a voluntary cross-sectional online survey conducted in 2019 targeting MSM. We calculated coverage of at least one dose of HPV vaccine and prevalence ratios (PR) of determinants with 95% confidence intervals (CI) using Poisson regression. Results Of 9,469 respondents (age range: 18–28 years), 15% (95% CI: 14–16) reported being vaccinated for HPV. Coverage was significantly higher among MSM < 24 years (PR: 1.25; 95% CI: 1.13–1.39), with education level below university degree (PR: 1.12; 95% CI: 1.08–1.32), living in rural areas (PR: 1.21; 95% CI: 1.08–1.36), attending sex parties (PR: 1.12; 95% CI: 1.03–1.33), using HIV-related biomedical prevention methods (PR: 1.31; 95% CI: 1.12–1.54), with STI diagnosis (PR: 1.22; 95% CI: 1.08–1.38) and with hepatitis A or B vaccination (PR: 4.56; 95% CI: 3.63–5.81 vs PR: 3.35; 95% CI: 2.53–4.44). Conclusions The HPV vaccination uptake among MSM in France was not satisfactory. It was higher among MSM benefitting from other vaccinations and biomedical preventive methods against HIV, suggesting a synergistic effect of the national preventive sexual health recommendations for MSM. Further efforts to improve HPV vaccination coverage targeting MSM are warranted.


Author(s):  
Lihong Ou ◽  
Shawn D. Youngstedt

Abstract This systematic review provided synthesized evidence regarding the effectiveness of the interventions promoting the human papillomavirus (HPV) vaccination in college-aged population. The HPV infection is the most prevailing sexually transmitted disease. Despite the availability and effectiveness of the 9-Valent HPV vaccine, the vaccine coverage among young adults remained low. In witness to the increasing burden of HPV-related infections and cancers, research focused on the vaccination interventions should be conducted to determine the effectiveness of the vaccination strategy and address the gap. The search was conducted through PubMed, Cochrane, and CINAL. Studies were included if they (1) included vaccination programs, (2) target population was young adults aged 17–26, (3) examined factors associated with the intervention effectiveness, (4) were published in English, and (5) were published between February 2010 and February 2020. HPV-related knowledge and intentions toward HPV vaccination were all reported increased after the intervention. Increased HPV vaccination intentions were found associated with the increased vaccine initiation and completion. Among bisexual or homosexual individuals, females were found more likely to complete the HPV dose 2 and 3. The review findings suggested using vaccination interventions incorporated with educational components to promote vaccine uptake among young adults. Supportive interventions tailored to different populations and settings are crucial to address the suboptimal HPV-related knowledge and vaccination status among the young beneficiaries.


2021 ◽  
Author(s):  
Nanina Anderegg ◽  
Christian L Althaus ◽  
Samuel Colin ◽  
Anthony Hauser ◽  
Anne Laube ◽  
...  

Background. In Switzerland, SARS-CoV-2 vaccination campaigns started early 2021. Vaccine coverage reached 65% of the population in December 2021, mostly using mRNA vaccines from Moderna and Pfizer-BioNtech. Simultaneously, the proportion of vaccinated among COVID-19-related hospitalizations and deaths rose, creating some confusion in the general population. We aim to assess vaccine effectiveness against severe forms of SARS-CoV-2 infection using routine surveillance data on the vaccination status of COVID-19-related hospitalizations and deaths and data on vaccination coverage in Switzerland.Methods. We consider all routine surveillance data on COVID-19-related hospitalizations and deaths received at the Swiss Federal Office of Public Health from 1 July 2021 to 1 December 2021. We estimate the relative risk of COVID-19 related hospitalization or death for non-fully vaccinated compared to fully vaccinated individuals, adjusted for the dynamics of vaccination coverage over time, by age and location. We stratify the analysis by age group and by calendar month. We assess variations in the relative risk of hospitalization associated with the time since vaccination.Results. We include a total of 5,948 COVID-19-related hospitalizations of which 1,245 (21%) were fully vaccinated, and a total of 739 deaths of which 259 (35%) were fully vaccinated. We find that the relative risk of COVID-19 related hospitalization is 12.5 (95%CI: 11.7 to 13.4) times higher for non-fully vaccinated than for fully vaccinated individuals. This translates into a vaccine effectiveness against hospitalization of 92.0% (95%CI: 91.4 to 92.5%). Vaccine effectiveness against death is estimated to 90.3% (95%CI: 88.6 to 91.8%). Effectiveness appears comparatively lower in age groups over 70 and during the months of October and November 2021. We also find evidence of a decrease in vaccine effectiveness against hospitalization for individuals vaccinated for 25 weeks or more, but this decrease only appears in age groups below 70.Conclusions. The observed proportions of vaccinated among COVD-19-related hospitalizations and deaths in Switzerland are compatible with a high effectiveness of mRNA vaccines from Moderna and Pfizer-BioNtech against hospitalization and death in all age groups. Effectiveness appears comparatively lower in older age groups, suggesting the importance of booster vaccinations. We find inconclusive evidence that vaccine effectiveness is waning over time. Repeated analyses will be able to better assess waning and the effect of boosters.


2018 ◽  
Vol 95 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Launcelot McGrath ◽  
Christopher K Fairley ◽  
Eoin F Cleere ◽  
Catriona S Bradshaw ◽  
Marcus Y Chen ◽  
...  

ObjectiveIn mid-2017, the Victorian Government funded a free time-limited human papillomavirus (HPV) vaccination catch-up programme for gay and bisexual men who have sex with men (MSM) aged up to 26 years through sexual health clinics or other immunisation centres. We aimed to examine the uptake of the HPV vaccine among young MSM attending the Melbourne Sexual Health Centre (MSHC).MethodsMSM aged ≤26 attending MSHC between 27 April 2017 and 31 December 2017 were included in the analysis. HPV vaccine uptake was calculated based on the first consultation of each patient during the period. Multivariable logistic regression was performed to examine the association between vaccine uptake and patient factors.ResultsThere were 2108 MSM aged ≤26 who attended MSHC over the study period, with 7.6% (n=161) reporting previous HPV vaccination. Of the 1947 eligible men, 1134 (58.2%, 95% CI 56.0% to 60.4%) were offered the vaccine by the clinicians, and 830 men received it on the day. The vaccine coverage among all eligible MSM was 42.6% (95% CI 40.4% to 44.9%; 830 of 1947) and among MSM who were offered the vaccine by the clinicians was 73.2% (95% CI 70.5% to 75.8%; 830 of 1134). Men with a history of genital warts (adjusted OR (aOR)=3.11, 95%CI 1.39 to 6.99) and those who had >4male partners in the last 12 months (aOR=1.38, 95% CI 1.04 to 1.85) were more likely to receive the HPV vaccine on the day. 304 men declined the vaccine; most men did not specify the reason (31.3%, n=95), while 27.3% (n=83) needed time to think.ConclusionAlthough vaccine uptake was 73.2% among those offered, the actual coverage of those eligible remained unsatisfactory (42.6%) in a sexual health clinic. This highlights a clinic-based targeted MSM programme may not reach sufficiently high vaccine coverage to provide MSM with the same vaccine benefits as heterosexuals.


2019 ◽  
Vol 6 (3) ◽  
Author(s):  
Marc Choisy ◽  
Son Tung Trinh ◽  
Thi Ngoc Diep Nguyen ◽  
Tran Hien Nguyen ◽  
Quynh Le Mai ◽  
...  

AbstractBackgroundDuring the first half of 2014, a severe outbreak of measles occurred in northern Vietnam, causing 15 033 confirmed cases and 146 deaths.MethodsTo evaluate the population-level seroprevalence of protection against measles in the period before the outbreak, we made use of an existing age-stratified serum bank, collected over the year before the outbreak, between November 2012 and December 2013, from 4 sites across the country (Hanoi, Hue, Dak Lak, and Ho Chi Minh City). Data from the UNICEF’s Multiple Indicator Clustered Surveys (MICS), carried out in Vietnam during the first quarter of 2014, were used to assess the vaccine coverage in 6 ecological regions of Vietnam.ResultsResults revealed a large discrepancy between levels of protection, as estimated from the serology and vaccine coverage estimated by UNICEF’s MICS. Variation in seroprevalence across locations and age groups corresponded with reported numbers of measles cases, most of which were among the 0–2-year-old age group and in the northern part of the country.ConclusionsOur study presents a strong case in favor of a serosurveillance sentinel network that could be used to proactively tune vaccination policies and other public health interventions.


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