Health Care Provider Attitudes and Barriers Regarding Human Papillomavirus (HPV) Vaccination: Factors Associated With Increasing HPV Vaccine Coverage Before and After an Intervention Program

PURPOSE Young cancer survivors are at increased risk for morbidities related to infection with the human papillomavirus (HPV), yet their HPV vaccine initiation rates remain low. Patient-/parent-reported lack of health care provider recommendation for HPV vaccination is strongly associated with vaccine noninitiation. We aimed to identify patient-level factors associated with survivor-/parent-reported lack of provider recommendation for HPV vaccination among young cancer survivors. METHODS Cancer survivors ages 9-26 years and 1-5 years off therapy completed a cross-sectional survey (parent-completed for survivors 9-17 years of age). Lack of health care provider HPV vaccine recommendation was the outcome of interest in a multivariable logistic regression model that included relevant patient-level sociodemographic, clinical, and vaccine-related variables. RESULTS Of 955 survivors, 54% were male, 66% were non-Hispanic White, and 36% had leukemia. At survey participation, survivors were an average age (± standard deviation) of 16.3 ± 4.7 years and 32.8 ± 14.7 months off therapy. Lack of provider HPV vaccine recommendation was reported by 73% (95% CI, 70% to 75%) of survivors. For the entire cohort, patient-level factors associated with lack of reported provider recommendation included perceived lack of insurance coverage for the HPV vaccine (odds ratio [OR], 4.0; 95% CI, 2.7 to 5.9; P < .001), male sex (OR, 2.8; 95% CI, 1.9 to 4.0; P < .001), and decreased parent-survivor communication regarding HPV vaccination (OR, 1.7 per unit decrease in score; 95% CI, 1.3 to 2.2; P < .001). In the sex- and age-stratified models, perceived lack of insurance coverage (all models) and male sex (age-stratified models) were also significantly associated with lack of reported provider recommendation. CONCLUSION We identified factors characterizing survivors at risk for not reporting receipt of a health care provider HPV vaccine recommendation. Future research is needed to develop interventions that facilitate effective provider recommendations for HPV vaccination among all young cancer survivors.

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Introduction of human papillomavirus (HPV) vaccination in Belgium, 2007-2008

Eurosurveillance ◽

10.2807/ese.14.46.19407-en ◽

2009 ◽

Vol 14 (46) ◽

Author(s):

C Simoens ◽

M Sabbe ◽

P Van Damme ◽

P Beutels ◽

M Arbyn

Keyword(s):

Human Papillomavirus ◽

Secondary School ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Target Population ◽

Hepatitis B Vaccination ◽

First Year ◽

Vaccine Introduction ◽

School Based

This paper documents the progress of human papillomavirus (HPV) vaccine introduction in Belgium. Information on vaccine use is based on sales statistics and reimbursement claims. From November 2007 to November 2008, the National Institute for Health and Disability Insurance reimbursed the HPV vaccine for girls aged between 12-15 years. In December 2008, the age limit was extended to include girls up to the age of 18. In November 2008, the total number of HPV vaccines sold exceeded 530,000 doses. The number of vaccines reimbursed in Belgium, for the period November 2007-November 2008, corresponds to the amount required to fully vaccinate 44% of all girls aged between 12-15 years. However, the trend was decreasing over the last 10 months. By the current reimbursement policy, we can expect that maximum half of the target population can be reached. In Flanders (one of the three Communities in Belgium), the intention is to start, from September 2010, with a free school-based HPV immunisation for girls in the first year of secondary school (12 years of age), complemented with vaccination by a physician of choice. This strategy ensures a higher HPV vaccine coverage which is expected to be as high as the current coverage in the hepatitis B vaccination programme (approximately 80%) offered to boys and girls in the same age group and under the same circumstances.

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Online media scans: Applying systematic review techniques to assess statewide human papillomavirus vaccination activities

Journal of Public Health Research ◽

10.4081/jphr.2019.1623 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

Emily Ann Groene ◽

Inari Mohammed ◽

Keith Horvath ◽

Nicole E. Basta ◽

Nicholas Yared ◽

...

Keyword(s):

Human Papillomavirus ◽

Health Education ◽

Rural Areas ◽

Hpv Vaccine ◽

Urban Areas ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Online Media ◽

Human Papillomavirus Vaccination ◽

Research Activities

Background. Although the human papillomavirus (HPV) vaccine has been approved for use in adolescents in the US for over a decade, vaccination uptake remains low. Of concern, HPV vaccine coverage is below the national average in Minnesota, USA. To understand the reach of current HPV programming and research, we use an online media scan; this method may be applied to other jurisdictions to gain insight about various public health issues.Design and Methods. This online media scan describes the nature and scope of ongoing activities to increase HPV vaccination in Minnesota. The media scan included: a) structured internet searches of HPV vaccine health education/promotion activities ongoing in Minnesota since 2013, and b) searches in research databases of the published literature on HPV vaccination in Minnesota from 2013 to 2018. Results. Searches resulted in 880 online and 142 research article matches, with 40 and 36 meeting selection criteria. Results were categorized by activities focusing on race/ethnicity, sex, health providers, parents, lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) populations, geographic location, catchup vaccination, and insurance status. Most activities were statewide (52% health education/promotion and 35% research), followed by activities located in entirely urban areas (15% health education/promotion and 41% research) with only 6% of health education/promotion activities and 2% of research activities carried out in entirely rural areas.Conclusions. A range of local and statewide HPV vaccine health education/promotion and research activities were identified in Minnesota. Several efforts partnered with American Indian and Somali/Somali-American communities, but fewer activities focused on HPV vaccination among LGBTQ youth and HPV vaccination in rural areas.

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18. Association Between State-level Voting Patterns and Prior Receipt of the HPV Vaccine, an Analysis Using Data from the Behavioral Risk Factor Surveillance System 2016 – 2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.063 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S31-S32

Author(s):

Maria A Corcorran ◽

Ethan Valinetz ◽

Abir Hussein ◽

Alyson J Littman ◽

Stephen E Hawes

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Surveillance System ◽

Vaccine Coverage ◽

Strong Association ◽

Hpv Vaccination ◽

State Level ◽

Vaccine Uptake ◽

Behavioral Risk ◽

Pharyngeal Cancer

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

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Opportunities to increase rates of human papillomavirus vaccination in the New South Wales school program through enhanced catch-up

Sexual Health ◽

10.1071/sh15132 ◽

2016 ◽

Vol 13 (6) ◽

pp. 536 ◽

Cited By ~ 5

Author(s):

Christine Staples ◽

Michelle Butler ◽

Jennifer Nguyen ◽

David N. Durrheim ◽

Patrick Cashman ◽

...

Keyword(s):

High School Students ◽

Human Papillomavirus ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Vaccination Program ◽

Completion Rates ◽

School Program ◽

Human Papillomavirus Vaccination ◽

Catch Up

Background The National Human Papillomavirus (HPV) Vaccination Program provides HPV vaccine to high school students through school-based vaccination. We aimed to: 1) assess the vaccine completion rates achieved when general practice is used for completing doses missed at school; 2) estimate the extent of under-notification by general practices of vaccine doses administered; and 3) assess the reasons reported by parents of students for non-completion of HPV vaccination. Methods: A postal survey was conducted of parents and carers of students and identified, using school-program records, as incompletely vaccinated in a large regional area of northern NSW vaccinated during 2010. Information about additional HPV vaccine doses received or reasons for non-completion were sought. Responses were analysed and records cross-checked against the National HPV Vaccination Program Register. Results: Of 660 parents or carers contacted, 207 (31.4%) responded. We found: 1) completion rates increased, an additional 122/207 (45.2%) students had completed all three doses of HPV through their general practitioner (GP); 2) under-notification of GP doses to the National HPV Vaccination Program Register was an issue with only 5/165 (3.0%) reported; 3) the main reason for non-completion was being unaware of the opportunity to catch-up at a GP. Conclusions: Underreporting by GPs of HPV vaccine doses administered and failure to complete courses identifies two opportunities to increase HPV vaccine coverage. These could be addressed by extending provision of catch-up HPV doses in school and by developing practice software solutions for automatic notification of doses from GPs. Reasons given by parents for non-completion, mostly logistical barriers, indicate a high degree of acceptance of HPV vaccination.

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Factors Associated with Health Care Provider Attitudes, and Confidence for the Care of Women and Girls Affected by Female Genital Mutilation/Cutting

Health Equity ◽

10.1089/heq.2020.0130 ◽

2021 ◽

Vol 5 (1) ◽

pp. 329-337

Author(s):

Christina X. Marea ◽

Nicole Warren ◽

Nancy Glass ◽

Crista Johnson-Agbakwu ◽

Nancy Perrin

Keyword(s):

Health Care ◽

Health Care Provider ◽

Care Provider ◽

Female Genital Mutilation ◽

Provider Attitudes ◽

Genital Mutilation ◽

Factors Associated ◽

Women And Girls ◽

Female Genital

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Low vaccination coverage for human papillomavirus disease among young men who have sex with men, France, 2019

Eurosurveillance ◽

10.2807/1560-7917.es.2021.26.50.2001965 ◽

2021 ◽

Vol 26 (50) ◽

Cited By ~ 1

Author(s):

Giuseppina Ortu ◽

Anne-Sophie Barret ◽

Kostas Danis ◽

Lucie Duchesne ◽

Daniel Levy-Bruhl ◽

...

Keyword(s):

Human Papillomavirus ◽

Vaccination Coverage ◽

Rural Areas ◽

Hpv Vaccine ◽

Online Survey ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Cross Sectional ◽

Vaccination Uptake ◽

Sex With Men

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.

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Women's Knowledge of Pap Smear Test and Human Papillomavirus: Acceptance of HPV Vaccination to Themselves and Their Daughters in an Islamic Society

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181dda2b9 ◽

2010 ◽

Vol 20 (6) ◽

pp. 1058-1062 ◽

Cited By ~ 23

Author(s):

Erdin Ilter ◽

Aygen Celik ◽

Berna Haliloglu ◽

Elif Unlugedik ◽

Ahmet Midi ◽

...

Keyword(s):

Health Care ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Health Care Professionals ◽

Hpv Vaccine ◽

Pap Smear ◽

Hpv Vaccination ◽

Cervix Uteri ◽

Pap Smear Test ◽

Smear Test

Objective:Cancer of cervix uteri is the second most common cancer among women, and it has been shown to be caused by human papillomavirus (HPV) infection in more than 99% of cases. We surveyed Muslim Turkish women, who mostly accept talking about sex as a taboo, to examine their knowledge about Papanicolaou (Pap) smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters.Methods:We surveyed 525 women aged between 19 and 53 years to examine their knowledge about cervical cancer screening Pap smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters with a questionnaire that is consisted of 5 parts with a total of 31 items.Results:The knowledge of cervical screening was high (70%), and 51% of the subjects were at least once had a Pap smear test, but most respondents (56%) had never heard of HPV. For most women, recommendations from health workers (67%) were the major influences in deciding to get vaccinated.Conclusions:The importance of successful introduction on the vaccine by the drug providers and health care professionals in Turkey was shown in this present study with a high rate of awareness of cervical cancer vaccine. "Early-age vaccination knowledge" before any sexual contact is probably due to the correct education of mothers by health care professionals. The professionals should be educated and trained about HPV, vaccination, and its relation with cervical cancer to increase the knowledge about it.

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Human Papillomavirus Vaccine Course Completion Among Gay and Bisexual Men Who Have Sex With Men From a Time-Limited HPV Vaccination Catch-Up Program in Victoria, Australia

Frontiers in Public Health ◽

10.3389/fpubh.2021.754112 ◽

2021 ◽

Vol 9 ◽

Author(s):

Kay Htaik ◽

Christopher K. Fairley ◽

Marcus Y. Chen ◽

Rebecca Wigan ◽

Elena Rodriguez ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Health Centre ◽

Bisexual Men ◽

Human Papillomavirus Vaccine ◽

Factors Associated ◽

Catch Up ◽

Sex With Men ◽

Hiv Negative

Background: To examine completion of the human papillomavirus (HPV) vaccination 3-dose regimen and factors associated with completion among men who have sex with men (MSM) aged ≤ 26 years participating in a time-limited HPV catch-up vaccination program in Victoria, Australia.Methods: MSM who received their first dose of HPV vaccine at Melbourne Sexual Health Centre in 2017 were followed until October 2019. Vaccination completion was defined as those who received three doses. Multivariable logistic regression was performed to examine factors associated with vaccine completion.Results: 931 of 1,947 (47.8%) eligible men received at least one dose of HPV vaccine, 750 (38.5%) received two and 590 (30.3%) received three doses. The median time to receiving the second and third dose was 2.8 (IQR = 2.1–4.8) and 7.2 (IQR = 6.3–10.7) months, respectively. Gay men had higher odds of receiving three doses compared to bisexual men (aOR = 2.17; 95%CI: 1.16–4.04). Compared with HIV-negative MSM not taking PrEP, HIV-positive MSM were more like to complete vaccination (aOR = 3.92, 95%CI: 1.62–9.47) but no difference was found compared to HIV-negative men taking PrEP (aOR = 1.55; 95%CI: 0.95–2.53).Conclusion: Less than one-third of men aged ≤ 26 years completed the three doses of HPV vaccine. Further studies are needed to understand the barriers of men not completing the vaccine.

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