scholarly journals Off-Label 9-Valent Human Papillomavirus Vaccination for Actinic Keratosis: A Case Series

2021 ◽  
pp. 457-463
Author(s):  
Emily Wenande ◽  
Niels Bech-Thomsen ◽  
Katrine Togsverd-Bo ◽  
Merete Haedersdal
Keyword(s):  
Human Papillomavirus ◽  
Actinic Keratosis ◽  
Hpv Vaccination ◽  
Case Series ◽  
Skin Lesions ◽  
Human Papillomavirus Vaccination ◽  
Off Label ◽  
Dermatology Clinic ◽  
Regular Control ◽  
Malignant Skin

<b><i>Background:</i></b> The suspected link between human papillomavirus (HPV) and the development of premalignant and malignant skin lesions remains inadequately examined in clinical settings. This case series describes HPV vaccination as an off-label adjuvant therapy for actinic keratosis (AK). <b><i>Methods:</i></b> Twelve immunocompetent AK patients underwent HPV vaccination at a private dermatology clinic in Naestved, Denmark. Prior to vaccination, all patients demonstrated a high AK burden that required regular control visits. At 0, 2, and 6 months, the patients received an intramuscular injection of a commercially available 9-valent HPV vaccine. Concurrently, patients continued conventional AK therapies at 3-month intervals. Clinical response, consisting of reduction in AK number and general change in skin appearance, was assessed by a dermatologist over 12 months following first vaccination. <b><i>Results:</i></b> All patients (mean age 76.2 years; 10 M and 2 F) completed the vaccine schedule. Overall, an average 85% reduction in total AK burden was recorded 12 months after beginning vaccination. Median AK burden thus fell from 56 (IQR: 44–80) to 13.5 (IQR: 1–18) lesions after 12 months. Lesion reduction was observable by the second inoculation at month 2 (34 AKs; IQR 22–80), continuing steadily until month 6 (15 AKs; IQR 5–30) and plateauing between 6 and 12 months. Clinically, HPV vaccination elicited fading of lesions’ erythematous background after the first dose, often followed by sloughing of hyperkeratotic elements in subsequent weeks. Patients reported no adverse effects related to HPV vaccination. <b><i>Conclusion:</i></b> This case series introduces the possibility that 9-valent HPV vaccination in combination with conventional treatments may be used as a therapeutic strategy for AK.

scholarly journals A Long-Term Observation on the Possible Adverse Effects in Japanese Adolescent Girls after Human Papillomavirus Vaccination

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 856
Author(s):  
Akiyo Hineno ◽  
Shu-Ihi Ikeda
Keyword(s):  
Human Papillomavirus ◽  
Adverse Effects ◽  
Orthostatic Intolerance ◽  
Hpv Vaccination ◽  
Pain Syndrome ◽  
Causal Link ◽  
Human Papillomavirus Vaccination ◽  
Chronic Regional Pain Syndrome ◽  
Laboratory Test Results ◽  
Long Term Observation

In Japan, a significant number of adolescent females noted unusual symptoms after receiving the human papillomavirus (HPV) vaccination, of which the vast majority of them were initially diagnosed with psychiatric illnesses because of the absence of pathologic radiological images and specific abnormalities in laboratory test results. Later these symptoms were thought to be adverse effects of HPV vaccination. However, a causal link between HPV vaccination and the development of these symptoms has not been demonstrated. Between June 2013 and March 2021, we examined 200 patients who noted various symptoms after HPV vaccination. In total, 87 were diagnosed with HPV vaccination-related symptoms based on our proposed diagnostic criteria. The clinical histories of these 87 patients were analyzed. The age at initial vaccination ranged from 11 to 19 years old (mean ± SD: 13.5 ± 1.5 years old), and the age at the first appearance of symptoms ranged from 12 to 20 years old (mean ± SD: 14.3 ± 1.6 years old). The patients received an initial HPV vaccine injection between May 2010 and May 2013, but the first affected patient developed symptoms in October 2010, and the last affected developed symptoms in October 2015. A cluster of patients with a post-HPV vaccination disorder has not appeared in Japan during the last five years. Our study shows that, in Japan, the period of HPV vaccination considerably overlapped with that of a unique post-HPV vaccination disorder development. This disorder appears as a combination of orthostatic intolerance, chronic regional pain syndrome, and cognitive dysfunction, but its exact pathogenesis remains unclear.

Human papillomavirus lesions in 16 MS patients treated with fingolimod: Outcomes and vaccination

2021 ◽  
pp. 135245852199143
Author(s):  
Elsa Mhanna ◽  
Agathe Nouchi ◽  
Céline Louapre ◽  
Raphael De Paz ◽  
Olivier Heinzlef ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Case Series ◽  
Good Tolerance ◽  
Prevalence Studies ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
Hpv Screening

Few cases of human papillomavirus (HPV) diseases have been reported in multiple sclerosis (MS) patients treated with fingolimod. We describe a case series of 16 MS patients (11 women, 5 men) developing HPV lesions after the onset of fingolimod, without previous HPV history. Fingolimod had to be discontinued in six patients. Six patients received vaccination for HPV, with good tolerance. Our report highlights that systematic HPV screening and discussion about HPV vaccination before fingolimod onset are crucial. In case of occurrence of HPV lesions during fingolimod treatment, a comprehensive workup of HPV disease is necessary, with discussion of HPV vaccination to prevent secondary lesions. Prevalence studies of HPV lesions are needed in MS patients with the different disease-modifying therapies.

scholarly journals Lack of school requirements and clinician recommendations for human papillomavirus vaccination

2018 ◽  
Author(s):  
Linda M. Niccolai ◽  
Anna L. North ◽  
Alison Footman ◽  
Caitlin E. Hansen
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
School Entry ◽  
Structured Interviews ◽  
Human Papillomavirus Vaccination ◽  
Strong Recommendation ◽  
Entry Requirements ◽  
Design And Methods ◽  
Purposive Sample

Background: A strong recommendation from a clinician is one of the best predictors of human papillomavirus (HPV) vaccination among adolescents, yet many clinicians do not provide effective recommendations. The objective of this study was to understand how the lack of school entry requirements for HPV vaccination influences clinicians’ recommendations. Design and Methods: Semi-structured interviews with a purposive sample of 32 clinicians were conducted in 2015 in Connecticut USA. Data were analysed using an iterative thematic approach in 2016-2017. Results: Many clinicians described presenting HPV vaccination as optional or non-urgent because it is not required for school entry. This was noted to be different from how other required vaccines were discussed. Even strong recommendations were often qualified by statements about the lack of requirements. Furthermore, lack of requirements was often raised initially by clinicians and not by parents. Many clinicians agreed that requirements would simplify the recommendation, but that parents may not agree with requirements. Personal opinions about school entry requirements were mixed. Conclusions: The current lack of school entry requirements for HPV vaccination is an important influence on clinicians’ recommendations that are often framed as optional or non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that remains strong and focused on disease prevention yet uncoupled from the lack of requirements that may encourage delays. Additionally, greater support for requirements among clinicians may be needed to successfully enact requirements in the future.

scholarly journals Awareness and knowledge of human papillomavirus vaccination and their influential factors among Chinese women: a systematic review

2019 ◽  
Vol 6 (4) ◽  
pp. 317-326
Author(s):  
Gui-Dan Tang ◽  
Gu-Qing Zeng ◽  
Bi-Xia Zhao ◽  
Yun-Li Li ◽  
Rong Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Chinese Women ◽  
Hpv Vaccination ◽  
Influential Factors ◽  
Perceived Behavioral Control ◽  
Human Papillomavirus Vaccination ◽  
Female Population ◽  
Multi Level

Abstract Objectives To systematically review the knowledge attitudes and the influential factors on human papillomavirus (HPV) vaccination among Chinese women. Methods Published studies on knowledge and attitudes of HPV vaccination for preventing cervical cancer among Chinese female population were retrieved using the major Chinese and English databases. Meanwhile, handwork retrieval was also conducted and the references including in the literature were retrieved. The quality of the literature was rigorously evaluated and extracted independently by two researchers and the data were analyzed and described by review manager 5.3 (RevMan5.3) software. Results In all, 19 articles including 8 articles in Chinese and 11 in English were chosen. A total of 30,176 participants were included and the sample size ranged from 64 to 6,024. The overall awareness of HPV and HPV vaccine among Chinese women was at a low level. Chinese women generally showed poor knowledge about HPV and HPV vaccine. Acceptance of HPV vaccination among Chinese women was at a high level. Vaccination intentions were influenced by the theory of planned behavior (TPB) and measured by attitudes subjective norms and perceived behavioral control. Conclusions The health authorities may evaluate and develop TPB-based interventions to increase HPV vaccination intentions of Chinese women. HPV vaccination programs should focus on carrying out multi-level and targeted health education and developing effective public health strategies after balancing the cost and benefit of HPV vaccine program. Medical staff should play the positive role in promoting the use of HPV vaccines in China. Integration of policy and community perspectives and multi-level interventions are essential to maximize the public health benefits of HPV vaccination.

scholarly journals Acceptability and feasibility of human papillomavirus vaccination for adolescents in school environments in Libreville

2020 ◽  
Vol 9 (9) ◽  
pp. 3541
Author(s):  
Nathalie L. Ambounda ◽  
Sylvain H. Woromogo ◽  
Olive M. Kenmogne ◽  
Felicite E. Yagata Moussa ◽  
Vicky N. Simo Tekem ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Precancerous Lesions ◽  
Hpv Vaccination ◽  
Immunization Coverage ◽  
Human Papillomaviruses ◽  
Professional Status ◽  
Human Papillomavirus Vaccination ◽  
Cross Sectional

Background: High-risk oncogenic human papillomaviruses (HPV) are the cause of sexually transmitted viral infection. Its persistence is a risk factor for precancerous lesions of the cervix, which will constitute the base of cervical cancer. In the world, the prevalence of high-risk oncogenic HPV is 66.7%, which is higher among women starting their sexual activity.Methods: An analytical cross-sectional study was conducted in high schools in Gabon regarding parents. The variables selected were the socio-cultural and demographic characteristics of the parents, their knowledge of human papillomavirus vaccination and their acceptability of HPV vaccination and finally the feasibility of HPV vaccination. The statistical test used was Pearson's Chi-square, and a difference was considered significant for p<0.05.Results: The majority of parents, 89%, were informed of the existence of cervical cancer. However, 73.4% of them were unaware of the existence of vaccination against cervical cancer. Only 2.4% of parents had vaccinated their daughters against cervical cancer at the time of the study. These parents only 53.4% expressed an interest in vaccinating their daughters in 53.4% of cases. The ability to vaccinate children is associated with the socio-professional status of parents (p˂0.000).Conclusions: The majority of parents approved school-based vaccination against human papillomavirus infections despite its reported cost and lack of information. The integration of anti-HPV vaccination into the expanded programme on immunization in Gabon will improve immunization coverage.

scholarly journals Human papillomavirus vaccination coverage among working women

2021 ◽  
Vol 6 (4) ◽  
pp. 714-722
Author(s):  
Sajeda Khatun ◽  
Ashees Kumar Saha ◽  
Irtiza Ahmed Chowdhury ◽  
Arifa Sultana ◽  
Mst Wazeda Begum ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Vaccination Coverage ◽  
Hpv Vaccination ◽  
Working Women ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
P Value ◽  
Human Papillomavirus Vaccination ◽  
Cross Sectional

Human papillomavirus (HPV) infection is one of the causes of cervical cancer which is preventable. The study was a cross-sectional study with the objective was to determine the Human papillomavirus (HPV) vaccination coverage among working women. A total 236 educated working women were selected purposively from different working places in Dhaka city. A pretested semi- structured questionnaire was used for data collection. The knowledge was assessed by using modified Blooms cut off points which was developed with cervical cancer and vaccine knowledge related questions. The study result revealed that among 236 working women 71.2% knew about the risk factor of cervical cancer. It was found that 92.8% knew about the way of prevention of cervical cancer respectively. The overall knowledge on cervical cancer and vaccine was found to be having good knowledge 21.2%, satisfactory knowledge 41.9% and poor knowledge 36.9%. Out of the total working women only 5.1% had HPV vaccination coverage. Reason behind non vaccinations, 50% mentioned had no knowledge about vaccine, 35.3% mentioned can’t decide and 8.9% mentioned high cost of vaccine. Significant association has been observed in between vaccination coverage with over all knowledge of cervical cancer (p value .04). It may be concluded that HPV vaccination coverage is very low which needs awareness program on this issues through mass media, educational session, counseling and so on to reduce human papillomavirus associated cancers as well as economic burden. Asian J. Med. Biol. Res. December 2020, 6(4): 714-722

Human papillomavirus vaccination: evidence base for efficacy and safety

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 125-130
Author(s):  
Yuliya E. Dobrokhotova ◽  
Ekaterina I. Borovkova
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Intraepithelial Neoplasia ◽  
Evidence Base ◽  
Hpv Infection ◽  
Efficacy And Safety ◽  
Human Papillomavirus Vaccination ◽  
Hpv Types ◽  
Further Development

The article provides a literature review on the prevention of cervical cancer by human papillomavirus (HPV) vaccination. Currently, 3 vaccines are available: the 4-valent vaccine against HPV types 6, 11, 16 and 18, the 9-valent vaccine against HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58 and the bivalent vaccine against HPV types 16 and 18. Vaccination provides protection for women and men against infection with HPV and further development of HPV-associated diseases. Following immunization, seroconversion develops in 93-100% of women and in 99-100% of men and is effective in preventing incident and persistent HPV infection as well as cervical intraepithelial neoplasia. HPV immunization is ineffective in treating an existing HPV infection, genital warts, or anogenital intraepithelial neoplasia. HPV vaccination status does not affect recommendations for cervical cancer screening.

scholarly journals Assessing the value of human papillomavirus vaccination in Gavi-eligible low-income and middle-income countries

2020 ◽  
Vol 5 (10) ◽  
pp. e003006
Author(s):  
Jessica Ochalek ◽  
Kaja Abbas ◽  
Karl Claxton ◽  
Mark Jit ◽  
James Lomas
Keyword(s):  
Human Papillomavirus ◽  
Low Income ◽  
Hpv Vaccination ◽  
Cost Effective ◽  
Health Impact ◽  
Healthcare Intervention ◽  
Human Papillomavirus Vaccination ◽  
Middle Income ◽  
Maximum Price ◽  
Healthcare Interventions

IntroductionEstimating the value of providing effective healthcare interventions in a country requires an assessment of whether the improvement in health outcomes they offer exceeds the improvement in health that would have been possible if the resources required had, instead, been made available for other healthcare activities in that country. This potential alternative use of the same resources represents the health opportunity cost of providing the intervention. Without such assessments, there is a danger that blanket recommendations made by international organisations will lead to the adoption of healthcare interventions that are not cost effective in some countries, even given existing donor mechanisms intended to support their affordability.MethodsWe assessed the net health impact to 46 Gavi-eligible countries of achieving one of the WHO’s proposed 90-70-90 targets for cervical cancer elimination, which includes 90% coverage of human papillomavirus (HPV) vaccination among girls by 15 years of age, using published estimates of the expected additional benefits and costs in each country and estimates of the marginal productivity of each healthcare system. We calculated the maximum price each country could afford to pay for HPV vaccination to be cost effective by assessing the net health impact that would be expected to be generated at different potential prices.ResultsAt Gavi negotiated prices, HPV vaccination offers net health benefits across most Gavi-eligible countries included in this study. However, if Gavi-eligible countries faced the average price faced by non-Gavi eligible countries, providing HPV vaccination would result in reduced overall population health in most countries.ConclusionEstimates of the net health impact of providing a healthcare intervention can be used to assess the benefit (or lack of) to countries of adhering to global guidance, inform negotiations with donors, as well as pricing negotiations and the value of developing new healthcare interventions.

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