Impact of Louisiana’s HPV Vaccine Awareness Policy on HPV Vaccination Among 13- to 17-Year-Old Females

2017 ◽  
Vol 44 (4) ◽  
pp. 548-558 ◽  
Author(s):  
Dudith Pierre-Victor ◽  
Mary Jo Trepka ◽  
Timothy F. Page ◽  
Tan Li ◽  
Dionne P. Stephens ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Female Adolescents ◽  
Physician Recommendation ◽  
Vaccination Rates ◽  
National Immunization ◽  
Before And After ◽  
The Difference ◽  
Vaccine Information ◽  
The Impact

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana’s policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.

Long-Term Implications of the Infomedic during the COVID-19 Pandemic to US Adolescents’ HPV Vaccination Rates: Maternal Engagement with Pro- and Anti-vaccine Social Media Posts and Overarching Vaccine Hesitancy (Preprint)

2020 ◽  
Author(s):  
Young Argyris ◽  
Yongsuk Kim ◽  
Won Song
Keyword(s):  
Hpv Vaccine ◽  
Negative Impact ◽  
Hpv Vaccination ◽  
Population Based ◽  
Vaccine Hesitancy ◽  
Healthcare Facilities ◽  
Vaccination Rates ◽  
Novel Coronavirus ◽  
The Impact

BACKGROUND The propagation of vaccine misinformation during the COVID-19 pandemic suggests that the pandemic may pose long-term harm on public health via depressed immunization rates. Between February 2020 and April 2020, the uptake rates of the HPV vaccine have decreased by 73%. Missing the critical age for HPV vaccination (i.e., 11-12 years old) will make adolescents susceptible to HPV-associated cancers in the next 20-30 years. Despite the importance, very few pro-vaccine interventions conducted on SM have succeeded in increasing HPV vaccination rates. OBJECTIVE Our overall objective is to identify the reasons why anti-vaccine messages effectively lower HPV vaccination rates while pro-vaccine messages do not increase such rates. In so doing, we suggest that overarching vaccine hesitancy is a reason for the discrepant outcomes of anti- vs. pro-vaccine SM posts. Our objective is pursued in two specific aims: we compare anti- and pro-vaccine posts in terms of (i) their roles in fostering overarching vaccine hesitancy among mothers (the main HPV vaccine decision-makers), and (ii) accompanying HPV vaccination rates among their adolescent children. METHODS In late December of 2019-mid January of 2020, we conducted a population-based survey among 426 mothers of US adolescents aged 13–18. The outbreak of the novel coronavirus in China occurred in December 2019, and awareness regarding the virus was increasing in the US during this time. Therefore, our data collected during this time allow us to infer the impact of increasing overarching vaccine hesitancy on HPV vaccination rates, while excluding the effects of access restrictions to healthcare facilities imposed since March of 2020. We developed a rigorous scale for engagement with anti- and pro-vaccine SM posts, measured adolescents’ HPV vaccination rates along the series initiation to completion, and conducted path analyses to assess the associations among them. RESULTS Our survey results show that mothers’ engagement with anti-vaccine content is negatively associated with their children’s HPV vaccine vaccination rates via their increased overarching vaccine hesitancy. In contrast, maternal engagement with pro-vaccine SM content is not associated with either overarching vaccine hesitancy or HPV vaccine vaccination rates. These results remained significant after controlling for socioeconomic, demographic, and accessibility factors, suggesting that mothers’ engagement with anti-vaccine messages on SM explains above and beyond what other known factors explain. CONCLUSIONS Our results suggest that increasing overarching vaccine hesitancy, heightened by the infodemic, can substantially reduce HPV vaccination rates, even after accessibility factors are controlled. Our results imply that the negative impact of the COVID-19 pandemic can be extended for many years to come through depressed HPV vaccination rates. As a result, there is an urgent need to develop interventions to increase HPV vaccination rates and to address vaccine hesitancy among mothers who feel emotionally challenged during the pandemic. CLINICALTRIAL N/A

scholarly journals 38. Strategies to Improve HPV Vaccination Rates Among Eligible Undergraduates and Graduate Students at Johns Hopkins University

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S43-S43
Author(s):  
John P Gentile ◽  
Roanna Kessler ◽  
Paul Auwaerter ◽  
Paul Auwaerter
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Control Period ◽  
College Campuses ◽  
Male Students ◽  
Vaccination Rates ◽  
Johns Hopkins University ◽  
Marketing Materials ◽  
The Difference ◽  
Research Grant

Abstract Background Completed Poster Presentation Methods Results Study period (8/15/2018 – 5/31/2019) was compared to prior year as a historical control (8/15/2017 – 5/31/2018). During the study, 888 HPV vaccines were administered vs. 504 in the control period (76.1 % increase). The difference between # of vaccines given during these 2 years was statistically significant at p< 0.01. The increase was particularly notable among male students: 383 vaccinations vs. 120 (219.2% increase). About half of the students who completed the EMR form saw the marketing materials on campus: 1,579 out of 3,228 responses. Of the marketing materials, the greatest number of students noticed the yard signs (596). The most frequently cited reason that providers did not give the HPV vaccine during their visit was that the patient already completed the HPV vaccine series (1,603). Conclusion A well-coordinated campaign with extensive awareness efforts and focused clinical interventions can dramatically impact the number of HPV vaccinations on college campuses. Disclosures Paul Auwaerter, Collidion (Consultant)DiaSorin (Consultant)Johnson and Johnson (Shareholder)MicroB-Plex (Research Grant or Support)Shionogi (Consultant)

Lowering the Age of Consent: Pushing Back against the Anti-Vaccine Movement

2016 ◽  
Vol 44 (3) ◽  
pp. 462-473 ◽  
Author(s):  
Allison M. Whelan
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
State Legislatures ◽  
Ripple Effect ◽  
Ongoing Debate ◽  
Vaccination Rates ◽  
Age Of Consent ◽  
Immunization Rates ◽  
The Impact ◽  
Robust Evidence

This article examines the rise of the anti-vaccination movement, the proliferation of laws allowing parental exemptions to mandatory school vaccines, and the impact of the movement on immunization rates for all vaccines. It uses the ongoing debate about the Human Papillomavirus (HPV) vaccine as an example to highlight the ripple effect and consequences of the anti-vaccine movement despite robust evidence of the vaccine's safety and efficacy. The article scrutinizes how state legislatures ironically promote vaccination while simultaneously deferring to the opposition by promulgating broad opt-outs from mandatory vaccine laws. This article concludes by offering an alternative legislative approach to specifically combat the anti-vaccine movement's impact on HPV vaccination rates. Lowering the age of consent has not been widely attempted or proposed and provides an alternative statutory mechanism to push back against vaccine resistance.

scholarly journals 1. The Impact of Behavioral Nudges, Communication Training and Assessment and Feedback on Adolescent Vaccination Rates and Parent Satisfaction

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S23-S23
Author(s):  
Andrea Bradley-Ewing ◽  
Kathy Goggin ◽  
Georgann Meredith ◽  
Brian R Lee ◽  
Susan Li ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Vaccine Safety ◽  
Communication Training ◽  
Antibiotic Prescribing ◽  
Effective Prevention ◽  
Vaccination Rates ◽  
Significant Difference ◽  
Adolescent Vaccination ◽  
The Impact

Abstract Background Effective prevention of HPV is possible, but < 50% of adolescents in the Midwest complete the recommended vaccine series. Strategies to increase HPV vaccination rates have demonstrated efficacy, however widespread implementation of these interventions has not been realized. Behavioral nudges have demonstrated efficacy in increasing uptake of desired heath behaviors among providers (e.g. hand hygiene, judicious antibiotic prescribing). This trial assessed the impact of an assessment and feedback, communication training, and behavioral nudge (i.e. poster-sized vaccine commitment statements) intervention (T3) on adolescent vaccination rates and parental satisfaction at four Midwestern pediatric practices. Methods Practices were randomly assigned to receive either 1) assessment and feedback or 2) T3 intervention. Providers (n=16) completed surveys regarding vaccine polices and parents of vaccine eligible adolescents (n=230) reported their child’s vaccine history and satisfaction with the consultation. Practice- level vaccination rates for Tdap, Meningococcal, and HPV were calculated through billing data queries from an integrated pediatric health network. Vaccination rates and provider/ parental responses were compared by intervention arm. Results All practices evidenced increased adolescent vaccine rates, ranging from 0.8% to 3.4% for Meningococcal and 1.3% to 12.1% for Tdap. Three of the four practices had increased HPV vaccination rates (1% to 10%), however there was no statistically significant difference by study arm. Most parents (M age 41.34; SD 8.05; 85% female, 68% White) indicated their child had previously initiated the HPV vaccine series (61%) and 72% indicated receipt of an HPV vaccine during the study visit. Concerns among HPV vaccine hesitant parents (n=60) included concerns about vaccine safety and necessity. Most (97%) of parents were satisfied with their consultation. Conclusion Practices in both intervention groups evidenced an increase in adolescent vaccination rates. While some parents had concerns about HPV vaccine safety and necessity, parents welcomed discussions about HPV vaccine and were satisfied with their provider’s communication regardless of their vaccine decisions. Disclosures Brian R. Lee, MPH, PhD, Merck (Grant/Research Support)

Teaching It Forward: Educating Parents About HPV/HPV Vaccine

2019 ◽  
Vol 12 (1) ◽  
pp. 46-58
Author(s):  
Jeanne Potts ◽  
Erik Southard
Keyword(s):  
Primary Care ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Primary Care Providers ◽  
Educational Video ◽  
Care Providers ◽  
Vaccination Rates ◽  
Before And After ◽  
Primary Care Office ◽  
Intent To Vaccinate

BackgroundHuman papillomavirus (HPV) vaccines are available to prevent HPV-associated cancers. However, parents are reluctant to make the decision to immunize their children. Nationally, HPV vaccination rates remain low.ObjectiveThe objectives were to improve parents' attitudes and knowledge about HPV/HPV vaccine, increase parental intent to vaccinate, and increase HPV vaccination rates in a primary care office.MethodsA one-group, pretest/posttest design was used to assess participants' attitude, knowledge, and intent to vaccinate before and after viewing an HPV educational video. Pre–post project HPV vaccination rates were compared.ResultsParticipants' attitudes toward HPV/HPV vaccine improved while knowledge increased. Intent to vaccine increased by 31% after viewing the HPV educational video. HPV vaccination rates increased 6% (females) and 9% (males).ConclusionsPrimary care providers (PCPs) should look for innovative ways to educate parents about HPV, help parents make informed decisions about the HPV vaccine, and work toward a common goal of preventing HPV-associated cancers.Implications for NursingImplications are three-fold benefiting parents, PCPs, and society. Parents will be more knowledgeable, providers will understand they are an important key in the vaccine process, and society will benefit from a decrease in HPV-associated cancers.

scholarly journals School-based HPV Vaccination: The Challenges in a Brazilian Initiative

2021 ◽  
Vol 43 (12) ◽  
pp. 926-931
Author(s):  
Julio Cesar Teixeira ◽  
Mariana Silva Castro Vianna ◽  
Diama Bhadra Vale ◽  
Daniella Moretti Arbore ◽  
Thais Helena Wilmers Perini ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Target Population ◽  
School Based ◽  
National Immunization ◽  
Competing Demands ◽  
Municipal Law ◽  
Competing Events ◽  
A Prospective Study ◽  
The Impact

Abstract Objective The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city. Methods A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results. Results The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested. Conclusion School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.

Implementation of Routine HPV Vaccination in the Management of Recurrent Respiratory Papillomatosis

2018 ◽  
Vol 128 (4) ◽  
pp. 309-315 ◽  
Author(s):  
Yin Yiu ◽  
Shannon Fayson ◽  
Holly Smith ◽  
Laura Matrka
Keyword(s):  
Hpv Vaccine ◽  
Odds Ratio ◽  
Financial Support ◽  
Disease Burden ◽  
Hpv Vaccination ◽  
Vaccination Rate ◽  
Recurrent Respiratory Papillomatosis ◽  
Post Vaccination ◽  
Vaccination Rates ◽  
Before And After

Objectives: To investigate vaccine compliance and clinical outcomes after implementation of an initiative to provide the human papillomavirus (HPV) vaccine to all patients with recurrent respiratory papillomatosis (RRP). Methods: A retrospective review was performed of all adult patients treated for RRP from 2012 to 2017. Rates of HPV vaccination were evaluated before and after December 2015, when a program was established to increase compliance by educating patients and providing financial assistance toward vaccine administration. Paired sample analyses were conducted to compare intersurgical intervals (ISIs) and number of procedures per year pre- and post-vaccination. Results: Fourteen patients with RRP completed the HPV vaccine series, with 11 patients undergoing vaccination after the initiative began. The pre-initiative vaccination rate of all patients with RRP was 9.7%; post-initiative rates improved to 43.8% ( P = .004; odds ratio, 7.26). Of vaccinated patients, there were significant differences between mean pre-vaccine ISI (3.5 months) and post-vaccine ISI (12.8 months; P = .0021), as well as between number of surgical procedures performed per year before and after vaccination (2.7 vs 0.81; P = .014). After vaccination, 5 patients demonstrated no evidence of papilloma regrowth for >12 months. Conclusions: Initiatives focused on patient education and financial support can successfully boost HPV vaccination rates in an RRP patient cohort. Our research mirrors prior findings that HPV vaccination is correlated with an increase in time between procedures and a decrease in number of procedures needed per year—factors that can dramatically reduce the disease burden on patients coping with RRP.

scholarly journals 216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
Christina Maguire ◽  
Dusten T Rose ◽  
Theresa Jaso
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Source Control ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Before And After ◽  
The Difference ◽  
Tract Infections ◽  
Length Of Therapy ◽  
The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

The Intersection of Problems, Policy, and Politics: The Adoption of an HPV Vaccine School-Entry Requirement in Puerto Rico

2021 ◽  
Vol 31 (5) ◽  
pp. 859-870
Author(s):  
Coralia Vázquez-Otero ◽  
Ellen M. Daley ◽  
Cheryl A. Vamos ◽  
Nancy Romero-Daza ◽  
Jason Beckstead ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Nonprofit Organizations ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
School Entry ◽  
Advisory Panel ◽  
Policy Entrepreneurs ◽  
Vaccination Rates ◽  
Policy Initiatives ◽  
Policy Window

Persistent human papillomavirus (HPV) infections can cause cancer (e.g., cervical/vaginal/penile/anal/oropharyngeal). The HPV vaccine prevents cancer, yet U.S. vaccination rates remain low. We explored sociopolitical factors in the adoption of Puerto Rico’s HPV vaccine school-entry requirement. Multiple streams framework explains how the intersection of problems, policy, and politics streams influence policy adoption. Policy entrepreneurs work on joining these streams. Interviews ( n = 20) were conducted with stakeholders (e.g., physicians/researchers/nonprofit organizations’ leaders). Data were analyzed using applied thematic analysis. High incidence of HPV and HPV-related cancers in Puerto Rico were indicators of problems. Focusing events included Rhaiza’s case and the HPV-Advisory Panel Report. During summer 2017, a policy window opened; the Department of Health (DOH) adopted the requirement in summer 2018. Stakeholders discussed policy initiatives. Political turnover positively influenced the process. Policy entrepreneurs created an extended period of intersection resulting in the adoption of the requirement. Findings can inform policy initiatives to improve HPV vaccination rates and reduce HPV-related cancers.

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