scholarly journals Human papillomavirus vaccination: the population impact

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 866 ◽  
Author(s):  
Lai-yang Lee ◽  
Suzanne M. Garland

We currently have the knowledge and experience to prevent much of human papillomavirus (HPV)-related disease burden globally. In many countries where prophylactic HPV vaccination programs have been adopted as highly effective public health programs with good vaccine coverage, we are already seeing, in real-world settings, reduction of vaccine-related HPV-type infections, genital warts and cervical pre-cancers with potential reductions in vulvar, vaginal and anal pre-cancers. Moreover, we are seeing a change in cervical screening paradigms, as HPV-based screening programs now have strong evidence to support their use as more sensitive ways to detect underlying cervical abnormalities, as compared with conventional cervical cytology. This article describes the impact of prophylactic vaccination on these outcomes and in settings where these vaccines have been implemented in national immunisation programs. Given the successes seen to date and the availability of essential tools, there has been a global push to ensure that every woman has access to effective cervical screening and every girl has the opportunity for primary prevention through vaccination. A gender-neutral approach by offering vaccination to young boys has also been adopted by some countries and is worthy of consideration given that HPV-related cancers also affect males. Furthermore, vaccination of young boys has the advantage of reducing the risk of HPV transmission to sexual partners, lowering the infectious pool of HPV in the general population and ultimately HPV-related diseases for both genders. Therefore, it is appropriate that all countries consider and promote national guidelines and programs to prevent HPV-related diseases.

Sexual Health ◽  
2010 ◽  
Vol 7 (3) ◽  
pp. 352 ◽  
Author(s):  
Philippe Beutels ◽  
Mark Jit

Background: This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs. Methods: We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination. Results: We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively. Conclusions: We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.


Sexual Health ◽  
2010 ◽  
Vol 7 (3) ◽  
pp. 310 ◽  
Author(s):  
Julia M. L. Brotherton ◽  
John M. Kaldor ◽  
Suzanne M. Garland

This paper describes a possible multifaceted approach to human papillomavirus (HPV) related surveillance in Australia following implementation of a national HPV vaccination program. We describe eight main components: monitoring of vaccine coverage, vaccine safety, type-specific HPV infection surveillance, cervical cytology (Pap screening) coverage and screen detected lesion prevalence, cervical cancer incidence and mortality, genital wart incidence, incidence of recurrent respiratory papillomatosis, and knowledge, attitudes and beliefs about HPV and HPV vaccination. Australia is well placed to monitor the impact of its HPV vaccination program as well as to measure vaccine effectiveness with existing HPV vaccines, cervical screening and cancer registries.


2019 ◽  
Vol 23 (3) ◽  
pp. 343-357 ◽  
Author(s):  
Kyriakos Martakis ◽  
Denise Alexander ◽  
Tamara Schloemer ◽  
Mitch Blair ◽  
Michael Rigby ◽  
...  

Children’s rights to autonomy of choice are differently expressed throughout Europe. We explored differences regarding expressions of respect for children’s autonomy throughout Europe, using the procedure of human papillomavirus (HPV) vaccination offer as indicator. We used a mixed methods approach, utilizing an expert survey within the frame of “Models of Child Health Appraised” (MOCHA), among all 30 European Union (EU) and European Economic Area states. A questionnaire was designed using vignettes regarding the vaccine provision. Thirty MOCHA country agents were invited to respond from June 2017 to April 2018. In total, 28 country agents responded. We studied the following themes: (i) provision of informed consent, (ii) parental and medical paternalism, (iii) relevance of the child’s chronological age or maturity, and (iv) vaccination programs targeting boys. These are being handled differently across the region. We explored associations of these implemented practices with the national vaccine coverage rate across Europe. We used the processes of HPV vaccination to study child’s autonomy, the paradigm change toward libertarian paternalism and issues of sex-equity. Interestingly, greater respect for children’s autonomy tends to be associated with medium or high vaccination coverage rates and lower respect with lower rates. Respect and empowerment seem to have practical as well as moral benefits. Identifying and transferring the most suitable ethical approaches is crucial and should be strengthened.


2020 ◽  
Vol 41 (1) ◽  
pp. 89-99
Author(s):  
Chigozie Anastacia Nkwonta ◽  
DeAnne K. Hilfinger Messias ◽  
Tisha Felder ◽  
Kathryn Luchok

We explored the impact of two community-based educational interventions on Nigerian adults’ knowledge and intention to take or encourage human papillomavirus (HPV) vaccine and cervical screenings. Face-to-face presentation and printed pamphlet intervention were delivered to 266 men and women aged 18 to 65 years in 12 locations in urban setting. At baseline, the majority (80%) had poor knowledge of HPV, and less than 12% had ever received or have a family member who had received HPV vaccine or cervical screening. Postintervention, there was significant increase (>70%) in the participants knowledge and intention to take or encourage HPV vaccination and cervical screening. In addition, more than half were willing to pay for HPV vaccine and screening even when expensive. Gender-focused and context-specific low-cost community-based educational interventions are effective in increasing HPV vaccine and cervical screening in sub-Saharan Africa.


2021 ◽  
Author(s):  
Codrin Gheorge ◽  
Verginica Schröder ◽  
Ramona Stoicescu ◽  
Irina Dumitru

"The study aims to compare different screening methods that are currently being used to confirm a cervical intraepithelial lesion (CIN) underlying the inherent advantages of the varied examination procedures. In this study we are looking at the quality contrast of the different paraclinical examinations relative to the cost, invasiveness and cultural acceptance of such procedures. Every year, more than 100,000 women in EU countries are diagnosed with cervix uteri cancers (CCU). This type of cancer can be prevented if precancerous cells are detected and treated. HPV is found in over 90% of cervix uteri cancers. In Europe, more than half of the countries have implemented screening programs for cervical cancer, and most European countries now have national HPV vaccination programs, however target populations vary depending on the epidemiological evidence and the budgetary level of each countries health system. In this study we evaluated and compared the current and modern techniques used for cervix cellular diagnostics. Also, this study helps improve the understanding on the economic and social implications of screening among female population and the impact it has on healthcare system relieving. Romania recorded an incidence of 22.6 cases of cervix uteri cancers / 100.000 women (age standardized rate), and a mortality of 9.6 / 100.000, ranking second highest in the EU zone."


Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 520 ◽  
Author(s):  
Luke B. Connelly ◽  
Ha N. D. Le

Background Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost-effectiveness of introducing a bivalent HPV vaccination program in Japan from a healthcare perspective. Methods: A Markov model of the natural history of HPV infection that incorporates both vaccination and screening was developed for Japan. The modelled intervention, a bivalent HPV vaccine with a 100% lifetime vaccine efficacy and 80% vaccine coverage, given to a cohort of 12-year-old Japanese girls in conjunction with the current screening program, was compared with screening alone in terms of costs and effectiveness. A discount rate of 5% was applied to both costs and utilities where relevant. Results: Vaccination alongside screening compared with screening alone is associated with an incremental cost-effectiveness ratio (ICER) of US$20 315 per quality-adjusted-life-year gained if 80% coverage is assumed. The ICER at 5% coverage with the vaccine plus screening, compared with screening alone, is US$1158. Conclusion: The cost-effectiveness results suggest that the addition of a HPV vaccination program to Japan’s cervical cancer screening program is highly likely to prove a cost-effective way to reduce the burden of cervical cancer, precancerous lesions and HPV16/18-related diseases.


2008 ◽  
Vol 54 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Anna Söderlund-Strand ◽  
Joakim Dillner ◽  
Joyce Carlson

Abstract Background: Human papilloma virus (HPV) is the major cause of cervical cancer. Use of HPV genotyping in cervical screening programs and for monitoring the effectiveness of HPV vaccination programs requires access to economical, high-throughput technology. Methods: We used the Sequenom MassARRAY platform to develop a high-throughput mass spectrometric (MS) method for detecting 14 specific oncogenic HPV genotypes in multiplex PCR products. We compared results from 532 cervical cell samples to the comparison method, reverse dot blot hybridization (RDBH). Results: The MS method detected all samples found positive by RDBH. In addition, the MS method identified 5 cases of cervical disease (cervical intraepithelial neoplasia of grade I or higher) that RDBH analysis had missed. Discrepancies in specific genotypes were noted in 20 samples, all positive by MS, with an overall concordance of κ = 0.945. Conclusions: The MS high-throughput method, with a processing capacity of 10 × 384 samples within 2 working days and at a consumables cost of about US$2 per sample, performed as well as or better than the comparison method.


2010 ◽  
Vol 15 (47) ◽  
Author(s):  
F Dorleans ◽  
C Giambi ◽  
L Dematte ◽  
S Cotter ◽  
P Stefanoff ◽  
...  

The Venice 2 human papillomavirus vaccination survey evaluates the state of introduction of the HPV vaccination into the national immunisation schedules in the 29 participating countries. As of July 2010, 18 countries have integrated this vaccination. The vaccination policy and achievements vary among those countries regarding target age groups, delivery infrastructures and vaccination coverage reached. Financial constraints remain the major obstacle for the 11 countries who have not yet introduced the vaccination.


Author(s):  
Louise Baandrup ◽  
Christian Dehlendorff ◽  
Susanne K Kjaer

Abstract Background Increasing evidence suggests that 1-dose human papillomavirus (HPV) vaccination may protect significantly against HPV-related disease. We provide nationwide, real-world data on the risk of genital warts (GWs) after <3 vaccine doses. Methods All Danish women born in 1985–2003 were identified, and individual-level vaccination data were retrieved. The cohort was followed up for first occurrence of GWs until 31 December 2016. Using Poisson regression, we calculated incidence rates (IRs) of GWs per 100 000 person-years and IR ratios (IRRs) with corresponding 95% confidence intervals (CIs) for GWs, according to vaccination status, age at first dose, and calendar time. Results The cohort comprised 1 076 945 girls and women, of whom 485 408 were vaccinated. For girls initiating vaccination at age 12–14 years and 15–16 years, 1-dose vaccine effectiveness (VE) was 71% (IRR = 0.29; 95% CI, .22–.38) and 62% (0.38; .29–.49), respectively, compared with unvaccinated girls. In the same age groups, 2-dose VE was 78% (IRR, 0.22; 95% CI, .18–.26) and 68% (0.32; .26–.38), respectively. After 2009, the IRRs for 3 versus 1 dose and 2 versus 1 dose increased towards unity over calendar time, being 0.69 (95% CI, .57–.84) and 0.86 (.68–1.08) in 2016, respectively. Conclusions In this study, 1 or 2 doses of quadrivalent HPV vaccine was associated with substantial protection against GWs in girls vaccinated at age ≤16 years. The 1-dose VE approached that of 3 or 2 doses over calendar time, probably reflecting the impact of herd protection.


Author(s):  
Kelsey E Palmer ◽  
Krystal L Moorman ◽  
Nancy A Nickman ◽  
David G Owen

Abstract Purpose Failure modes and effects analysis (FMEA) was used to identify ways in which community clinic practices related to suboptimal human papillomavirus (HPV) vaccination rates could be improved. Method FMEA is a standardized safety method that helps determine where processes fail, the impact of failures, and needed process changes. In a quality improvement initiative conducted at an academic health center–based community clinic, a multidisciplinary team used FMEA to map HPV vaccination processes and identify areas for improvement of vaccination practices. Risk priority numbers (RPNs) were assigned to identified failure modes based on likelihood of occurrence, likelihood of detection, and ability to correct locally. Failure modes with the highest RPNs were targeted for process improvements. Results High RPN failure modes were related to clinic processes for follow-up, immunization status checks during well-child visits, and vaccination discussions during sick-child visits. New procedures included scheduling follow-up vaccinations and reminders during the initial vaccination appointment. HPV immunization rates improved following implementation of these procedures, indicating that clinic processes focused on patient follow-up can impact vaccination series completion. Conclusion FMEA processes can help health systems identify workflow barriers and locally relevant opportunities for improvement. Team-based approaches to care process improvements can also benefit from standardized problem identification and solving.


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