Response: Re: Parental Acceptance of a Mandatory Human Papillomavirus (HPV) Vaccination Program

Background Men who have sex with men are a risk group for anal human papillomavirus (HPV) and anal cancer. Australia introduced a universal school-based HPV vaccination program in 2013. Self-reported HPV vaccination status has been widely used in clinical and research settings, but its accuracy is understudied. Objective We aimed to examine the accuracy of self-reported HPV vaccination status among gay and bisexual adolescent males. Methods We included 192 gay and bisexual males aged 16-20 years from the Human Papillomavirus in Young People Epidemiological Research 2 (HYPER2) study in Melbourne, Australia. All participants had been eligible for the universal school-based HPV vaccination program implemented in 2013 and were asked to self-report their HPV vaccination status. Written informed consent was obtained to verify their HPV vaccination status using records at the National HPV Vaccination Program Register and the Australian Immunisation Register. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of self-reported HPV vaccination status. Results The median age of the 192 males was 19 (IQR 18-20) years. There were 128 males (67%) who had HPV vaccination records documented on either registry. Self-reported HPV vaccination had a sensitivity of 47.7% (95% CI 38.8%-56.7%; 61/128), a specificity of 85.9% (95% CI 75.0%-93.4%; 55/64), a positive predictive value of 87.1% (95% CI 77.0%-93.9%; 61/70), and a negative predictive value of 45.1% (95% CI 36.1%-54.3%; 55/122). Conclusions Self-reported HPV vaccination status among Australian gay and bisexual adolescent males underestimates actual vaccination and may be inaccurate for clinical and research purposes.

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Cost-effectiveness of a bivalent human papillomavirus vaccination program in Japan

Sexual Health ◽

10.1071/sh14241 ◽

2015 ◽

Vol 12 (6) ◽

pp. 520 ◽

Cited By ~ 5

Author(s):

Luke B. Connelly ◽

Ha N. D. Le

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Screening Program ◽

Vaccine Coverage ◽

Precancerous Lesions ◽

Hpv Vaccination ◽

Vaccination Program ◽

Human Papillomavirus Vaccination ◽

The Cost

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.

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Accuracy of Self-reported Human Papillomavirus Vaccination Status Among Gay and Bisexual Adolescent Males: Cross-sectional Study (Preprint)

10.2196/preprints.32407 ◽

2021 ◽

Author(s):

Eric PF Chow ◽

Christopher K Fairley ◽

Rebecca Wigan ◽

Jane S Hocking ◽

Suzanne M Garland ◽

...

Keyword(s):

Human Papillomavirus ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Hpv Vaccination ◽

Vaccination Status ◽

Adolescent Males ◽

Vaccination Program ◽

School Based ◽

And Bisexual

BACKGROUND Men who have sex with men are a risk group for anal human papillomavirus (HPV) and anal cancer. Australia introduced a universal school-based HPV vaccination program in 2013. Self-reported HPV vaccination status has been widely used in clinical and research settings, but its accuracy is understudied. OBJECTIVE We aimed to examine the accuracy of self-reported HPV vaccination status among gay and bisexual adolescent males. METHODS We included 192 gay and bisexual males aged 16-20 years from the Human Papillomavirus in Young People Epidemiological Research 2 (HYPER2) study in Melbourne, Australia. All participants had been eligible for the universal school-based HPV vaccination program implemented in 2013 and were asked to self-report their HPV vaccination status. Written informed consent was obtained to verify their HPV vaccination status using records at the National HPV Vaccination Program Register and the Australian Immunisation Register. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of self-reported HPV vaccination status. RESULTS The median age of the 192 males was 19 (IQR 18-20) years. There were 128 males (67%) who had HPV vaccination records documented on either registry. Self-reported HPV vaccination had a sensitivity of 47.7% (95% CI 38.8%-56.7%; 61/128), a specificity of 85.9% (95% CI 75.0%-93.4%; 55/64), a positive predictive value of 87.1% (95% CI 77.0%-93.9%; 61/70), and a negative predictive value of 45.1% (95% CI 36.1%-54.3%; 55/122). CONCLUSIONS Self-reported HPV vaccination status among Australian gay and bisexual adolescent males underestimates actual vaccination and may be inaccurate for clinical and research purposes.

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Association between sexual mixing and genital warts in heterosexual men in Australia: the herd protection from the female human papillomavirus vaccination program

Sexual Health ◽

10.1071/sh16053 ◽

2016 ◽

Vol 13 (5) ◽

pp. 489 ◽

Cited By ~ 4

Author(s):

Eric P. F. Chow ◽

Christopher K. Fairley

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccination ◽

Health Centre ◽

Genital Warts ◽

Vaccination Program ◽

Heterosexual Men ◽

Heterosexual Couples ◽

Human Papillomavirus Vaccination ◽

Female Partners ◽

Herd Protection

Australian-born women aged ≤32 years were eligible for the free female human papillomavirus (HPV) vaccination program introduced in 2007. A total of 1165 heterosexual couples attending the Melbourne Sexual Health Centre between 2011 and 2014 were included in this analysis. Findings showed the odds of having penile warts was 0.52-fold lower among men who had a female partner aged ≤32 years compared with men who had a female partners aged >32 years. This suggests men would have received herd protection from their female partners and hence they are at lower risk of acquiring genital warts.

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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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Measuring human papillomavirus (HPV) vaccination coverage and the role of the National HPV Vaccination Program Register, Australia

Sexual Health ◽

10.1071/sh10001 ◽

2011 ◽

Vol 8 (2) ◽

pp. 171 ◽

Cited By ~ 68

Author(s):

Dorota M. Gertig ◽

Julia M. L. Brotherton ◽

Marion Saville

Keyword(s):

Human Papillomavirus ◽

Vaccination Coverage ◽

Hpv Vaccination ◽

Vaccine Delivery ◽

Pap Test ◽

Vaccine Effectiveness ◽

Vaccination Program ◽

Cross Linking ◽

Female Population

Accurate estimates of HPV vaccination coverage are critical for determining the proportion of the target female population that is not protected by the vaccine, as well as for monitoring the performance of vaccine delivery programs. The implementation of an HPV vaccination register, either as part of an existing immunisation register or stand-alone, can add substantial benefits to an HPV vaccination program. In Australia, the National HPV Vaccination Program Register supports the HPV vaccination program by providing information to consumers and providers about incomplete courses as well as estimates of vaccination coverage by age and area. Future monitoring of vaccine effectiveness will be facilitated by cross-linking to Pap test registries.

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Human papillomavirus transmission and cost-effectiveness of introducing quadrivalent HPV vaccination in Denmark

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462310000085 ◽

2010 ◽

Vol 26 (2) ◽

pp. 183-191 ◽

Cited By ~ 49

Author(s):

Jens Olsen ◽

Martin Rudbeck Jepsen

Keyword(s):

Human Papillomavirus ◽

Cost Effectiveness ◽

Discount Rate ◽

Hpv Vaccination ◽

Intraepithelial Neoplasia ◽

Hpv Infection ◽

Vaccination Rate ◽

Vaccination Program ◽

Transmission Model ◽

Percent Discount

Objectives: The objective of this study was to simulate human papillomavirus (HPV) infection in a heterosexual population and subsequently analyze the incremental costs and effects of introducing a vaccination program against HPV types 6, 11, 16, and 18 in Denmark compared with screening alone.Methods: The analysis was performed in two phases. First, an agent-based transmission model was developed that described the HPV transmission without and with HPV vaccination. Second, an analysis of the incremental costs and effects was performed. The results of prevalence estimates of HPV, genital warts, cervical intraepithelial neoplasia (CIN1–3), and cervical cancer in the model simulations before and after introduction of HPV vaccination were extrapolated to the Danish population figures. Incremental costs and effects were then estimated. Future costs and effects were discounted.Results: Cost-effectiveness ratios for annual vaccination of 12-year-old girls, with a vaccination rate of 70 percent without a catch-up program, were estimated at approximately €1,917 per quality-adjusted life-year (QALY, 3 percent discount rate) and €10,846/QALY (5 percent discount rate), given a 62-year time horizon.Conclusions: A vaccination program would incur extra vaccination costs but would save treatment costs and improve both quality of life and survival.

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