scholarly journals Automated Immunization Surveillance: Using Business Intelligence to Improve Up-to-Date Rates

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Judy Shlay ◽  
Emily McCormick Kraus ◽  
Nicole Steffens ◽  
Noam H. Atzt ◽  
Arthur Davidson
Keyword(s):  
Public Health ◽  
Business Intelligence ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Completion Rates ◽  
Hpv Vaccines ◽  
Intelligence System ◽  
Health Measures ◽  
Adults And Children ◽  
Trends Over Time

ObjectiveTo describe a business intelligence system designed to reprocess and utilize an immunization information system’s (IIS) data to visualize, and track population trends in immunization coverage in an urban population.IntroductionIIS have effectively increased vaccination rates through targeted engagement and outreach, often with clinicians and patients. Little has been published around IIS use for generating meaningful population health measures. To leverage IIS data for sub-county population health measures, new tools are required to make IIS data easily accessed for this distinct use case.Human papillomavirus (HPV), the most common sexually transmitted infection in the United States, has a highly effective (97%) vaccine to prevent infection when administered to individuals 9-26 years old. According to the National Immunization Survey, only 47% of Colorado females 13-17 years had completed the HPV vaccine series in 2011. In 2012, Denver metropolitan health departments were awarded a three year grant to support the Alliance for HPV Free Colorado, where media and clinic coaching were used to improve HPV vaccination coverage among adolescents (11-17 years) in Adams, Arapahoe, Denver, Douglas, and Jefferson counties. Recent HPV vaccination schedule changes from three to two required doses highlighted further challenges in monitoring vaccination UTD rates.MethodsWe describe a Denver metropolitan area HPV case study where IIS data were used to inform and evaluate the impact of Alliance for HPV Free Colorado activities. IIS data were processed through the Immunization Calculation Engine (ICE)TM, a state-of-the-art open-source web application that provides immunization evaluation and forecasting, typically for patients and providers at the point of care. With the IIS data, the goal of ICE processing was to identify communities of low adolescent HPV coverage (11-17 years) for targeted media placement and track HPV trends over time at the clinic and population level. The Immunization Business Intelligence System (IBIS), processed IIS data from the Colorado Department of Public Health and Environment; using ICE, the validity of each vaccine was evaluated. Each HPV vaccine was evaluated for validity and an assessment made for each individual regarding HPV series initiation and completion (i.e., percent of individuals receiving 1, 2 or 3 valid HPV doses) depending on interval between vaccine and age at first dose. IBIS components and functionality were developed through collaborative design with a goal of developing lessons relevant for future surveillance efforts. Tableau dashboards were constructed to calculate rates of HPV initiation and completion for each participating county and healthcare practice.IBIS contained data on 33 million vaccines administered to 2.5 million adults and children residing in metro counties. In 2017, IBIS received approximately 2 million vaccines administered to 959,000 adults and children, representing roughly 35% of the 2.7 million metro residents estimated by the American Community Survey (2016). Specific to HPV vaccines, IBIS received over 900,000 HPV vaccines administered to roughly 400,000 individuals by over 1100 clinics; 2017 data included 91,951 HPV vaccines administered to 81,795 patients.Between 2015 and 2017, 186,489 HPV vaccines were administered to 116,901 adolescents 11 to 17 years residing in the Denver metro area. Using ICE, 85% of HPV vaccines were valid, 10% were accepted as extra doses not needed to complete the HPV series, 4% were invalid because the dose was given too soon after the previous dose, and less than 1% as invalid because the dose was administered too early (under nine years).As of 12/31/2017, 65,447 or 56% of adolescents 11 to 17 years had completed the HPV vaccine series, among those receiving any HPV vaccines. County specific completion rates varied from 53% to 60%, among adolescents receiving any HPV vaccines. Completion increased with age from 7% at 11 years, 34% at 12 years, 70% at 14 years, 76% at 15 years and then declined to 68% at 17 years of age. Among adolescents receiving any vaccines in the past decade, HPV completion rates were lower but increased with age from 2% at 11 years to 39% at 14 years and down to 22% at 17 years.Tableau reports displayed monthly age and county specific HPV completion rates, tracking trends over time. As ICE implemented modifications aligned with 2016 HPV schedule changes (from 3 doses to 2), IBIS was updated and trend data were reprocessed to accurately reflect current ACIP rules. IBIS was indexed to optimize direct query using Tableau for stratified dashboard reporting by demographic and/or geographic populations.IIS-based vaccination surveillance and reporting provided important guidance for public health program direction. IBIS repurposed a knowledge management system for a population-focused HPV surveillance use case applies across the metro area of Colorado. IBIS was built on a scalable platform, allowing for expansion of data capture and reporting across broader geographies and demographic groups, as well as different vaccines, vaccine groups and vaccine schedules. Collaboration across public health entities was important to construct appropriate infrastructure to build and maintain IBIS for broader public health use. Future development of IBIS includes expanding reporting to 10 additional Colorado counties and vaccines in 2018.How the Moderator Intends to Engage the Audience in Discussions on the TopicThe moderator will engage audience members in a discussion about the lessons learned from developing the IBIS tool at an LPHA including challenges to understand and interpret up to date rates and opportunities for translation in other jurisdictions. 

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.

Human papillomavirus (HPV) vaccination: from clinical studies to immunization programs

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Based ◽  
Immunization Programs ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Middle Income Countries

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.

scholarly journals Human Papillomavirus (HPV) Vaccine Knowledge, Awareness and Acceptance among Dental Students and Post-Graduate Dental Residents

2020 ◽  
Vol 8 (2) ◽  
pp. 45
Author(s):  
Steven Kent Mann ◽  
Karl Kingsley
Keyword(s):  
Public Health ◽  
Human Papillomavirus ◽  
Side Effects ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Dental Students ◽  
Dental Student ◽  
Specific Information ◽  
Post Graduate ◽  
Professional Acceptance

Introduction: The recent development of a vaccine that is highly effective against the human papillomavirus (HPV) has been met with widespread clinical and public health professional acceptance. However, social and societal barriers to vaccination may hamper public health efforts to prevent HPV-mediated diseases. Although a few studies have evaluated knowledge or awareness of HPV vaccination among dentists or dental educators, few studies have evaluated the acceptance, knowledge and awareness of HPV vaccination among dental students and post-graduate dental residents. The primary goal of this study is to evaluate survey responses regarding acceptance, knowledge and awareness of HPV vaccination among dental students and post-graduate dental residents. Methods: This study was a retrospective analysis of a previously administered and collected questionnaire. The original protocol was reviewed by the UNLV Biomedical Institutional Research Board (IRB) and was deemed excluded from IRB review (OPRS#0811-2911). Results: Two hundred and ninety-three (N = 293) dental student and forty-one (N = 41) post-graduate dental resident questionnaires were available for a total sample size of N = 334. In brief, although the majority of dental students and residents agreed that vaccines are safe and effective, less than half of dental students (37.5%) or dental residents (48.7%) had discussed the HPV vaccine with a physician or had received the vaccine themselves. In addition, a significant percentage of dental students and residents felt they did not have enough information regarding the HPV vaccine (25.6% and 26.8%, respectively) or had significant concerns about the side effects (17.1%). Conclusions: The data suggest more specific information in dental school microbiology and immunology courses might be needed to increase awareness and knowledge of the safety and effectiveness of vaccines, including the HPV vaccine. This enhanced education might also serve as a curricular focal point to answer questions regarding vaccine-related side effects and provide a mechanism for answering important questions regarding this vaccine.

Recent Developments in Health Law

2009 ◽  
Vol 37 (1) ◽  
pp. 149-159 ◽  
Author(s):  
Ching Ping Ang ◽  
Joseph Wolpin ◽  
Elisha Baron
Keyword(s):  
Public Health ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
The United States ◽  
Green Card ◽  
The Supreme Court ◽  
Recent Developments ◽  
Public Health Officials ◽  
Mandatory Vaccination ◽  
Permanent Residents

As of July 1, 2008, females aged 11-26 years seeking status as permanent residents in the United States must produce documentation that they have received the human papillomavirus (HPV) vaccine before the U.S. Citizenship and Immigration Services will approve their status adjustment. Immigration rights activists and public health officials have objected to this new requirement on the grounds that it is unnecessary and imposes unreasonable barriers to lawful immigration due to its expense. The Supreme Court has generally upheld mandatory vaccination requirements for citizens and non-citizens and has tolerated federal immigration regulations that would be unconstitutional if applied to citizens. However, the HPV vaccination requirement may be arbitrary, unnecessary, and discriminatory as applied to green card applicants who pose no greater threat to public health than citizens who are not subject to the same requirements. Furthermore, the requirement may also impose unreasonable restraints on aliens individual liberties as well as real barriers to immigration.

scholarly journals Human Papillomavirus Vaccination and Social Media: Results in a Trial With Mothers of Daughters Aged 14–17

2021 ◽  
Vol 3 ◽  
Author(s):  
David B. Buller ◽  
Sherry Pagoto ◽  
Kimberly Henry ◽  
Julia Berteletti ◽  
Barbara J. Walkosz ◽  
...  
Keyword(s):  
Social Media ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Vaccine Uptake ◽  
Drug Misuse ◽  
Relative Advantage ◽  
Control Group ◽  
Hpv Vaccines ◽  
Self Reports

Introduction: Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken with the aims of (a) determining whether the pre–post-change occurred in self-reports of the mothers on HPV vaccination of their adolescent daughters; (b) describing the comments and reactions to vaccine posts; (c) exploring the relationship of campaign engagement of the mothers assessed by their comments and reactions to posts to change in the self-reports of the mothers of HPV vaccination.Materials and Methods: Mothers of daughters aged 14–17 were recruited from 34 states of the US (n = 869). A social media campaign was delivered in two Facebook private groups that differed in that 16% of posts in one were focused on indoor tanning (IT) and 16% in the other, on prescription drug misuse, assigned by randomization. In both groups, posts promoted HPV vaccination (n = 38 posts; no randomization) and vaccination for other disease (e.g., influenza, n = 49). HPV and other vaccination posts covered the need for a vaccine, the number of adolescents vaccinated, how vaccines are decreasing the infection rates, and stories of positive benefits of being vaccinated or harms from not vaccinating. Guided by social cognitive theory and diffusion of innovations theory, posts were intended to increase knowledge, perceived risk, response efficacy (i.e., a relative advantage over not vaccinated daughters), and norms for vaccination. Some vaccination posts linked to stories to capitalize on identification effects in narratives, as explained in transportation theory. All mothers received the posts on vaccination (i.e., there was no randomization). Mothers completed surveys at baseline and 12- and 18-month follow-up to assess HPV vaccine uptake by self-report measures. Reactions (such as sad, angry) and comments to each HPV-related post were counted and coded.Results: Initiation of HPV vaccination (1 dose) was reported by 63.4% of mothers at baseline, 71.3% at 12-month posttest (pre/post p &lt; 0.001), and 73.3% at 18-month posttest (pre/post p &lt; 0.001). Completion of HPV vaccination (two or three doses) was conveyed by 50.2% of mothers at baseline, 62.5% at 12-month posttest (pre/post p &lt; 0.001), and 65.9% at 18-month posttest (pre/post p &lt; 0.001). For posts on HPV vaccines, 8.1% of mothers reacted (n = 162 total), and 68.4% of posts received a reaction (63.2% like; 13.2% love, 7.9% sad). In addition, 7.6% of mothers commented (n = 122; 51 unfavorable, 68 favorable, 1 neutral), and 50.0% of these posts received a comment. There were no differences in pre–post change in vaccine status by the count of reactions or comments to HPV vaccine posts (Ps &gt; 0.05). Baseline vaccination was associated with the valence of comments to HPV vaccine posts (7.2% of mothers whose daughters had completed the HPV series at baseline made a favorable comment but 7.6% of mothers whose daughters were unvaccinated made an unfavorable comment).Conclusion: Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them. Mothers whose daughters complete the HPV vaccine course might be recruited as influencers on HPV vaccines, as they may be predisposed to talk favorably about the vaccine. Comments from mothers who have not been vaccinated should be monitored to ensure that they do not spread vaccine-critical misinformation. Study limitations included lack of randomization and control group, relatively small number of messages on HPV vaccines, long measurement intervals, inability to measure views of vaccination posts, reduced generalizability related to ethnicity and social media use, and use of self-reported vaccine status.Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT02835807.

scholarly journals Human Papilloma Virus Transmission: Knowledge and Uptake of HPV Vaccine among In-school Adolescent Girls in South-South Nigeria

2020 ◽  
pp. 25-37
Author(s):  
I. N. Ojule ◽  
I. E. Anika
Keyword(s):  
Adolescent Girls ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Virus Transmission ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Hpv Vaccines ◽  
Cross Sectional ◽  
Multi Stage ◽  
Rivers State

Background: HPV infection is the most common STI in sexually active adolescents. It has been implicated in majority of cases of cervical cancers. HPV is preventable. Potent Vaccines are available. Objective: This study assessed what adolescents know about HPV infection and HPV vaccination, their attitude and uptake of HPV vaccine. This was also to raise awareness and obtain data that will be useful in identifying where to intervene to improve coverage. Materials and Methods: A descriptive cross-sectional study carried out in Rivers State, Nigeria. Study tool was a semi-structured, self-administered questionnaire. Multi-stage sampling method was used to recruit adolescent girls from secondary schools. Results: 445 in-school adolescent girls aged 9 to 19 years participated. Mean age was 13.4 SD = ±2.2 years. 36.6% and 36.8% had heard of HPV infection and HPV vaccine respectively. Only 3.1% of the participants knew HPV could be prevented through vaccination. 71.7% indicated willingness to obtain the vaccine. Only 3.6% self reported to have received at least one dose of the vaccine at the time of the survey. Uptake of HPV vaccine (P=0.00), willingness to be vaccinated (P=0.005) highest among adolescents that had heard of HPV vaccine and those who perceived themselves to be at risk for HPV infection (P=0.005). Insufficient health information, cost of HPV vaccines identified as key barriers to vaccines utilization. Conclusion: Notwithstanding the low level of knowledge about HPV infection and HPV vaccines willingness to be vaccinated was high. Our study shows that uptake of vaccination is low in our locality.

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

Sexual Health ◽  
2016 ◽  
Vol 13 (6) ◽  
pp. 536 ◽  
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.

scholarly journals Social and cultural construction processes involved in HPV vaccine hesitancy among Chinese women: a qualitative study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Judy Yuen-man Siu ◽  
Timothy K. F. Fung ◽  
Leo Ho-man Leung
Keyword(s):  
Decision Making ◽  
Hong Kong ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Influential Factors ◽  
Medical System ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Decision Making Process ◽  
Hpv Vaccines

Abstract Background HPV vaccine is a prophylactic vaccine to prevent HPV infections. Recommended by the World Health Organization, this vaccine is clinically proven to be one of the most effective preventive measures against the prevalence of cervical cancer and other HPV-associated cancers and chronic genital conditions. However, its uptake rate among women in Hong Kong is insignificant—only approximately 2.9% adolescent girls and 9.7% female university students received HPV vaccination in 2014. With the notion of Critical Medical Anthropology, we aimed to identify if different influential factors, ranging from individual, societal, and cultural, are involved in the decision-making process of whether to receive HPV vaccination. Methods We adopted a qualitative approach and conducted in-depth individual semistructured interviews with 40 women in Hong Kong between May and August 2017. Results We noted that the following factors intertwined to influence the decision-making process: perceptions of HPV and HPV vaccine; perceived worthiness of HPV vaccines, which was in turn influenced by vaccine cost, marriage plans, and experiences of sexual activities; history of experiencing gynecological conditions, stigma associated with HPV vaccination, acquisition of information on HPV vaccines, distrust on HPV vaccines, and absence of preventive care in the healthcare practice. Conclusions HPV vaccination is promoted in a manner that is “feminized” and “moralized” under the patriarchal value system, further imposing the burden of disease on women, and leading to health inequality of women in pursuing the vaccination as a preventive health behaviour as a result. We believe that this ultimately results in an incomplete understanding of HPV, consequently influencing the decision-making process. The “mixed-economy” medical system adopting capitalist logic also molds a weak doctor–patient relationship, leading to distrust in private practice medical system, which affects the accessibility of information regarding HPV vaccination for participants to make the decision.

scholarly journals Burden of Human Papillomavirus (HPV)-Related Cancers Attributable to HPVs 6/11/16/18/31/33/45/52 and 58

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Silvia de Sanjosé ◽  
Beatriz Serrano ◽  
Sara Tous ◽  
Maria Alejo ◽  
Belén Lloveras ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Vaccination Programs ◽  
Hpv Dna ◽  
Hpv E6 ◽  
Potential Impact

Abstract Background Many countries, mainly high- and upper-middle income, have implemented human papillomavirus (HPV) vaccination programs, with 47 million women receiving the full course of vaccine (three doses) in 2014. To evaluate the potential impact of HPV vaccines in the reduction of HPV-related disease, we aimed to estimate the HPV type distribution and burden of anogenital and head and neck cancers attributable to HPV types (HPVs 16/18/31/33/45/52/58/6/11) included in currently licensed HPV vaccines. Methods In all, 18 247 formalin-fixed paraffin-embedded specimens were retrieved from 50 countries. HPV DNA detection and typing were performed with the SPF-10 PCR/DEIA/LiPA25 system. With the exception of cervical cancer, HPV DNA-positive samples were additionally subjected to HPV E6*I mRNA detection and/or p16INK4a immunohistochemistry. For cervical cancer, estimates were based on HPV DNA, whereas for other sites, estimates were based on HPV DNA, E6*I mRNA, and p16INK4a biomarkers. Results The addition of HPVs 31/33/45/52/58 to HPVs 16/18/6/11 in the nonavalent HPV vaccine could prevent almost 90% of cervical cancer cases worldwide. For other sites, the nonavalent HPV vaccine could prevent 22.8% of vulvar, 24.5% of penile, 60.7% of vaginal, 79.0% of anal cancers, 21.3% of oropharyngeal, 4.0% of oral cavity, and 2.7% of laryngeal cancer cases. Conclusions Our estimations suggest a potential impact of the nonavalent HPV vaccine in reducing around 90% of cervical cancer cases and a global reduction of 50% of all the cases at HPV-related cancer sites.

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