High Human Papillomavirus Vaccine Acceptability and Cost-Effectiveness of the Chinese 2-Valent Vaccine Among Men Who Have Sex With Men: A Cross-Sectional Study in Shenyang, China

Background: Despite the insupportable burden caused by the human papillomavirus (HPV) and high vaccine acceptability, vaccination programs are not currently available for men who have sex with men (MSM). We aimed to assess HPV infection by examining the willingness for vaccination among MSM and cost-effectiveness of the Chinese 2-valent HPV vaccine.Methods: We recruited MSM in Shenyang, China between July and December 2020 to conduct anal HPV testing and an online survey regarding HPV-related knowledge and vaccine acceptability. We performed a cost-effectiveness analysis to evaluate the incremental cost-effectiveness ratios (ICERs) of the Chinese 2-valent HPV vaccine.Results: A total of 234 participants completed the online survey; of those, 203 were successfully tested for HPV. The median age was 30 years [interquartile range (IQR): 23–38 years]. Most participants had at least undergraduate education (136/234, 58.1%). The acceptability rate for the free HPV vaccine was 57.7% (135/234). The prevalence of HPV types 16 and 18 was 14.9% (18/121) and 26.8% (22/82) in the willing and unwilling to vaccinate groups, respectively (P > 0.05). The prevalence of high-risk HPV among participants aged <30 and ≥50 years was 48.6 and 38.9%, respectively. Using the Chinese per capita gross domestic product (GDP) as a threshold, the Chinese 2-valent HPV vaccine would be a “very cost-effective” strategy, with an ICER value of USD 4,411. This evidence showed that the Chinese 2-valent HPV vaccine was more cost-effective than other imported vaccines.Conclusions: Targeted strategies should be utilized in MSM with different rates of vaccine acceptability. A pilot HPV vaccination program based on the Chinese 2-valent HPV vaccine for MSM is urgently warranted to reduce the burden of HPV and anal cancer.

COVID-19 Vaccine Acceptability and Hesitancy in Africa: Implications for Addressing Vaccine Hesitancy

Background: Increased acceptance and uptake of Coronavirus Disease 2019 (COVID-19) vaccines is very essential in containing the ongoing COVID-19 pandemic. Vaccine hesitancy is a threat to public health containment of infectious diseases. Aim: The main aim of this study was to review published articles regarding COVID-19 vaccine acceptability and hesitancy across all populations in Africa. Materials and methods: This was a narrative review. A comprehensive literature search was done using PubMed, Google Scholar, Scopus, and EMBASE using the keywords vaccine acceptability, vaccine hesitancy, COVID-19 vaccine, COVID-19 pandemic, H1N1 vaccine, swine flu, swine flu vaccine, Africa, and the Boolean word AND. The cited literature was published between March 2001 and June 2021. Results: The few studies were done in Africa so far are among healthcare workers and medical students. Acceptance of vaccination against COVID-19 in Africa ranged from 15.4% to 55.9%. This shows increased hesitancy to receive the COVID-19 vaccines in African countries. Many people were concerned about the potential adverse effects and ineffectiveness of COVID-19 vaccines. Misinformation about the COVID-19 vaccines has contributed to the hesitancy reported from different studies. Moreover, sociodemographic characteristics were also predictors of the acceptability of COVID-19 vaccines. Conclusion: Low acceptability rates reported in Africa indicates increased hesitancy to vaccination against COVID-19. The low acceptance of vaccines in Africa can hinder the required 60-70% vaccinations to achieve herd immunity. Therefore, there is a need to develop strategies that will address hesitancy against the COVID-19 vaccines across countries and populations in Africa and the entire globe.