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Objective Design Sample Measurements Results Conclusion This study aims to examine the relationship between human papillomavirus (HPV) testing attitudes and beliefs, knowledge, and vaccination attitudes.This study was a cross‐sectional design.This study was conducted between March 15, 2024, and June 2, 2024, through social media platforms such as Facebook, Instagram, Twitter, and Telegram, by sharing on forum pages, and involved 674 women who volunteered to participate.The research data were collected using the “health belief model scale regarding HPV infection and vaccination (HBMS‐HPVV)” and the “HPV Testing Attitudes and Beliefs Scale (HTABS),” which were developed by the researchers through a literature review.The average age of the women participating in the study was 46.59 ± 11.15 years; 81.5% were married, 57.6% had no knowledge about cervical cancer, and 62.2% had no knowledge about the HPV vaccine, a protective vaccine against cervical cancer. The average scores for the subdimensions of severity, barriers, benefits, and susceptibility of the HBMS‐HPVV were 3.19 ± 0.60, 2.96 ± 1.22, 2.29 ± 1.40, and 3.92 ± 0.49, respectively. The average scores for the subdimensions of personal barriers, social norms, confidence, and worries of the HTABS were 31.14 ± 19.27, 7.57 ± 4.47, 30.03 ± 7.18, and 11.91 ± 2.52, respectively. A statistically significant positive relationship was found between all HBMS‐HPVV subdimensions and the HTABS subdimensions (p < 0.001).The study found that as the perceived severity increases, the perceived benefits, susceptibility, and confidence increase, while the perceived barriers, personal barriers, social norms, and worries decrease. Based on these results, it is recommended that women's health nurses provide education and seminars to raise awareness about cervical cancer, early screening and diagnosis programs, and the HPV vaccine. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case details adult‐onset Still's disease (AOSD) onset post‐human papillomavirus (HPV) vaccination and acute gastroenteritis. The timing of HPV vaccine and vaccine‐autoimmune disease literature may potentially confound the well‐established link between infections and AOSD onset. [ABSTRACT FROM AUTHOR]

Japan has a particularly critical situation surrounding its collapsed HPV vaccination program for preventing HPV‐caused cervical cancers, a problem exacerbated by the lack of a national immunization database. We have determined the year‐to‐year HPV vaccination uptake by Japanese females and analyzed by birth fiscal year (FY) the monthly number of people receiving initial HPV vaccination. Our analysis covers the period from the start of public subsidies in 2010 to September 2023, using data provided by local governments. We calculated the cumulative number of monthly immunizations for those unimmunized as of April (the beginning of each vaccination year). The monthly number of initial HPV vaccinations was highest in August for every FY from FY 2010 to FY 2023; a second vaccination peak tended to occur in March when the vaccination year ended. The highest number of August vaccinations occurred in FY 2011, followed (in order) by 2012, 2021, 2022, 2023, and 2013. In Japan's ongoing catch‐up vaccination program for young women, the monthly number of vaccinations increased in August 2022 but then slowed the following year. After FY 2021, the cumulative vaccination coverage of subjects unvaccinated at the beginning of the vaccination year but subsequently covered by routine immunizations was slightly improved. FY 2021 was when the governmental recommendations for HPV vaccination were resumed. More recent vaccination rates are considerably lower than those in FY 2011–2012 when vaccinations were first fully endorsed. Paralyzing HPV vaccination hesitancy, which began in FY 2013, will linger in Japan in FY 2024. [ABSTRACT FROM AUTHOR]

Objective: To validate the efficacy of a virtual, interdisciplinary workshop in improving HPV knowledge, and vaccination practices among primary care and dental trainees. Methods: A virtual platform was utilized to hold HPV educational workshops with primary care and dental trainees. Online surveys were distributed before and after the 1‐h interactive workshop, led by otolaryngology residents. Surveys included the workshop's impact on (a) improving knowledge of HPV‐associated oropharyngeal squamous cell carcinoma (OPSCC) and (b) affecting change in HPV vaccination practices. The vaccination rates of trainees were recorded prior to and after workshop attendance. Results: After the workshop, participants demonstrated significantly improved scores related to knowledge of HPV in the head and neck (p = 0.003) and showed an increased comfort level with counseling on HPV vaccination (p = 0.002). Respondents were also more aware that the HPV vaccine is approved to prevent OPSCC (61% vs. 95%, p < 0.05). Ninety‐seven percent of respondents stated that the workshop changed their HPV vaccination practices, and 95% of those not fully vaccinated stated they would now be more likely to receive the vaccine themselves. There was a significant increase in the average number of HPV vaccines administered at the studied trainee clinic, from 16.83 vaccines/month to 37.6 vaccines/month (percent increase = 123%) in 5 months following the workshop (p = 0.002). Conclusion: The present interactive virtual workshop demonstrates efficacy in improving HPV‐related knowledge and vaccination practices among trainees. The virtual nature of the course facilitates knowledge transfer and can be used to foster multi‐institutional partnerships regarding medical education and vaccination efforts. Level of Evidence: 4 Laryngoscope, 134:3096–3101, 2024 [ABSTRACT FROM AUTHOR]

Background and Aims: Human papillomavirus (HPV) infections that continue to exist are the main cause of cervical cancer (CC), two‐thirds of CC occurrences worldwide are caused by HPV 16 and HPV 18, and 99.7% of CC tumors are linked to oncogenic HPV infection. To identify challenges of CC and its prevention and treatment modalities. Methods: This review examined the epidemiology, predisposing factors, genetic factors, clinical assessment methods, current treatment options, and prevention approaches for CC. We had perform a narrative data synthesis rather than a pooled analysis. A thorough literature search in pertinent databases related to CC was done with the inclusion of data that were published in the English language. Results: Early detection of CC is of utmost importance to detect precancerous lesions at an early stage. Therefore, all responsible agencies concerned with health should make all women aware of the benefits of CC screening and educate the general public. HPV vaccination coverage is very low in resource‐limited settings. Conclusion: To achieve the goal of eliminating CC as a public health problem in 2030, the World Health Organization will pay special attention to increasing HPV vaccination coverage throughout the world. To further improve HPV vaccine acceptability among parents and their children, safety‐related aspects of the HPV vaccine should be further investigated through post‐marketing surveillance and multicentre randomized clinical trials. [ABSTRACT FROM AUTHOR]

In 2013, the national human papillomavirus (HPV) immunization program began. However, in June 2013, Japan's Ministry of Health, Labor and Welfare (MHLW) announced a "temporary" suspension of its recommendation for the human papillomavirus vaccine. Finally, in November 2021, the MHLW ended its suspension of the recommendation of the HPV vaccine. To address the 9‐year gap in HPV vaccinations the suspension had caused, the MHLW conducted a program of catch‐up vaccinations from April 2022 to March 2025. Finally, in April 2023, the 9‐valent HPV vaccine was approved for both the routine and catch‐up vaccination programs in Japan. In this study, we investigated the potential effects of the introduction of the 9‐valent vaccine on the increased risk of cervical cancer in females born after fiscal year (FY) 2000. We estimated the lifetime relative risk of cervical cancer incidence and death using the improved routine and catch‐up vaccination rates after the recent resumption of the governmental recommendation for women and girls to have the HPV vaccination. These relative risks were calculated using a lifetime risk of 1.000 for cervical cancer incidence and death for females born in FY 1993. We predicted that even if a 90% vaccination rate were to be achieved by FY 2024 with the 9‐valent vaccine among women born between FY 2000 and FY 2005, the risk would remain higher than for the vaccination generation. Therefore, for women born between FY 2000 and FY 2005, it will be necessary to significantly improve the cervical cancer screening rate to compensate for this increased risk. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the human papillomavirus (HPV) genotype distribution in a large cohort of high‐grade vaginal intraepithelial neoplasia (VaIN) (vaginal HSIL, VaIN2/3) patients from two Italian referral centers. We included all patients with histologically confirmed VaIN2/3 from the Department of Surgical Sciences, Sant'Anna Hospital, University of Torino, Torino, Italy, and Ospedale Maggiore della Carità, Novara, Italy, between 2003 and 2022. After the histological evaluation of formalin‐fixed paraffin‐embedded samples, we performed HPV genotyping with VisionArray HPV Chip 1.0. We detected HPV DNA in 94.4% of VaIN2/3 (168/178), with HPV 16 as the most prevalent genotype, accounting for 51.8% of all infections, 41.2% of VaIN2 and 77.6% of VaIN3 cases. Other frequent genotypes were HPV 58 (8.3%, 10.9% of VaIN2 and 2.0% of VaIN3), HPV 73 (5.4%, 5.0% of VaIN2 and 6.1% of VaIN3), and HPV 31 (5.4%, 6.7% of VaIN2 and 2.0% of VaIN3). 73.2% of VaIN2/3 had a single HPV genotype infection and 26.8% a multiple infection (20.8% a double infection, 4.8% a triple infection, and 1.2% a quadruple infection). Single infection was more frequently present in VaIN3 than VaIN2 (81.6% vs. 69.8%). 69.1% of single infections and 73.3% of multiple infections had one or more genotypes covered by nine‐valent HPV vaccine. HPV vaccination is expected to have a large impact on reducing the incidence of vaginal intraepithelial neoplasia. [ABSTRACT FROM AUTHOR]

Objective: Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors influencing the Human Papilloma Virus (HPV) vaccination uptake in European women. Methods: As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed. Results: Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p‐value of 0.001. Neither knowledge about HPV vaccination (OR = 1.39, CI: 0.73–2.65, Z = 1.01, p = 0.31) nor knowledge about CC screening (OR = 1.05, CI: 0.55–1.98, Z = 0,14, p = 0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR = 1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z = 4.94 and p = 0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low. Conclusions: Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage. [ABSTRACT FROM AUTHOR]

Background: Vaccination against human papillomavirus (HPV) is a pivotal tool for preventing a significant cause of cervical cancer. One particular culturally recognized context associated with negative attitudes toward the HPV vaccine is the religiousness of parents. However, relatively speaking, there remains a scarcity of studies that have focused specifically on religious groups, especially non‐Christian groups. Purpose: To better understand the basis for members of an ultra‐Orthodox Jewish community to object to the HPV vaccine and how such objections can and cannot be reduced, thereby improving cultural competence—namely, the cultural understanding and ethical addressing of HPV vaccination refusal. Methods: This qualitative study conducted semi‐structured interviews with ten Israeli ultra‐Orthodox mothers who are opposed to administering the HPV vaccine to their daughters. The content analysis addressed these results and extracted the major issues arising from these particular interviews. Results: Four main novel insights were found pertaining to the negative stance toward HPV vaccination among mothers in an ultra‐Orthodox Jewish community: (a) lack of knowledge about the HPV vaccine is not part of the reasoning against it; (b) rabbinical authority might have a lesser influence than expected for the moderation of HPV vaccine refusal; (c) complicated viewpoints regarding childhood vaccination may be the larger non‐moderating context for HPV vaccination refusal; and (d) cultural competence is important for the ability to change the negative attitudes toward HPV vaccination. Conclusions: The study may improve cultural competence regarding HPV vaccination and contribute to decreasing objections to the HPV vaccine in ultra‐Orthodox communities. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) vaccination is an effective way to prevent cervical cancer. In Vietnam, there has been a lack of research specifically targeting the student population in the field of health sciences. Objectives: This study aimed to assess HPV vaccination knowledge, attitudes, and practices among health science students in Vietnam, focusing on differences between pharmacy students and other health science students. Methods: The study used a cross‐sectional descriptive design, conducted at a medical university in southern Vietnam. This survey was managed by Google Form which was distributed online to students via posts on Facebook and student chat groups on health science courses on Message, Zalo. Results: Out of the 1010 students surveyed, 213 (21.1%) were pharmacy students. There was no difference between pharmacy and non‐pharmacy students in terms of knowledge scores about HPV, cervical cancer (median = 7 vs. median = 7, p = 0.301), and vaccine knowledge (median = 8 vs. median = 7, p = 0.273). Pharmacy students had a less positive attitude toward HPV, cervical cancer, and HPV vaccines than non‐pharmacy students (median = 36 vs. median = 37, p = 0.014). Parents' education level, history of cervical cancer screening, HPV vaccine knowledge, and attitudes toward HPV, cervical cancer, and HPV vaccine were identified as significant factors influencing HPV vaccination in the women population. Conclusion: Pharmacy and non‐pharmacy students differ significantly in their attitudes toward HPV, cervical cancer, and HPV vaccines. These findings can help develop educational programs and counseling to improve students' understanding, awareness, and vaccination decisions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of a health maintenance reminder (HMR) on human papillomavirus (HPV) vaccine administration and completion across different age, insurance, and race cohorts. Study Design: Retrospective pre‐post analysis. Setting: Academic primary care. Methods: Patients aged 9 to 26 who had initiated the HPV vaccine series from 2016 to 2021 were analyzed, based on current age‐based standards. The cohort was divided based on vaccine uptake before and after the implementation of the HMR program in February 2020. The multivariate analysis estimated the odds of vaccine completion based on sociodemographic factors, and variable interactions were investigated to determine independent associations between sociodemographic factors and HMR implementation. Results: There were 7654 individual patients (mean age was 15.8 years; 46.7 were males; and 50.7% were white). HPV vaccine completion rates increased post‐HMR implementation by 59.2% (37% pre‐, and 58.9% post‐HMR; p <.001) in the entire cohort. Overall, black patients (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.60, 0.70) and patients ≥18 years (aOR = 0.13; 95% CI: 0.11, 0.15) were significantly less likely to complete their vaccine series; however, this improved significantly following HMR in these groups (p <.001). Post‐HMR, race, and insurance status were not independently associated with disparate vaccine completion rates, however, age was, and patients ≤14 or younger had higher odds of vaccine completion (aOR = 3.54; 95% CI: 2.91, 4.32). Conclusion: The implementation of an HMR was associated with increased HPV vaccine uptake across age and race groups in this single‐institution study. Future research should explore barriers to implementing HMRs in different health care settings. [ABSTRACT FROM AUTHOR]

Background: Solid‐organ transplant recipients are at increased risk of developing human papillomavirus‐related diseases. Methods: To evaluate the immunogenicity of a quadrivalent vaccine, a prospective observational study included females aged 12–19 years who had received kidney or liver transplants, or were otherwise healthy volunteers. With the three‐dose vaccination, serum antibodies were measured. Results: The study included 17 transplant recipients (seven kidney and 10 liver) and 16 healthy participants. Six of seven kidney transplant recipients were on three immunosuppressive medications, whereas 9 of the 10 liver transplant recipients were on one. For the serology within 6 months from the last vaccine dose, the geometric mean titers of human papillomavirus types 6, 11, 16, and 18 were 26.7, 8.6, 35.7, and 42.4 (kidney transplant); 579.2, 569.3, 3097.3, and 835.7 (liver transplant); and 860.5, 638.8, 4391.6, and 902.6 milli‐Merck Units/ml (healthy). The seropositivity rates of kidney transplant recipients for the four serotypes ranged from 50% to 75%, while all liver transplant recipients and healthy participants had 100% seropositivity rates for all four types. While there were no statistical differences of titers between liver transplant recipients and healthy participants, the titers of kidney transplant recipients were lower than those of healthy participants for type 6 (p =.034), type 11 (p =.032), and type 16 (p =.032). Conclusions: The results support the recommendation of human papillomavirus vaccination in pediatric transplant recipients given the significant risk of human papillomavirus‐related diseases in this population, though immunogenicity was lower in kidney transplant recipients on multiple immunosuppressive medications. [ABSTRACT FROM AUTHOR]

In November 2021, the government of Japan announced a reversal of its decision in 2013 to suspend the previous proactive recommendation for HPV vaccination. However, the program for young girls to receive routine and catch‐up vaccinations has not necessarily developed as expected. We conducted a nationwide questionnaire survey by mail in September 2022. The survey was mailed to 133 municipalities consisting of all cities/wards of the Tokyo and Osaka Prefectures and all other prefectural capital cities. Responses were received from 82 municipalities (62.7%). Notification of routine HPV vaccinations had already been sent to 76 (92.7%) of the municipalities; 70 (85.4%) had been encouraged to promote catch‐up vaccinations. The questionnaire forms for registration and pre‐vaccination screening for routine immunization had been sent to 74.1% (60/81) of the municipalities and 68.8% (55/80) for catch‐up immunizations. For catch‐up vaccination, only 54 municipalities (65.9%) had detailed vaccination records for those eligible. In total, 10 municipalities (12.2%) had virtually no vaccination records because these had already been discarded. In addition, 61 municipalities (74.4%) had notified only women and girls eligible for a catch‐up vaccination based on their vaccination record, whereas 25.6% (21/82) of the municipalities reported that they had sent, or would send, the notification to all women and girls within the targeted grades, including those who had already been vaccinated with three injections. The survey revealed disparities among the municipalities in their HPV vaccine notification processes. Future research on monitoring HPV vaccination rates and incidence rates of cervical cancer and precancerous lesions in each municipality will be desirable. [ABSTRACT FROM AUTHOR]

Background: The current study examined self‐reported human papillomavirus (HPV) vaccination uptake and intentions, and associations with psychosocial constructs among United States adults aged 18 to 26 and 27 to 45 years. Methods: Data were collected via an online survey from participants recruited from a research panel. Outcomes were HPV vaccination uptake and intentions. Multivariable binary and ordered logistic regression models were used to examine associations between HPV vaccination outcomes and psychosocial constructs, sociodemographics, and previous health behaviors. Results: HPV vaccination uptake in both age cohorts (N = 2722) was associated with multiple variables, including but not limited to: provider recommendation (adjusted odds ratio [aOR], 11.63 [95% CI, 7.70–17.56] and aOR, 14.26 [95% CI, 9.52–21.38], for those aged 18 to 26 and 27 to 45 years, respectively) and positive HPV vaccine attitudes (aOR, 2.40 [95% CI, 1.70–3.40] and aOR, 1.46 [95% CI,1.06–2.02]). Among those who did not report or were unsure of prior HPV vaccination (N =1894), only 4.6% and 8.1% (aged 18–26 and 27–45 years, respectively) reported being very likely to receive the HPV vaccine in the next year. Increased intentions were associated with more positive vaccine attitudes (aOR, 2.45 [95% CI, 1.91–3.15] and aOR, 2.19 [95% CI, 1.72–2.78]) and provider recommendation (yes vs no; aOR, 1.97 [95% CI, 1.38–2.83] and aOR, 1.82 [95% CI, 1.31–2.52]; don't know/can't remember vs no; aOR, 1.38 [95% CI, 1.03–1.84] and aOR, 1.60 [95% CI, 1.17–2.18]). Sociodemographics and health behaviors associated with increased intentions differed for each age cohort. Conclusions: Individual and interpersonal factors were associated with HPV vaccination uptake and intentions. Findings reveal the need for targeted interventions to improve HPV vaccination rates among these age groups. Findings on low human papillomavirus vaccination proportions highlight the need for vaccine promotion among age‐eligible individuals. Factors to target in future age‐relevant interventions include provider recommendations, modifiable health behavior constructs, and sociodemographics. [ABSTRACT FROM AUTHOR]

Quality control is very important during the development of 3‐valent (16/18/58), 9‐valent (6/11/16/18/31/33/45/52/58), and 15‐valent human papillomavirus (HPV) vaccines (6/11/16/18/31/33/35/39/45/52/56/58/59/68). All 3‐valent, 9‐valent, and 15‐valent HPV vaccines contain the HPV16 antigen; therefore, a detection method that can specifically identify HPV16 in vaccines is urgently required. This study aimed to develop and characterize monoclonal antibodies to assemble a highly specific HPV16 detection kit. The HPV16 L1 pentameric protein developed as an immunogen was used to prepare monoclonal antibodies. From the pool of prepared monoclonal antibodies, we selected 4G12 and 5A6 to screen and evaluate their subtypes, specificity, neutralizing activity, serum competition, binding affinity, and gene sequencing. After these characterizations, an enzyme‐linked immunosorbent assay kit for these monoclonal antibodies was developed, and excellent quality was demonstrated in the assessment of linearity, repeatability, and specificity. The developed detection kit has great potential for wide use in clinical testing and quality control in vaccine production processes. [ABSTRACT FROM AUTHOR]

It is believed that human papilloma virus infection (HPV), which is caused by the DNA virus, is the most prominent factor contributing to sexually transmitted disease (STD) in the world, with males having a prevalence rate of 3.5%–45% while that women are 2%–44%. Infertility is a rising problem on a global basis, affecting anywhere from 10% to 30% of couples who have reached reproductive age. This study aims to investigate the existing research on HPV, its connection to male infertility, and how it could be a helpful tool for medical professionals managing HPV in the context of reproductive health care. Infection with HPV has been identified as a risk factor for several spontaneous abortions; however, there is a lack of evidence on how HPV influences individuals undergoing assisted reproductive technology (ART) in terms of live births. The significance of the immune response to HPV‐infected male reproductive system cells and its effect on embryos, as well as the oxidative stress generated by high‐risk HPV DNA damage and genomic instability, is discussed in this review. Further, the association between male individuals infected with HPV and asthenozoospermia should provide a compelling case for vaccinating young people against HPV. [ABSTRACT FROM AUTHOR]

Objective: To understand the effect of changing from cytology-based to primary HPV screening on the positive predictive value (PPV) of colposcopy referrals for cervical intraepithelial neoplasia (CIN) in a cohort offered HPV vaccination. Design: Retrospective pre/post observational cohort study. Setting: Scotland. Population or sample: 2193 women referred to colposcopy between September 2019 and February 2020 from cytology-based screening and between September 2020 and February 2021 from primary high-risk HPV (hrHPV) screening. Methods: Calculating positive predictive values (PPVs) for two cohorts of women; one having liquid-based cytology screening and the other, the subsequent hrHPV cervical screening as a pre/post observational study. Main outcome measures: Positive predictive values of LBC and hrHPV cut-offs for colposcopy referral for CIN at colposcopy. Results: Three papers fitted our criteria; these reported results only for cytology-based screening. The PPV was lower for women in HPV-vaccinated cohorts indicating a lower prevalence of disease. Vaccination under the age of 17 had the lowest PPV reported. Scottish colposcopy data concerning hrHPV and cytology showed a non-significant difference between PPV (17.5%, 95% CI 14.3–20.7, and 20.6, 95% CI 16.7–24.5, respectively) for referrals with a cut-off of low grade dyskaryosis (LGD); both met the standard set of 8–25%. The hrHPV PPV (66.7, 95% CI 56.8–76.6) was comparable to cytology (64.1, 95% CI 55.8–72.4) for referrals with a cut-off of high grade dyskaryosis (HGD) but neither met the standard set of 77–92%. Conclusions: Current literature only provides PPVs for LBC and, overall, the vaccinated cohort had lower PPVs. Only LG dyskaryosis met PHE criteria. The PPV for HPV-vaccinated women undergoing either LBC or HR-HPV screening were not statistically different. However, similar to papers in the current literature, HG dyskaryosis (HGD) PPVs of both techniques did not meet the PHE threshold of 76.6–91.6% outlined in the cervical standards data report. [ABSTRACT FROM AUTHOR]

Synopsis: There are cultural and institutional barriers to HPV vaccine uptake in Peruvian indigenous adolescents, highlighting the presence of myths and distrust towards vaccines and health personnel. [ABSTRACT FROM AUTHOR]

Introduction: In settings with high HIV prevalence, cervical cancer incidence rates are up to six‐fold higher than the global average of 13.1 cases per 100,000 women‐years. To inform strategies for global cervical cancer elimination, we used a dynamic transmission model to evaluate scalable screening and treatment strategies, accounting for HIV‐associated cancer risks and weighing prevention gains against overtreatment. Methods: We developed a dynamic model of HIV‐HPV co‐infection and disease progression, which we calibrated to KwaZulu‐Natal, South Africa. Our baseline scenario reflects the current practice of HPV vaccination with a multi‐visit screening and treatment strategy involving cytology and colposcopy triage. We evaluated 13 comparator scenarios with increased vaccination coverage and one‐time, two‐time or repeat HIV‐targeted cervical cancer screening with the following single‐visit strategies: HPV DNA testing, HPV genotyping, automated visual evaluation (AVE) and HPV DNA with AVE triage. In all scenarios, HIV antiretroviral therapy, condom use and voluntary male medical circumcision continue at baseline levels. We simulated cancer incidence under each scenario from 2020 to 2120 using the 25 best‐fitting parameter sets. We present the median and range of model output from these simulations to account for parameter uncertainty. Results: We estimate that cervical cancer incidence will decrease by 87% with the continuation of current cervical cancer and HIV prevention strategies, from an age‐standardized rate per 100,000 women of 80.4 (range 58.2, 112.1) in 2020 to 10.7 (4.2, 29.9) in 2120. Scenarios scaling up vaccination and single‐visit strategies resulted in near‐ and long‐term gains. With repeat HIV‐targeted screening, incidence rates were projected to be 29–34% lower in 2030 relative to the baseline scenario, and elimination (incidence <4/100,000) was achieved with HPV DNA testing in 2095 and with AVE in 2114. A strategy of HPV DNA with AVE triage optimized the tradeoff between cancer cases averted and overtreatment. Conclusions: Single‐visit screening strategies could avert a substantial burden of cervical cancer and accelerate progress towards elimination in settings with a high burden of HIV. Increasing the screening frequency among women with HIV and reducing loss‐to‐follow‐up for treatment will be key components of a successful elimination strategy. [ABSTRACT FROM AUTHOR]

Cervical cancer is caused by infections of the human papillomavirus (HPV), which can be prevented by vaccinations. In Japan, although about 3000 people die of cervical cancer annually, the HPV vaccination rate has remained extremely low in the eligible population since many Japanese have been concerned that "diverse symptoms," such as chronic pain, movement disorders, and cognitive impairment, may occur as adverse reactions after HPV vaccination. The concern has been raised by media coverage of the ongoing HPV vaccine lawsuits, in which the plaintiffs complained of their symptoms caused by HPV vaccination. The claims have been based on the alleged pathogenic findings in research articles on HPV vaccines, summarized in the document prepared by the plaintiffs' attorneys. We critically evaluated these articles, in which the authors proposed the following findings/hypothesis: (i) molecular mimicry between HPV L1 and human proteins leads to the production of cross‐reactive antibodies; and (ii) HPV vaccine injection in mice causes damage in the brain, a mouse model for HPV vaccine associated neuro‐immunopathic syndrome (HANS). We found that these hypotheses were based mainly on the findings from a few research groups and that all the articles had flaws in the method, result, or discussion sections. Our current evaluation should help better understand the validity of the findings, which have been often misunderstood as the truth by the general public. We propose to accumulate high‐quality data on potential adverse events following HPV vaccination and to continue critically evaluating them. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to analyse the temporal trend of HPV vaccination coverage (VC) in Spain in women aged 15‐55 years not included in systematic vaccination programmes during the period 2007‐2020. Methods: We assessed the vaccine coverage rate in this population based on three estimations: 1) annual vaccination coverage with at least one dose (VCR ≥ 1d), 2) annual VC for the full schedule (VCR3d), and 3) cumulative VC for the full schedule (aVCR). Results: Annual VCR ≥ 1d and VCR3d were highest in 2008 (2.40% and 0.66% respectively) and subsequently decreased drastically in 2011 (0.55% and 0.15%). From 2017 to 2019 there was an increase from 1.4‐fold to 1.6‐fold, respectively, which decreased in 2020. In relation to aVCR, there was an increasing trend throughout the study period with approximately 4.03% of the study population having been vaccinated against HPV in 2020. Conclusion: In Spain, the cumulative vaccination coverage against HPV in women between 15‐55 years old not included in current vaccination programmes remains very low. Nonetheless, the temporal trend has shown a slight increase in recent years. Despite the COVID‐19 pandemic in 2020, no significant negative impact on vaccination coverage has been observed in this population. In Spain, cumulative vaccination coverage against HPV in women aged 15–55 years remains very low, but temporal trend has increased slightly in recent years. [ABSTRACT FROM AUTHOR]

Japanese girls aged 12–16 years are offered free human papillomavirus (HPV) vaccination and cervical cancer screening is conducted with cytology and not HPV testing from the age of 20 years. So far, no study has analyzed the effect of HPV vaccination against cervical precancers considering HPV infection status and sexual activity. We aimed to analyze the vaccine effectiveness (VE) against HPV infection and cytological abnormalities, adjusted for sexual activity. This study comprised women aged 20–26 years who underwent cervical screening in Niigata. We obtained HPV vaccination status from municipal records and a questionnaire along with information concerning sexual activity. Of 5194 women registered for this study, final analyses included 3167 women in the vaccinated group (2821 vaccinated women prior to sexual debut) and 1386 women in the unvaccinated group. HPV 16/18 (0.2% vs 3.5%), 31/45/52 (3.4% vs 6.6%), and 31/33/45/52/58 (5.0% vs 9.3%) positive rates were significantly lower in the vaccinated group (P < 0.001). No women vaccinated before sexual debut had HPV 16/18‐related cytological abnormalities. VE for HPV 16/18 infection and high‐grade cytological abnormalities in women vaccinated prior to sexual debut were 95.8% (95% CI 81.9–99.0%; P < 0.001) and 78.3% (95% CI 11.3–94.7%; P = 0.033), respectively, in multivariate analyses adjusted for age and number of sexual partners. However, analyses of all vaccinated women did not show significant effectiveness against cytological abnormalities. Our results showed the effectiveness of HPV vaccine against high‐grade cervical cytological abnormalities and the importance of the vaccination before sexual debut. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to clarify (1) the effectiveness of human papillomavirus (HPV) vaccine against precancerous lesions of uterine cervical cancer and (2) the difference in these effectiveness based on smoking status. Methods: This retrospective cross‐sectional study considered women aged 20–24 who underwent cervical cancer screening in Saga City from April 2014 to March 2020. Cervical cytology and histological diagnosis were compared with or without HPV vaccination and smoking. Results: The study included 7253 women (2467 vaccinated and 4786 unvaccinated). Among the vaccinated women, 462 were smokers, 2003 were nonsmokers: among the nonvaccinated women, the numbers were 1217 and 3554, respectively. 0.28% (7/2467) of participants with vaccination had HSIL+ compared to 0.77% (37/4786) without vaccination (odds ratio [OR] 0.36, 95% confidence interval [CI], 0.16–0.81). About 0.32% (8/2467) with vaccination had cervical intraepithelial neoplasia (CIN) 2+ compared to 0.69% (33/4786) without vaccination (OR 0.46, 95% CI, 0.21–1.00). Four women without vaccination had CIN3+. In nonsmokers, HPV vaccination significantly suppressed the incidence of HSIL+ from 0.42% (15/3554) to 0.1% (2/2003) (OR 0.21, 95% CI, 0.05–0.95), but the suppressive effect was not significant in smokers (OR 0.59, 95% CI, 0.22–1.56). In vaccinated women, the incidence of CIN2+ was 0.20% (4/2003) in nonsmokers and 0.87% (4/462) in smokers (OR 0.22, 95% CI, 0.05–0.89, p = 0.02). Conclusions: HPV bivalent/quadrivalent vaccination is effective in protecting against CIN but insufficient in smokers. The nine‐valent vaccine should be introduced into routine vaccination as soon as possible to prevent high‐risk HPV infection other than 6/11/16/18. [ABSTRACT FROM AUTHOR]

In Japan, public funding for HPV vaccination began in 2010 for girls aged 13–16 years (birth cohort years 1994–1997) and women born in 1994 who turned 25 in 2019. We aimed to verify the long‐term effectiveness of the bivalent HPV vaccine in women aged 25 years. Subjects were women aged 25–26 years who underwent cervical cancer screening and HPV testing in Niigata from 2019 to 2020 (birth cohort years 1993–1994). Information on vaccination status and sexual behavior was obtained from a questionnaire and municipal records. We compared the HPV infection rates of the vaccinated and unvaccinated groups. Of the 429 registrants, 150 (35.0%) and 279 (65.0%) were vaccinated and unvaccinated, respectively. The average period from HPV vaccination to HPV testing was 102.7 months (8.6 years), with a median of 103 months (range 92–109 months). The HPV high‐risk infection rate was 21.3% (32/150) in the vaccinated group and 23.7% (66/279) in the unvaccinated group (P = 0.63). The HPV16/18 infection rate was 0% (0/150) in the vaccinated group and 5.4% (15/279) in the unvaccinated group, showing a significant difference (P = 0.0018), and the vaccine effectiveness was 100%. The cross‐protective type HPV31/45/52 infection rate in the vaccinated group was significantly lower than that in the unvaccinated group (3.3% vs. 10.0%, P = 0.013). There was no significant difference in the mean age at sexual debut and the number of previous sexual partners between the two groups. We have demonstrated the long‐term 9‐year effectiveness of the bivalent vaccine against HPV infection for the first time in Japan. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) infection is the main cause of female precancerous lesions and cervical cancer. The development and application of HPV prophylactic vaccines have been recognized as a major effective intervention for the control of cervical lesions. However, the infection rate and clinical characters of non-9-valent vaccine covered HPV subtypes are still worth studying. In this retrospective study, we included patients diagnosed and treated in the Department of Gynecology of Shanghai General Hospital between January 2017 and February 2021. The clinical features of non-9-valent vaccine covered HPV subtypes were explored in 2179 patients who have normal results, 338 patients with cervical intraepithelial neoplasia 1 (CIN1), and 153 patients with ≥CIN2. Univariate analysis showed that compared to the normal cervix group, age ≥50, pregnancy ≥5, delivery ≥3, menopause, no condom use, and cervical transformation zone type III were risk factors for CIN1 or ≥CIN2 (p < 0.05). Thirty-one percent of CIN1 and 26% of ≥CIN2 were attributed to HPV51, HPV53, HPV56, and HPV68. Multivariate analysis revealed that HPV53, HPV81, age, menopause, cervical transformation area and involved glands were independent risk factors for ≥CIN2 group compared to the CIN1 group (p < 0.05). Additionally, among the 14 non-9-valent vaccine covered HPV subtypes, the infection rates of HPV53, 56, 51, and 68 were higher in this study. In conclusion, our study demonstrated the distribution and pathogenic risk of non-9-valent vaccine covered HPV subtypes in cervical lesions. These findings might supply a foundation for optimizing cervical cancer prevention in the post-vaccine era. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: The current state of the U.S. public's knowledge of the relationship between human papillomavirus (HPV) and HPV vaccinations to oropharyngeal squamous cell carcinoma (OPSCC) is unknown. Our objective was to 1) assess the general population's knowledge of human papillomavirus (HPV) and willingness to vaccinate, and 2) assess whether targeted education on HPV‐related OPSCC can change intentions to vaccinate. Study Design: Online cross‐sectional survey. Methods: An online, cross‐sectional survey utilizing U.S. census‐derived quotas to represent the U.S. population was distributed and analyzed to 517 adults in 2020. Results: Exactly 72.7% of participants stated that they had or would vaccinate their child against HPV and were designated as "vaccinators." In multivariate regression, Black individuals were less likely to be vaccinators (OR 0.51 [95% CI 0.27–0.94]), but those who were aware of HPV's role in OPSCC were more likely to vaccinate (OR 2.56 [95% CI 1.47–4.46]). Knowledge about vaccination side‐effects, eligibility, and mechanisms of HPV spread was low. Only 30.6% of the sample reported understanding the role of HPV in OPSCC. Of these, 43.0% gained this knowledge exclusively from nonhealthcare professional sources, like television. When presented with four short HPV‐OPSCC‐centered facts (HPV's role in OPSCC etiology, prevalence of infection, clinically silent course, and vaccine preventative effects), 54.0% of "nonvaccinators" indicated a willingness to change their minds. Conclusions: General knowledge about HPV, HPV's role in OPSCC, and the vaccine remains low in the general population. There are racial disparities in willingness to vaccinate within this sample, but these may be overcome by effective education on HPV‐related OPSCC. Level of Evidence: 3 Laryngoscope, 132:528–537, 2022 [ABSTRACT FROM AUTHOR]

Different types of cancer including cervical (>90%), anal (~88%), vaginal (~40%), and penile (~40%) cancers are associated with human papillomaviruse (HPV) infections. Three prophylactic vaccines (Cervarix, Gardasil, and Gardasil‐9) were approved to provide immuno‐protection against certain types of HPVs. Currently, next‐generation HPV vaccines such as L1/L2‐based vaccines are being developed to provide broad‐type HPV protection. In this study, we introduced a comprehensive framework for design of L1/L2 polyepitope‐based HPV vaccine candidate. This framework started with protein sequence retrieval and followed by conservancy analysis between high‐risk HPVs, MHC‐I and MHC‐II epitope mapping, and B‐cell and T‐cell epitope mapping. Subsequently, we performed Tap transport and proteasomal cleavage, population coverage, antigenicity, allergenicity and cross‐reactivity. After that, peptide‐MHCI/II flexible docking and comprehensive conservancy analysis against all HPV types were carried out. The next steps were prediction of interferon‐gamma and interleukin‐10 inducing epitopes, epitope selection and construct design, tertiary structure prediction, refinement and validation, discontinuous B‐cell epitope prediction, vaccine‐TLR4 molecular docking, and codon optimization. Our data showed that two designed vaccine constructs harboring 8 L1 peptides or 7 L2 peptides, individually were highly conserved between all well‐known HPV types. In addition, the combination of in silico/in vivo approaches indicated the potential ability of L1 and L2 polyepitope constructs for development of next generation prophylactic/therapeutic HPV vaccine. [ABSTRACT FROM AUTHOR]

HPV, a sexually transmitted viral infection, is the etiological agent of significant dermatologic disease including benign anogenital warts and invasive cancers. Sexual and gender minority individuals are particularly vulnerable to HPV‐associated disease due to reduced vaccination rates in these cohorts, low awareness of HPV, lack of provider recommendation, and inadequate consensus guidelines on screening and prevention in these individuals. A targeted approach is needed with regards to vaccination in all children —especially those from racial, ethnic, sexual, and gender minorities; provider recommendation, especially from pediatric dermatologists, is crucial. Effort must also be made to use transgender and non‐binary affirming language as dividing vaccination programs by anatomic sex and sexuality reinforces problematic notions of gender identity and sexuality, isolating the most vulnerable. [ABSTRACT FROM AUTHOR]

In Japan, the age‐adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data were collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20‐y‐old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of cervical intraepithelial neoplasia (CIN)1+ in women born in FY 1990 to 1993, that is those who reached the national vaccination target age prior to the introduction of publicly subsidized HPV vaccinations, referred here after as "the pre‐introduction generation", was 1.42% (242/17 040). The incidence in the "vaccination generation" (women born in FY 1994 to 1997, that is those who were heavily vaccinated as a group when they were of the nationally targeted age of 13‐16) was 1.66% (135/8020). There was no significant difference between these incidence rates. However, our FY birth year‐by‐year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the trend for CIN1+ seen in the pre‐introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccination generation than in the pre‐introduction generation (P =.0008). The incidence of CIN was already tending to increase in both the pre‐introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual effects of the HPV vaccine for reducing mild cervical lesions. [ABSTRACT FROM AUTHOR]

The prevalence of human papillomavirus (HPV) types varies geographically between various countries and different parts of the same country. The efficacy of the HPV vaccines is dependent on the prevalent HPV types. Here, we have studied the prevalence of high‐risk HPV (hrHPV) and its genotypes in women in our population. Cervical samples of 2443 women were screened for the presence of hrHPV using the careHPV system. To determine the HPV genotypes, viral DNA was isolated from the hrHPV‐positive samples, nested PCR was used to amplify the L1 hypervariable region, and was subjected to Sanger sequencing. The prevalence of hrHPV was found to be 2%. HPV16 (52%), HPV33 (40%), HPV18 (4%), HPV31 (2%), and HPV66 (2%) genotypes were found in this study. In Kerala, HPV16 and HPV33 genotypes were found to be significantly higher compared with the other HPV types detected. As the bivalent (Cervarix) and quadrivalent (Gardasil‐4) vaccines offer limited cross‐protection against HPV33, nonavalent (Gardasil 9) vaccine would be more effective in preventing cervical carcinoma in Kerala. Highlights: Prevalence of high risk HPV and its genotypes in women from Kerala, India was analyzed.HPV16 (52%) and HPV33 (40%) were found to be most prevalent genotypes in this population.As the bivalent (Cervarix) and quadrivalent (Gardasil‐4) vaccines offer limited cross protection against HPV33, nonavalent (Gardasil 9) vaccine would be more effective in preventing cervical carcinoma in Kerala. [ABSTRACT FROM AUTHOR]

In the present study, we examine socio‐cultural and practical aspects of human papillomavirus vaccination (HPVV) through a multi‐sited study of framings. We ask how HPVV is framed in the daily lives of vaccination‐aged Finnish girls and in school nurses' everyday work. We then mirror these framings against both each other and Finland's official vaccination campaign. Based on analysis of interviews with 24 nurses and 12 girls and the campaign materials, we argue first that the campaign frames vaccination as an individual, knowledge‐based decision reflecting the informed consent principle. Second, however, the vaccination is framed in the everyday lives of eligible girls through gendered social ties and as a gendered and cohort‐specific event pivoting around the needle prick. Third, HPVV is not primarily framed in the school nurses' work as preparing the girls for the vaccination decision by sharing official information but through trust‐based social relationships with the girls and their parents. We conclude that, as the vaccination is not an issue of individually reflected and knowledge‐based decision‐making for the two interviewed key groups, the official Finnish HPVV campaign and the undergirding informed consent principle drift into problems in their practical implementation. [ABSTRACT FROM AUTHOR]

Objective: Despite recent advancement recurrent respiratory papillomatosis (RRP) remains a rare but challenging benign airway neoplasm. In recent years there has been significant shifts in incidence of this disease due to changes in vaccination and prevention for human papilloma virus (HPV) and its related pathology. This review will highlight the epidemiology, prevention and treatment of RRP. Methods: The PubMed database was searched using relevant MeSH terms including "recurrent respiratory papillomatosis." The titles and abstracts were reviewed to assess relevance and unrelated articles were excluded. A full‐text review for select articles was performed, the data and discussions were interpreted and synthesized to create a concise update on the management of RRP. Results: With the increasing utilization of the 9‐valent and quadrivalent HPV vaccine in Australia, we have seen a significant decrease in the incidence of RRP. Preliminary data in the US shows a similar trend of decreased incidence after implementation of vaccination. Single dose Gardasil in developing countries has shown sustained immunization for at least 7 years. Preliminary clinical trials and retrospective studies have shown the HPV vaccine may have benefit as a treatment method in addition to prevention for HPV related diseases. Bevacizumab (Avastin), a VEGF monoclonal antibody, has shown promise as a systemic treatment for RRP. The Corona Virus Disease 2019 (COVID‐19) pandemic has affected perioperative management of RRP. Conclusion: RRP continues to decline in incidence since the implementation of HPV vaccination. Advancement in the medical management including Bevacizumab show promise as an additional option for the management of RRP. [ABSTRACT FROM AUTHOR]

Cervical cancer remains among the most common cancers in women worldwide and can be prevented by vaccination. The Ministry of Health, Labour and Welfare of Japan suspended active recommendation of regular human papillomavirus (HPV) vaccines in 2013 because of various symptoms including chronic pain and motor impairment. This nationwide case‐control study from April 2013 to March 2017 targeted women aged 20‐24 years old at cervical screening. We compared HPV vaccination exposure between those with abnormal and normal cytology. Abnormal cytology was classified based on the results of histological test and we calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 – OR) × 100. A total of 2483 cases and 12 296 controls (one‐to‐five matching) were eligible in 31 municipalities in Japan. The distribution of histological abnormalities among cases was 797 CIN1 (including dysplasia) (32.1%), 165 CIN2 (6.7%), 44 CIN3 (1.8%), and eight squamous cell carcinoma (SCC) (0.3%). The OR of HPV vaccination compared with no vaccination for abnormal cytology, CIN1+, CIN2+, and CIN3+ versus controls was 0.42 (95% CI, 0.34‐0.50), 0.42 (95% CI, 0.31‐0.58), 0.25 (95% CI, 0.12‐0.54), and 0.19 (95% CI, 0.03‐1.15), respectively, equating to a vaccine effectiveness of 58.5%, 57.9%, 74.8%, and 80.9%, respectively. Eight patients had SCC, none was vaccinated. This nationwide case‐control study in Japan demonstrated a substantial risk reduction in abnormal cytology and CIN among women who did versus those who did not receive HPV vaccination. [ABSTRACT FROM AUTHOR]

Synopsis: One‐dose human papillomavirus (HPV) vaccination schedules are now recommended by the WHO. We explore HPV vaccination challenges and research needs for women living with HIV. [ABSTRACT FROM AUTHOR]

Childhood cancer survivors are at high risk for developing subsequent human papillomavirus (HPV)‐associated cancers. In this issue, Henderson and colleagues examine risk factors for subsequent malignant neoplasms associated with HPV among enrollees in the Childhood Cancer Survivor Study and report that improved, targeted efforts to increase HPV vaccination and HPV‐related surveillance among childhood cancer survivors are needed. [ABSTRACT FROM AUTHOR]

Background: The burden of human papillomavirus (HPV) infection and HPV‐associated diseases is consistently growing worldwide. Several combination therapies are being tested nowadays for the treatment of recalcitrant warts, with promising results. Aims: To evaluate the potential therapeutic role of combined bivalent HPV vaccine (Cervarix) and Candida antigen versus candida antigen alone in the treatment of multiple recalcitrant warts. Patients/Methods: Forty patients with recalcitrant warts were enrolled into this study. They were divided into two groups (A and B), each including 20 patients. Patients in the group (A) received intralesional Candida antigen injection alone for five sessions at 2‐week intervals. Patients in the group B received combined treatment of bivalent recombinant HPV vaccine and intralesional Candida antigen. Candida antigen was administered as in the group A, while Cervarix vaccine was given intramuscularly at 0, 1, and 6 months as scheduled. Follow‐up was made monthly for 6 months to detect any possible recurrence. Results: Eight patients (40%) in the group (A) showed complete clearance of warts after intralesional Candida antigen injection alone, while 14 patients (70%) in the group (B) showed complete regression of warts after the combined therapy. No significant side effects were reported in both groups, and no recurrence was detected. Conclusion: Bivalent human papillomavirus vaccine combined with Candida antigen is a promising, effective, and safe modality for the treatment of multiple recalcitrant warts. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the present study was to examine differences in oral human papillomavirus (HPV) prevalence among adults based on HPV vaccination status and periodontitis status.Methods: Data from 2011 to 2012 and 2013 to2014 National Health and Nutrition Examination Surveys (n = 822) were retrieved in order to predict the prevalence of oral HPV in 24 separate demographic groups (age by sex by race) based on the following characteristics: HPV vaccination status and periodontitis status. A multiple logistic regression model, controlling for gender, age, race, smoking behavior, alcohol consumption, and sexual partners, was calculated in order to generate prevalence estimates.Results: Median predicted oral HPV prevalence rates per 1,000 in 2011-2012 were highest among nonvaccinated individuals with periodontitis [median ( x˜ ) = 31.62, interquartile range (IQR) = 102.97], followed by nonvaccinated individuals without periodontitis ( x˜ = 24.63, IQR = 81.84), vaccinated individuals with periodontitis ( x˜ = 18.40, IQR = 62.27), and vaccinated individuals without periodontitis ( x˜ = 14.29, IQR = 48.96). Median predicted oral HPV prevalence rates per 1,000 in 2013-2014 were highest among nonvaccinated individuals with periodontitis ( x˜ = 9.50, IQR = 33.02), followed by nonvaccinated individuals without periodontitis ( x˜ = 7.37, IQR = 25.76), vaccinated individuals with periodontitis ( x˜ = 5.48, IQR = 19.27), and vaccinated individuals without periodontitis ( x˜ = 4.25, IQR = 14.98).Conclusions: Interventions that integrate primary care and dental care are needed, given increased risk for oral HPV among unvaccinated individuals with periodontitis. [ABSTRACT FROM AUTHOR]

The effectiveness of a vaccination program is influenced by its design and implementation details and by the target population characteristics. Using routinely collected population‐based individual‐level data, we assessed the effectiveness (against cervical dysplasia) of Manitoba's quadrivalent human papillomavirus (qHPV) routine school‐based vaccination program and a short‐lived campaign that targeted women at high‐risk of developing cervical cancer. Females ≥9 years old who received the qHPV vaccine in Manitoba (Canada) between September 1, 2006, and March 31, 2013 (N = 31,442) were matched on age and area of residence to up to three unvaccinated females. Cox proportional hazards models were used to estimate qHPV VE against high‐grade (HSILs) and low‐grade squamous intraepithelial lesions (LSILs) and atypical squamous cells of undetermined significance (ASCUS). Among 14–17‐year‐old participants who had Pap cytology after enrollment, the adjusted qHPV VE estimates were 30% (17–58%) and 36% (21–48%) against the detection of HSILs and LSILs, respectively. There was, however, no evidence of program effectiveness among females vaccinated at ≥18 years of age and among those with a history of abnormal cytology, who were mostly vaccinated as part of the high‐risk program. Estimates of VE for females vaccinated in the school‐based program are consistent with the expected benefits from qHPV vaccination. No similar benefits were detected among women vaccinated at an older age, and those with abnormal cytology, who were targeted by the high‐risk program. Further efforts should be targeted at achieving higher vaccine coverage among preadolescents, prior to the initiation of sexual activity. What's new? Vaccination with the quadrivalent human papillomavirus (qHPV) prevents infection with HPV types responsible for the vast majority of cervical cancers and genital warts. In Manitoba, the qHPV vaccine has been available in school‐based vaccination programs since 2008. This study shows that levels of protection against cervical dysplasia among adolescent girls vaccinated in Manitoba's routine school‐based qHPV vaccination program are similar to benefit levels estimated from randomized clinical trials. Women vaccinated at age 18 or older or who had a history of abnormal cytology did not experience comparable benefits, likely owing to a combination of factors, including prior HPV exposure. [ABSTRACT FROM AUTHOR]

With the human papillomavirus (HPV) vaccine positioned as the "right tool" to protect girls' health and sexual health, public discourse positions parents as "responsible" if they vaccinate, "irresponsible" if they do not. The problem with this binary, however, is that it cannot account for the full spectrum of responsibilities and social norms that parents enact in vaccine decisions. In this paper, and in the context of low HPV vaccination rates, I confront this binary and encourage a fuller view of adolescent health and sexual health. Using data from qualitative semi‐structured interviews with 28 Canadian mothers tasked with consenting to the HPV vaccine, I examine the complexity of this responsibility. I find HPV vaccine‐consenting mothers have normative conceptualisations of responsibility aligned with dominant interpretations of public health. Rather than expressing irresponsibility, some non‐HPV vaccine‐consenting mothers articulated alternate responsibilities, aligned with broad efforts to manage their teens' sexual health and sexuality. They extend responsibility beyond cancer protection vis‐à‐vis vaccines to a general responsibility for daughters' sexual health and self‐esteem. In conclusion, I recommend the need for a broader public health approach to HPV, which includes, and goes beyond vaccination. Moreover, I suggest that some of these alternate responsibilities be viewed as complementary to vaccination. [ABSTRACT FROM AUTHOR]

BACKGROUND: School nurses and personnel play a vital role in promoting the human papillomavirus (HPV) vaccine. The purpose of this study was to identify factors associated with school nurses' and personnel's professional practice to provide parents with HPV vaccine information and to encourage parents to vaccinate their child against HPV. METHODS: School nurses and personnel from Ohio and Missouri completed a survey to assess their professional practice in providing HPV vaccine information and encouraging parents to vaccinate their child against HPV. Independent variables included demographics, HPV knowledge/attitudes, perceptions of their as an opinion leader for the HPV vaccine, self‐efficacy to provide vaccine education, and perception of school district support. RESULTS: Providing parents with HPV vaccine information was predicted by age, role within the school, grade‐serving, knowledge, perceptions, self‐efficacy, and district support; accounting for 38% of the variance (p < .000, R2 = .38). Encouraging parents to vaccinate their child against HPV was predicted by perception, self‐efficacy, and grade‐serving; accounting for 39% of the variance (p < .000, R2 = .39). CONCLUSIONS: To enhance school nurses' and personnel's professional practice, interventions should focus on nurses' and personnel's perception of their role as opinion leaders and self‐efficacy to provide HPV education and vaccine recommendation. [ABSTRACT FROM AUTHOR]

In 2008, Panama became the first country in Latin America to offer the Human Papilloma Virus (HPV) vaccine at no cost to 10‐year‐old girls as part of its National Immunization Program. Vaccine completion rates remain suboptimal, and knowledge is limited regarding public perceptions of the HPV vaccine in Panama. A cross‐sectional survey of 333 Panamanian women aged 18–65 was conducted in Panama City, Panama. Although 93 percent of respondents had heard of HPV, only 59.8 percent had heard of the HPV vaccine. Acceptability of HPV vaccination of daughters was high (95 percent). In multivariate analyses, HPV vaccine awareness was associated with age and education, but not with income, Internet use as preferred source of health information, indigenous race, or marital status. Additionally, after controlling for age, education, income, race, and Internet use, women who completed a pap test in the past 36 months were 3.12 times more likely to have heard of the HPV vaccine when compared to those who had not (95%CI 1.04–9.34). Future efforts to educate Panamanian women about the HPV vaccine should include special attention to vulnerable populations, including those of younger age and limited education. [ABSTRACT FROM AUTHOR]

This paper analyses the tensions between scientific literature and systematic reviews in the production of evidence in healthcare. Systematic reviews are devices developed – within evidence‐based medicine – to navigate the complexities of scientific literature promising a clear and simple account of the knowledge on a particular issue. However, in practice, systematic reviews have a more complex relation with literature. Systematic reviews are shaped according to the interest of the local groups that produce them. In this paper, I explore the formatting, making and managing of systematic reviews of evidence relating to HPV vaccines in Colombia. This case shows the ways in which systematic reviews mediate between the requirement of presenting the evidence that emerges from the international literature and the necessity of having data locally relevant. [ABSTRACT FROM AUTHOR]

Objective: To evaluate associations between insurance status and HPV vaccination.Methods: The present cross-sectional study analyzed data from women aged 18-26 years who participated in the National Health and Nutritional Examination Surveys 2009-2012 in the USA.Results: The study included 621 women; 424 (68.3%) had some type of insurance and 198 (30.6%) had received the HPV vaccine. In the multivariable model, we found significant interactions between race/ethnicity and insurance status on receiving HPV vaccination. Compared with individuals with no insurance, non-Hispanic black women with any type of insurance demonstrated increased likelihood of HPV vaccination (adjusted odds ratio [aOR] 3.63, 95% confidence interval [CI] 1.60-8.21; P=0.002). Among Mexican Americans, there was a negative association between having some insurance and HPV vaccination (aOR 0.35, 95% CI 0.15-0.81; P=0.007). For non-Hispanic black women, the association remained significant across all insurance types (private [aOR 4.29, 95% CI 1.67-11.00; P=0.003], Medicaid [aOR 2.86, 95% CI 1.15-7.13; P=0.025], and other [aOR 4.74, 95% CI 1.06-21.15; P=0.042]). Non-Hispanic white women with insurance other than private or Medicaid had a higher likelihood of HPV vaccination compared with uninsured individuals (aOR 8.36, 95% CI 2.79-25.05; P<0.001).Conclusion: The present findings help to identify at-risk populations less likely to receive the HPV vaccine. [ABSTRACT FROM AUTHOR]

The value, preliminary results, and key principles of girl‐centered campaigns supporting the HPV vaccine in resource‐limited countries are discussed. [ABSTRACT FROM AUTHOR]

Policy Points: Policymakers in the United States should consider expanding pharmacy practice laws to allow pharmacists to vaccinate adolescents as a way to improve geographic access to adolescent vaccines, particularly for human papillomavirus (HPV) vaccine, which has low uptake. Our state‐level analysis showed that pharmacists are more geographically dispersed than primary care physicians in the US state of Texas. Including pharmacists among available adolescent vaccine providers would improve the geographic distribution of vaccine providers, especially in areas with an inadequate number of primary care physicians. Context: The largest disparities in human papillomavirus (HPV) vaccination in the United States are due to geography. One potential way of addressing these disparities is by improving geographic access to HPV vaccination. Two federal panels have recommended including community pharmacists as HPV vaccine providers as a strategy to improve opportunities for HPV vaccination for adolescents. We sought to evaluate whether community pharmacists can improve the number of vaccine providers in areas with primary care physician shortages in the US state of Texas. Methods: We gathered publicly available physician and pharmacist 2016 workforce data from the Texas Medical Board and Board of Pharmacy. We conducted geospatial analysis of census tracts to analyze the distribution of physicians and pharmacists and how pharmacists change vaccine provider coverage across the state. Findings: Census tracts with high numbers of physicians per capita tended to be located near one another, in 5 of 5 analyses of Moran's I (median = .04). In contrast, pharmacist rates were not spatially dependent on census tract in any of our analyses. If pharmacists were added to primary care physicians as vaccine providers, 35% of urban census tracts that previously had inadequate coverage would be adequately covered, while 18% of inadequately covered rural census tracts would become adequately covered. Overall, when pharmacists were included with primary care physicians as vaccine providers, vaccine providers per capita increased in 2,413 of the 4,508 urban census tracts (54%), while the rate increased in 223 of 746 rural census tracts (30%). Conclusions: Pharmacists are more geographically dispersed across census tracts than primary care physicians. As a result, adding pharmacists to the workforce would increase the availability of vaccine providers in areas with inadequate primary care provider coverage. [ABSTRACT FROM AUTHOR]

In Québec province in Canada, a public school‐based and catch‐up HPV vaccination programs with the quadrivalent vaccine have been introduced in September 2008 for girls aged 9‐17 years. We assessed the early impact of the HPV vaccination program on the incidence of anogenital warts (AGW) in the Quebec general population. We used the provincial health administrative data of the Régie de l'assurance maladie du Québec (RAMQ). AGW were identified either through a prescription of podofilox, or a medical procedure code specific to AGW, or a diagnostic code for viral warts followed by a prescription of imiquimod or fluorouracil. Sex‐ and age‐specific incidence rates were calculated for pre‐vaccination (2004‐2007) and vaccination (2009‐2012) periods. We found a significant decline of 45% and 19% in the incidence of AGWs among females aged 15‐19 and 20‐24 years, respectively. A decline of 21% was also seen among males aged 15‐19 years. The median age at an episode of AGW increased from 27 years in 2004 to 31 years in 2012 among females and remained stable in males. Our findings indicate that the HPV public vaccination program is associated with an important reduction in the incidence of AGW among young females and males. The benefit is more pronounced among females 15‐19 years of age, who were eligible for the public vaccination program. The observed decline among young males could be due to herd immunity and/or privately paid vaccination. [ABSTRACT FROM AUTHOR]

ABSTRACT: Host factors such as nutritional status and immune cell state are important for vaccine efficacy. Inflammasome activation may be important for triggering vaccine‐induced humoral and cell‐mediated immune responses. Formulations with alum as a typical adjuvant to overcome the effects of host factors have recently been shown to induce inflammasome activation, which augments vaccine efficacy. Apoptosis‐associated speck‐like protein containing a caspase recruitment domain (ASC) is one of the main components of inflammasomes, but it is not clear whether ASC affects the vaccine‐induced immune response. Herein, we used two types of vaccines: inactivated influenza vaccine not formulated with alum, and HPV vaccine formulated with alum. We gave the vaccines to ASC knockout (ASC−/−) mice to investigate the role of ASC in vaccine efficacy. Influenza vaccine‐immunized ASC−/− mice did not show antibody titers in week 2 after the first vaccination. After boosting, the antibody titer in ASC−/− mice was about half that in wild type (WT) mice. Furthermore, a cytotoxic T‐lymphocyte response against influenza vaccine was not induced in ASC−/− mice. Therefore, vaccinated ASC−/− mice did not show effective protection against viral challenge. ASC−/− mice immunized with alum‐formulated HPV vaccine showed similar antibody titers and T‐cell proliferation compared with immunized WT mice. However, the HPV vaccine without alum induced up to threefold lower titers of HPV‐specific antibody titers in ASC−/− mice compared with those in WT mice. These findings suggest that alum in vaccine can overcome the ASC‐deficient condition. [ABSTRACT FROM AUTHOR]

Background: The human papillomavirus (HPV) is associated with the diagnosis of anal, penile, and oropharyngeal cancers in men. Evidence indicates that correct condom use in addition to obtaining the HPV vaccine provides the greatest protection from HPV infections.Objective: To explore young men's beliefs and behavioral intention in relation to receiving the HPV vaccine and using a condom correctly and consistently for sexual contact.Methods: A cross-sectional study underpinned by the theory of planned behavior (TPB) was conducted with male participants (n = 359, 18-28 years) who completed an online survey. Descriptive, correlational, and hierarchical regression analyses were performed on both status variables and variables of the TPB.Results: Subjective norms (β = 0.519, P < .001) was identified as the most influential predictor in relation to men's intention to receive the HPV vaccine, while relationship status (β = -0.215, P < .001) and attitudes (β = 0.394, P < .001) presented as the most significant predictors of intention to use a condom. Summarily, 51% of the variance in intention to receive the HPV vaccine and 44% in intention to use a condom were explained by the TPB model.Conclusion: Results from this study will impact on future sexual health research, education programs, and interventions for both HPV preventative behaviors towards the elimination of HPV-related cancers in men. [ABSTRACT FROM AUTHOR]