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The COVID-19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID-19 pandemic., (© 2021 Wiley Periodicals LLC.)

Purpose: To discover the prevalence of pica, the documentation of pica on medical records, and any relationship of pica to pregnancy outcomes in rural socioeconomically disadvantaged pregnant women., Study Design and Methods: Prospective, descriptive, correlational investigation with 128 women who sought prenatal care from two rural community health agencies. Demographic and sociocultural variables, pica practices, pica substances ingested, and pregnancy outcomes were collected., Results: Thirty-eight percent of these pregnant women practiced pica. African-American women reported practicing pica more often than other ethnicities. Substances ingested included ice (>1 cup/day), freezer frost, laundry starch, cornstarch, clay dirt, and baked clay dirt. Polypica (ingestion of more than one substance) was practiced by 11 women. Women practicing pica were more likely to have been underweight prior to pregnancy, and smoked fewer cigarettes. Women reporting daily pica practice were significantly more likely to have lower prenatal hematocrits than women who did not practice pica, or who practiced pica less frequently than daily. No specific pregnancy complication was associated with the practice of pica., Clinical Implications: Pica exists, and might be more common than healthcare providers assume. Although this study did not show specific pregnancy complications associated with pica, other studies have shown anemia and lead poisoning among women who practice pica. It is not clear that patients volunteer information about pica, so it would be helpful if nurses queried patients at each prenatal visit regarding pica practice. Discussion of pica practices should be based on a nonjudgmental model, for pica may have strong cultural implications, and may be practiced for cultural reasons unknown to the nurse.