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Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination.

ABSTRACT: Adolescent human papillomavirus (HPV) vaccination uptake, as a means of cervical cancer prevention, remains suboptimal with significant racial disparity. A survey study of mothers already engaging in their own cancer screening, at a predominantly black urban site and a predominantly white suburban site, finds that a majority of mothers surveyed support hypothetical mandates for adolescent HPV vaccination three years after the introduction of these vaccines. Enactment of state laws may represent an efficient means to improve HPV vaccination in adolescent daughters of these mothers. Nevertheless, in a sizable minority, maternal perceptions of the HPV vaccine may hinder adherence to these vaccination laws. In these women, tailored interventions directed at these perceptions may be required.

SUBMITTER: Carlos RC

PROVIDER: S-EPMC3166478 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination.

Carlos Ruth C RC Dempsey Amanda F AF Resnicow Ken K Ruffin Mack M Patel Divya A DA Straus Christopher M CM Vanessa K Dalton D

Human vaccines 20110201 2

Adolescent human papillomavirus (HPV) vaccination uptake, as a means of cervical cancer prevention, remains suboptimal with significant racial disparity. A survey study of mothers already engaging in their own cancer screening, at a predominantly black urban site and a predominantly white suburban site, finds that a majority of mothers surveyed support hypothetical mandates for adolescent HPV vaccination three years after the introduction of these vaccines. Enactment of state laws may represent ...[more]

PMID: 21325877

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Project description:IntroductionWHO recommends vaccination against HPV for girls before sexual debut. Uganda started HPV vaccination in 2008 as pilot programs in 2 districts, followed by national roll out in 2015. Despite the availability of vaccines against human papillomavirus (HPV) in Uganda in the period covered by the study, there was reported low HPV vaccine uptake and completion especially of the second dose in Uganda; with little information available on timely completion of HPV vaccine and the associated factors in Uganda. This study was therefore done to determine the HPV vaccine dose 2 completion and describe the possible factors associated with timely HPV vaccine completion and non-completion among girls of age 9-14 years attending the adolescent clinic at Mulago hospital.MethodsA retrospective mixed methods study was conducted in Mulago National Referral hospital adolescent clinic. Data were mainly collected through review of charts and folders for clinic attendance by eligible girls and focus group discussions with eligible girls that completed the 2 doses of HPV vaccine on recommended/scheduled time.ResultsOut of the 201 girls studied, 87 girls (43.3%) had timely completion of the HPV vaccination. Knowledge about HPV infection and HPV vaccine benefits, positive peer influence and healthcare worker recommendation to get vaccinated at health facility level positively influenced timely completion of HPV vaccine. Among barriers to completion of HPV vaccine identified were: inadequate information about HPV infection and HPV vaccine, concerns about HPV vaccine efficacy and safety, unclear communication with adolescents/caregivers from healthcare workers and -stock out of the HPV vaccine.ConclusionTimely completion of the second dose of HPV vaccine among girls attending the adolescent clinic of Mulago hospital was low (at 43.3%) but higher when compared to earlier published reports. Interventions around improved social mobilization, enhanced outreach and static vaccination approach and education of eligible girls on HPV vaccination can help increase vaccine uptake.

Project description:BackgroundIncreasingly, countries have introduced female vaccination against human papillomavirus (HPV), causally linked to several cancers and genital warts, but few have recommended vaccination of boys. Declining vaccine prices and strong evidence of vaccine impact on reducing HPV-related conditions in both women and men prompt countries to reevaluate whether HPV vaccination of boys is warranted.MethodsA previously-published dynamic model of HPV transmission was empirically calibrated to Norway. Reductions in the incidence of HPV, including both direct and indirect benefits, were applied to a natural history model of cervical cancer, and to incidence-based models for other non-cervical HPV-related diseases. We calculated the health outcomes and costs of the different HPV-related conditions under a gender-neutral vaccination program compared to a female-only program.ResultsVaccine price had a decisive impact on results. For example, assuming 71% coverage, high vaccine efficacy and a reasonable vaccine tender price of $75 per dose, we found vaccinating both girls and boys fell below a commonly cited cost-effectiveness threshold in Norway ($83,000/quality-adjusted life year (QALY) gained) when including vaccine benefit for all HPV-related diseases. However, at the current market price, including boys would not be considered 'good value for money.' For settings with a lower cost-effectiveness threshold ($30,000/QALY), it would not be considered cost-effective to expand the current program to include boys, unless the vaccine price was less than $36/dose. Increasing vaccination coverage to 90% among girls was more effective and less costly than the benefits achieved by vaccinating both genders with 71% coverage.ConclusionsAt the anticipated tender price, expanding the HPV vaccination program to boys may be cost-effective and may warrant a change in the current female-only vaccination policy in Norway. However, increasing coverage in girls is uniformly more effective and cost-effective than expanding vaccination coverage to boys and should be considered a priority.

Project description:BACKGROUND:Parental reports are commonly used for adolescent HPV vaccination status but may be subjected to bias. Guided by the Socioecological Framework, our study explores potential multilevel factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status. METHODS:Data from parents of 19,683 adolescents with provider-verified data were analyzed using multilevel modeling. Correlates included adolescent characteristics, parent/household factors, number of providers seen, state-level median income, and state-level HPV vaccine policy. Outcomes included inaccuracy in reporting: vaccine initiation (?1 dose), completion (3 doses), and number of doses. RESULTS:24% and 25% of parents reported initiation and completion inaccurately; 28% under-reported and 11% over-reported number of doses. All adolescent characteristics, parent/household factors, and number of healthcare providers seen were associated with the outcomes. Of note, compared to parents of White adolescents, parents of racial/ethnic minority adolescents were more likely to inaccurately report all outcomes (aOR ranges from 1.43 to 1.76 for initiation, 1.45-1.75 for completion, 1.98-2.05 for under-reporting, and 1.17-1.41 for over-reporting). Households with higher maternal education (aOR?=?0.70, 0.92, 0.79, and 0.80) and income (aOR?=?0.54, 0.62, 0.50, and 0.70) were less likely to inaccurately report initiation, report completion, under-report, and over-report, respectively. Those having seen more providers were less likely to inaccurately report initiation and completion but more likely to over-report number of vaccine doses. DISCUSSION:Being parents of females, older adolescents, and racial/ethnic minority adolescents, having lower material education, and poverty status were associated with higher odds of inaccurately reporting HPV vaccination status. These results have implications for estimates drawn from self-reports. Future research can examine sources of inaccuracies (e.g., social desirability or health literacy); they could also explore solutions (e.g., access to vaccine records) that can help parents accurately report vaccination status. State policy does not appear to have an impact on report accuracy.

Dataset Information

Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination.

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Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination.

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