Dataset Information

Stronger responders-uptake and decline of HPV-vaccination in Denmark.

ABSTRACT: BACKGROUND:The purpose of this study was to identify the stronger responders behind the fluctuating coverage with the HPV-vaccine in Denmark in order to facilitate information campaigns targeted at specific subgroups. METHODS:Newspaper articles published from 2006 to 2009 with information about coverage with the HPV-vaccine in Denmark were identified from the database Infomedia.dk. Vaccination coverage of recent years was retrieved from the publically accessible statistics from the State's Serum Institute. Data on average disposable income nationally and for each municipality was retrieved from Statistics Denmark. RESULTS:According to numbers published in newspapers, girls residing in municipalities with a high disposable income were the first ones to secure the HPV-vaccine in Denmark. Years later, at the start of the debate about possible side effects of the HPV-vaccine, the decline in vaccination coverage was slightly steeper for girls from high income municipalities than for girls from low income municipalities. CONCLUSIONS:Girls from municipalities with a high disposable income seem to be the stronger responders of the fluctuating coverage with the HPV-vaccine in Denmark. This was the case both during the initial surge in coverage after the vaccine's introduction on the market, and during the later decline following the debate on possible side effects. Identification of this dispersion pattern enables health authorities to initiate targeted information campaigns.

SUBMITTER: Lubker CL

PROVIDER: S-EPMC6532829 | biostudies-other | 2019 Jun

REPOSITORIES: biostudies-other

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Stronger responders-uptake and decline of HPV-vaccination in Denmark.

Lübker Charlotte Lynderup CL Lynge Elsebeth E

European journal of public health 20190601 3

<h4>Background</h4>The purpose of this study was to identify the stronger responders behind the fluctuating coverage with the HPV-vaccine in Denmark in order to facilitate information campaigns targeted at specific subgroups.<h4>Methods</h4>Newspaper articles published from 2006 to 2009 with information about coverage with the HPV-vaccine in Denmark were identified from the database Infomedia.dk. Vaccination coverage of recent years was retrieved from the publically accessible statistics from th ...[more]

PMID: 30412236

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Project description:Highlights • 19 studies which utilized mHealth interventions to improve HPV vaccination outcomes.• Interventions recorded positive but not always statistically significant outcomes.• Limitations of the included studies indicate that further research is needed. The objective of this review was to synthesize existing evidence on mobile health (mHealth) interventions geared at improving HPV related knowledge, HPV vaccination intent and HPV vaccination uptake. Between November and December 2019, systematic searches were performed in the databases PubMed, Ebsco/CINAHL, Ebsco/PsycINFO, and Clarivate Analytics/Web of Science Social Science Citation Index (SSCI). We identified 805 articles of which 92 were eligible for inclusion after abstract screening. 19 articles met the inclusion criteria of the review based on full article review and all but one of the included interventions were conducted in the United States. mHealth interventions ranged from text messages, phone calls to interactive voice recordings and software on tablets. All four interventions which attempted to improve HPV knowledge and vaccination intent, reported positive findings, however, only two interventions reported statistically significant improvements between intervention and control groups. 14 interventions reported an increase in HPV vaccination uptake and vaccination series completion among the intervention groups; including when mHealth interventions were compared to control groups or non-mHealth interventions. Some factors noted in the successful interventions included frequency of messages, combinations of multiple interventions including in-person education session, written educational materials, texts alongside call or emails; tailored messages as well as participant’s intent to vaccinate at baseline. mHealth interventions potentially show promise as tools in improving short-term vaccination knowledge, intent, and uptake of HPV vaccination. There is however a need to refine components which can promote mHealth interventions’ success as well as for the evaluation of such interventions in different contexts and over time.

Project description:BackgroundVaccines against HPV16/18 are approved for use in females and males but most countries currently have female-only programs. Cultural and geographic factors associated with HPV vaccine uptake might also influence sexual partner choice; this might impact post-vaccination outcomes. Our aims were to examine the population-level impact of adding males to HPV vaccination programs if factors influencing vaccine uptake also influence partner choice, and additionally to quantify how this changes the post-vaccination distribution of disease between subgroups, using incident infections as the outcome measure.MethodsA dynamic model simulated vaccination of pre-adolescents in two scenarios: 1) vaccine uptake was correlated with factors which also affect sexual partner choice ("correlated"); 2) vaccine uptake was unrelated to these factors ("unrelated"). Coverage and degree of heterogeneity in uptake were informed by observed data from Australia and the USA. Population impact was examined via the effect on incident HPV16 infections. The rate ratio for post-vaccination incident HPV16 in the lowest compared to the highest coverage subgroup (RR(L)) was calculated to quantify between-group differences in outcomes.ResultsThe population-level incremental impact of adding males was lower if vaccine uptake was "correlated", however the difference in population-level impact was extremely small (<1%) in the Australia and USA scenarios, even under the conservative and extreme assumption that subgroups according to coverage did not mix at all sexually. At the subgroup level, "correlated" female-only vaccination resulted in RR(L)= 1.9 (Australia) and 1.5 (USA) in females, and RR(L)= 1.5 and 1.3 in males. "Correlated" both-sex vaccination increased RR(L) to 4.2 and 2.1 in females and 3.9 and 2.0 in males in the Australia and USA scenarios respectively.ConclusionsThe population-level incremental impact of male vaccination is unlikely to be substantially impacted by feasible levels of heterogeneity in uptake. However, these findings emphasize the continuing importance of prioritizing high coverage across all groups in HPV vaccination programs in terms of achieving equality of outcomes.

Project description:BackgroundPublic trust in the human papilloma virus (HPV) vaccination programme has been challenged by reports of potential severe adverse effects. The reported adverse symptoms were heterogeneous and overlapping with those characterised as chronic fatigue syndrome (CFS) and have been described as CFS-like symptoms. Evidence suggests that CFS is often precipitated by an infection. The aim of the study was to examine if an infection in temporal proximity to HPV vaccination is a risk factor for suspected adverse effects following HPV vaccination.Methods and findingsThe study was a nationwide register-based cohort study and case-crossover analysis. The study population consisted of all HPV vaccinated females living in Denmark, born between 1974 and 2006, and vaccinated between January 1, 2006 and December 31, 2017. The exposure was any infection in the period ± 1 month around time of first HPV vaccination and was defined as (1) hospital-treated infection; (2) redemption of anti-infective medication; or (3) having a rapid streptococcal test done at the general practitioner. The outcome was referral to a specialised hospital setting (5 national HPV centres opened June 1, 2015) due to suspected adverse effects following HPV vaccination. Multivariable logistic regression was used to estimate the association between infection and later HPV centre referral. The participants were 600,400 HPV-vaccinated females aged 11 to 44 years. Of these, 48,361 (9.7%) females had a hospital-treated infection, redeemed anti-infective medication, or had a rapid streptococcal test ± 1 month around time of first HPV vaccination. A total of 1,755 (0.3%) females were referred to an HPV centre. Having a hospital-treated infection in temporal proximity to vaccination was associated with significantly elevated risk of later referral to an HPV centre (odds ratio (OR) 2.75, 95% confidence interval (CI) 1.72 to 4.40; P < 0.001). Increased risk was also observed among females who redeemed anti-infective medication (OR 1.56, 95% CI 1.33 to 1.83; P < 0.001) or had a rapid streptococcal test (OR 1.45, 95% CI 1.10 to 1.93; P = 0.010). Results from a case-crossover analysis, which was performed to adjust for potential unmeasured confounding, supported the findings. A key limitation of the study is that the HPV centres did not open until June 1, 2015, which may have led to an underestimation of the risk of suspected adverse effects, but stratified analyses by year of vaccination yielded similar results.ConclusionsTreated infection in temporal proximity to HPV vaccination is associated with increased risk for later referral with suspected adverse vaccine effects. Thus, the infection could potentially be a trigger of the CFS-like symptoms in a subset of the referred females. To our knowledge, the study is the first to investigate the role of infection in the development of suspected adverse effects after HPV vaccination and replication of these findings are needed in other studies.

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Stronger responders-uptake and decline of HPV-vaccination in Denmark.

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Stronger responders-uptake and decline of HPV-vaccination in Denmark.

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