BackgroundAustria introduced a school-based gender-neutral human papillomavirus (HPV) immunization program in February 2014. In order to assure high coverage, factors influencing acceptance of the vaccine need to be identified. In this study we aim to assess parents’ attitude and related socio-demographic factors in relation to the newly implemented gender-neutral, school-based HPV Immunization program.MethodsParents of 4th grade school children in 20 randomly selected primary schools were asked to fill out questionnaires on socio-demographic factors and on the level of information and attitude towards HPV infection and HPV vaccine.ResultsA total of 439 parents with 449 vaccine eligible children participated in the study. Fifty nine percent of vaccine eligible girls and 51.8% of eligible boys received the first dose of the vaccine. Fear of side effects and child being too young for the vaccine were the most commonly cited reasons by parents electing not to let child receive the vaccine. Children who had received other school-based vaccines have more than fifteen times higher probability of receiving HPV vaccine. To have received HPV-related information from physicians positively influenced vaccine acceptance (OR (95% CI)=1.60 (1.06–2.43)). Higher paternal (fathers’) educational status significantly increased the chances of a male child to be HPV vaccinated (OR (95% CI)=2.45 (1.29–4.78)).ConclusionDespite the efforts to provide HPV vaccine free-of-costs and as a school-based program, the study found that a significant proportion of vaccine eligible children failed to receive the vaccine. Involvement front line physicians and men with higher educational status may be utilised by public health policy makers in the effort to increase awareness. For a better acceptability of the vaccine, there is a need to consider lifting the age of “eligibility” for the school-based vaccination program.
Many currently used vaccines are less immunogenic and effective in the elderly compared to younger adults due to age-related changes of the immune system. Most vaccines utilized in the elderly contain antigens, with which the target population had previous contact. Therefore, most studies investigating vaccine-induced immune responses in the elderly do not analyze responses to neo-antigen but rather booster responses. It can be hypothesized that age-related differences in the immune response are distinct for primary and recall responses. We therefore aimed to investigate primary and recall responses using the same antigen in young and older adults and chose Hepatitis B vaccine as a model antigen. Young (20–40 years) and elderly (>60 years) healthy volunteers received either a primary series (no prior vaccination) or a single booster shot (documented primary vaccination more than 10 years ago) of the registered vaccine Twinrix. Expression of immunity-related genes was measured before and 1 day after vaccination and antibody titers were determined at several time points with a long-term follow-up 6 months after the last vaccination. Antibody responses were lower and seemed to be delayed in the elderly compared to young adults. Non-responders after the 3-dose primary series were more frequent in the elderly group. Antibody titers after booster vaccination increased in all participants. Associations between early expression-profiles on day 1 and antibody responses were found.
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