Modeling the consequences of regional heterogeneity in human papillomavirus (HPV) vaccination uptake on transmission in Switzerland

Riesen, Maurane; García, Victor; Low, Nicola; Althaus, Christian L.

doi:10.1016/j.vaccine.2017.10.103

Cited by 22 publications

(20 citation statements)

References 27 publications

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“…To our knowledge, this study was one of the first to directly assess the prevalence of HPV and the effectiveness of the HPV vaccination directly in the population through the use of self-sampling in Switzerland. The other studies carried out on the subject had a more modeling objective of the prevalence of this infection after the introduction of the HPV vaccination in Switzerland without trying to measure it directly in the population [ 26 ], but one large study with another methodology had shown the same results in another Swiss county [ 27 ].…”

Section: Strength and Limitationsmentioning

confidence: 99%

Prevalence of Vaccine Type Infections in Vaccinated and Non-Vaccinated Young Women: HPV-IMPACT, a Self-Sampling Study

Jeannot

Viviano

Pree

et al. 2018

IJERPH

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Background: The human papillomavirus (HPV) vaccination program for young girls aged 11–26 years was introduced in Switzerland in 2008. The objective of this study was to evaluate the prevalence of high- and low-risk HPV in a population of undergraduate students using self-sampling for monitoring the HPV vaccination program’s effect. Methods: Undergraduate women aged between 18–31 years, attending the Medical School and University of Applied Sciences in Geneva, were invited to participate in the study. Included women were asked to perform vaginal self-sampling for HPV testing using a dry cotton swab. Results: A total of 409 students participated in the study—aged 18–31 years—of which 69% of the participants were vaccinated with Gardasil HPV vaccine and 31% did not received the vaccine. About HPV prevalence, 7.2% of unvaccinated women were HPV 16 or 18 positive, while 1.1% of vaccinated women were infected by HPV 16 or 18 (p < 0.01). Prevalence of HPV 6 and 11 was 8.3% in non-vaccinated women versus 2.1% in vaccinated women (p < 0.02). We observed no cross-protection for the other HPV genotypes of a low- and high-risk strain. Conclusions: Prevalence of HPV 6/11/16/18 was lower in vaccinated women versus unvaccinated women. Continued assessment of HPV vaccine effectiveness in real population is needed.

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Section: Strength and Limitationsmentioning

confidence: 99%

Prevalence of Vaccine Type Infections in Vaccinated and Non-Vaccinated Young Women: HPV-IMPACT, a Self-Sampling Study

Jeannot

Viviano

Pree

et al. 2018

IJERPH

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“…As mentioned, there is regional and linguistic variation regarding vaccination uptake in Switzerland in the setting of different cantonal levels of school vaccination programmes39 78 and health authority support for vaccination programmes 79. On the other hand, we expect the prevalence of vaccine hesitancy and of its determinants to be relatively homogeneous across different geographical and language regions of Switzerland.…”

Section: Methods and Designmentioning

confidence: 99%

“…The most common reasons for women not being vaccinated against HPV, according to a 2014 survey, included being too old, lack of information, fear of side effects, being against vaccination in general or against HPV vaccination only, HPV vaccination felt to be unnecessary, and simple logistical issues,38 with 7% and 6% of women not vaccinated against HPV reporting that the physician or friends/family recommended against HPV vaccine, respectively. Further research has shown that living in cantons with school-based vaccination increases uptake of HPV vaccination 39 40. However, spatial variation modelling has shown that variables such as political opinion, religion and community opinion might be additional determinative factors in the presence of school-based vaccination programmes 40.…”

Section: Introductionmentioning

confidence: 99%

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme

et al. 2019

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IntroductionVaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing study (2017–2021) focuses on biomedical and complementary and alternative medicine (CAM) providers and their patients since healthcare professionals play important roles in vaccination decision-making. This national research programme seeks to assess the sociocultural determinants of vaccine hesitancy regarding childhood and human papillomavirus vaccines in Switzerland. We aim to provide a detailed characterisation of vaccine hesitancy, including CAM and biomedical perspectives, patient–provider interactions, and sociocultural factors, to establish the mediating effects of vaccine hesitancy on underimmunisation, and to design an intervention to improve vaccination communication and counselling among physicians, parents and adolescents.Methods and analysisOur transdisciplinary team employs a sequential exploratory mixed-methods study design. We have established a network of more than 150 medical providers across Switzerland, including more than 40 CAM practitioners. For the qualitative component, we conduct interviews with parents, youth, and biomedical and CAM providers and observations of vaccination consultations and school vaccination information sessions. For the quantitative component, a sample of 1350 parents of young children and 722 young adults (15–26 years) and their medical providers respond to questionnaires. We measure vaccine hesitancy with the Parent Attitudes about Childhood Vaccines 15-item survey and review vaccination certificates to assess vaccination status. We administer additional questions based on findings from qualitative research, addressing communication with medical providers, vaccine information sources and perceptions of risk control vis-à-vis vaccine-preventable diseases. The questionnaires capture sociodemographics, political views, religion and spirituality, and moral foundations.Ethics and disseminationThe study was approved by the local ethics committee. The results will be published in peer-reviewed journals and disseminated to healthcare professionals, researchers and the public via conferences and public presentations.

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“…We developed a mathematical model to describe the spread of nvCT in Sweden (table 1, online supplementary material S1). We implemented the spatial structure of Sweden consisting of 21 counties using a gravity model in a meta-population framework 15–17. We considered the population of Swedish sexually experienced heterosexual adults aged 15–29 years, subdivided into a low and a high sexual activity class (online supplementary figure S1).…”

Section: Methodsmentioning

confidence: 99%

Rise and fall of the new variant of Chlamydia trachomatis in Sweden: mathematical modelling study

et al. 2019

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ObjectivesA new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden in 2006. The nvCT has a plasmid deletion, which escaped detection by two nucleic acid amplification tests (Abbott-Roche, AR), which were used in 14 of 21 Swedish counties. The objectives of this study were to assess when and where nvCT emerged in Sweden, the proportion of nvCT in each county and the role of a potential fitness difference between nvCT and co-circulating wild-type strains (wtCT).MethodsWe used a compartmental mathematical model describing the spatial and temporal spread of nvCT and wtCT. We parameterised the model using sexual behaviour data and Swedish spatial and demographic data. We used Bayesian inference to fit the model to surveillance data about reported diagnoses of chlamydia infection in each county and data from four counties that assessed the proportion of nvCT in multiple years.ResultsModel results indicated that nvCT emerged in central Sweden (Dalarna, Gävleborg, Västernorrland), reaching a proportion of 1% of prevalent CT infections in late 2002 or early 2003. The diagnostic selective advantage enabled rapid spread of nvCT in the presence of high treatment rates. After detection, the proportion of nvCT decreased from 30%–70% in AR counties and 5%–20% in counties that Becton Dickinson tests, to around 5% in 2015 in all counties. The decrease in nvCT was consistent with an estimated fitness cost of around 5% in transmissibility or 17% reduction in infectious duration.ConclusionsWe reconstructed the course of a natural experiment in which a mutant strain of C. trachomatis spread across Sweden. Our modelling study provides support, for the first time, of a reduced transmissibility or infectious duration of nvCT. This mathematical model improved our understanding of the first nvCT epidemic in Sweden and can be adapted to investigate the impact of future diagnostic escape mutants.

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Modeling the consequences of regional heterogeneity in human papillomavirus (HPV) vaccination uptake on transmission in Switzerland

Cited by 22 publications

References 27 publications

Prevalence of Vaccine Type Infections in Vaccinated and Non-Vaccinated Young Women: HPV-IMPACT, a Self-Sampling Study

Prevalence of Vaccine Type Infections in Vaccinated and Non-Vaccinated Young Women: HPV-IMPACT, a Self-Sampling Study

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme

Rise and fall of the new variant of Chlamydia trachomatis in Sweden: mathematical modelling study

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