Parental Acceptability of Vaccines for Sexually Transmitted Infections

Rosenthal, Susan L.; Stanberry, Lawrence R.

doi:10.1001/archpedi.159.2.190

Cited by 6 publications

(5 citation statements)

References 13 publications

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Section: Applicationmentioning

confidence: 99%

“…[22][23][24][25] Although fi ndings from our study support the need for disseminating information about the HPV vaccine to primary care clinicians, other counseling factors related to the context of the adolescent encounter may be equally, if not more, important when considering the vaccine's acceptance among patients and their families. 26,27 We have identifi ed 4 potential challenges related to the nature of prospective discussions about HPV infection with younger and older adolescents and their parents.The fi rst challenge relates to the current context in which clinicians report counseling about HPV infection and its implications for discussing the vaccine. Clinicians in our study indicated that they did not often include HPV or cervical cancer prevention in their adolescent anticipatory guidance counseling about STDs; rather, they addressed it as a result of a more acute problem, such as when the patient had abnormal Papanicolaou smear fi ndings.…”

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confidence: 99%

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HPV and Cervical Cancer Prevention Counseling With Younger Adolescents: Implications for Primary Care

Sussman¹,

Helitzer²,

Sanders³

et al. 2007

The Annals of Family Medicine

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PURPOSE Primary care clinicians will continue to play an important role in cervical cancer prevention, particularly with regard to administration of the newly licensed human papillomavirus (HPV) vaccine and continued administration of Papanicolaou tests. Little is known about the factors that infl uence cervical cancer prevention counseling, particularly in the adolescent encounter. We conducted a qualitative study to better understand the implications for counseling about cervical cancer prevention by primary care clinicians who care for adolescents. METHODSWe conducted in-depth interviews with 37 primary care clinicians in New Mexico to understand the context in which they provide anticipatory guidance about sexual health risks as well as their attitudes about counseling for the forthcoming HPV vaccine. RESULTSClinicians identifi ed 4 categories of factors related to their counseling experiences with adolescents about HPV: (1) the need to build rapport with adolescent patients, (2) the presumption that adolescent patients engage in high-risk behaviors, (3) the situational delivery and complexity of HPV counseling, and (4) perceptions of clinician and community receptivity to the HPV vaccine.CONCLUSION Our fi ndings show that conditions of the preadolescent and young adolescent visit pose a challenge to the successful integration of counseling about cervical cancer prevention in primary care. Counseling strategies that are designed to emphasize a preventive focus while including parents in the discussion at the time of vaccination and that are appropriate to populations with different cultural values and beliefs will help to enhance communication about cervical cancer prevention and the particular role of the HPV vaccine. 2007;5:298-304. DOI: 10.1370/afm.723. Ann Fam Med INTRODUCTIONH uman papillomavirus (HPV) ranks as the most commonly acquired sexually transmitted infection in the United States, and infection with HPV is linked to cervical cancer and genital warts.1,2 In June 2006, the fi rst HPV vaccine (Merck) was approved for females aged 9 to 26 years. 3 Shortly after its approval, the National Advisory Committee on Immunization Practices recommended that the vaccine be given to girls aged 11 to 12 years. 4 The approval of the HPV vaccine marks the beginning of a new stage in preventing sexually transmitted diseases (STDs) and their sequelae, in this case cervical cancer. Currently, the hepatitis B vaccine, administered during infancy, is the only existing vaccine that prevents a sexually transmitted disease, although several other STD vaccines are in various stages of development. 3,[5][6] Collectively, these vaccines have the potential to serve as powerful disease prevention weapons against chronic illnesses, including cancer. The availability of these vaccines will have important implicaAndrew L. Sussman, PhD 299CERVIC A L C A NCER PR EVENT ION COUNSELING tions for adolescents who, because they are at higher risk for contracting these diseases, will likely be the targeted recipients for these...

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Section: Applicationmentioning

confidence: 99%

mentioning

confidence: 99%

HPV and Cervical Cancer Prevention Counseling With Younger Adolescents: Implications for Primary Care

Sussman¹,

Helitzer²,

Sanders³

et al. 2007

The Annals of Family Medicine

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“…Research also indicates that parents play an important role in guiding adolescents on the issue of immunization [4,5]. Parental involvement is clearly an important influence in decision-making and also provides more concrete support such as transportation, insurance coverage, and authorization for vaccination to take place (although adolescents are often able to consent to vaccination related to sexually transmitted infections).…”

Section: Statement Of the Problem: Immunizing The Adolescent Populationmentioning

confidence: 99%

“…For example, data indicate that parents will support the use of a vaccine to prevent sexually transmitted infections (STIs) including HPV, especially after receiving education and an understanding of the potential outcomes of the disease [7][8][9][10]. In addition, provider acceptability is important to parents and their adolescent children [5]. Thus, health care professionals need to educate themselves, parents and patients with the goal of promoting the health and well-being of patients regardless of the transmission routes of infection and disease.…”

Section: Statement Of the Problem: Immunizing The Adolescent Populationmentioning

confidence: 99%

Adolescent immunizations: A position paper of the Society for Adolescent Medicine

Middleman

Rosenthal

Rickert

et al. 2006

Journal of Adolescent Health

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“…We do not know at present how long the immunity conferred by these vaccines lasts: ideally, such a vaccine would be administered with other childhood vaccines, removing any link with sexual activity in the minds of parents. 9 However, that would depend on the immunity lasting for decades, or boosters being given. And should we not vaccinate boys as well as girls?…”

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confidence: 99%

Prophylactic vaccines for human papillomavirus: a bright future for cervical cancer prevention

Szarewski

2005

J Med Screen

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Cervical cancer affects nearly half a million women each year, and nearly half of them die of the disease. The greatest problem is in the developing world, though even in the UK around 3000 women develop cervical cancer each year.Infection with certain types of sexually transmitted human papillomavirus (HPV), in particular HPV 16 and HPV 18, is the main cause of cervical cancer. It has been shown that 99.7% of cervical cancers contain HPV DNA. 1HPVs are members of a large family of viruses: the so-called low-risk types (chiefly 6 and 11) are responsible for genital warts, while the high-risk types (mainly 16, 18, 31, 33, 35, 45, 52 and 56) are implicated in cervical cancer. Of these, types 16 and 18 together account for approximately 70-80% of cervical cancers.2 Infection with HPV appears to be extremely common in young people, but is usually transient.3 It appears that the presence of HPV is more meaningful in older women (over 30 years old), who have persistent infection.Screening tests detect cellular abnormalities early, but the ultimate solution to a viral disease is obviously a vaccine. In contrast to most viral vaccines, which are based on an attenuated form of the virus (for example polio vaccine), the development of an attenuated HPV vaccine has been difficult because there is no effective culture system to propagate the virus. An attenuated vaccine could also potentially cause disease in vaccinated subjects, particularly if they were immunocompromised. The solution has therefore been to manufacture virus-like particles (VLPs) using the L1 and/or L2 virus coat proteins. VLPs have the outward appearance of the actual virus and generate a powerful immune response, but as they contain no DNA they are harmless. Another problem is the number of cervical cancer HPV types which need to be included (potentially 15). However, two prophylactic vaccines against types 6, 11, 16 and 18 are showing great promise in clinical trials. 4,5 One of these contains all four HPV types and would thus protect against genital warts (types 6 and 11), as well as the most common cervical cancer HPV types (16 and 18). The other contains types 16 and 18 and thus targets cervical cancer alone. Both vaccines are currently in large, multicentre, worldwide Phase III clinical trials and have shown excellent tolerability, safety and efficacy. So far, the bivalent vaccine appears to be 90-100% effective in preventing both incident and persistent HPV 16 and 18 infection, 4 and similar results have been reported for the quadrivalent vaccine.5 A feature of HPV infection is that the virus is very successful at avoiding the host immune system, and therefore causing natural immunity. Both vaccines, however, probably due to the addition of an adjuvant, result in antibody titres that are enormously (60-100 times) higher and longer lasting (10-16 times higher at 18 months) than those generated by natural infection.4,5 HPV infection and persistence rates are endpoints which are obviously not as robust as cervical cancer rates, but given that there ...

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Parental Acceptability of Vaccines for Sexually Transmitted Infections

Cited by 6 publications

References 13 publications

HPV and Cervical Cancer Prevention Counseling With Younger Adolescents: Implications for Primary Care

HPV and Cervical Cancer Prevention Counseling With Younger Adolescents: Implications for Primary Care

Adolescent immunizations: A position paper of the Society for Adolescent Medicine

Prophylactic vaccines for human papillomavirus: a bright future for cervical cancer prevention

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