Human papillomavirus (HPV) is one of the most frequent sexually transmitted infectious agents worldwide, and it is responsible for a significant burden of cancers. The aim of this study was to evaluate HPV knowledge and awareness in a sample of Northeastern Italian adolescents and parental support available to them, in order to highlight potential room for improvement towards optimal HPV vaccination adherence. Between April and May 2018 an observational questionnaire-based study was conducted in 1st year students of secondary upper schools in Udine (Italy). We quantitatively evaluated HPV knowledge, awareness and parental support level of male and female adolescents. The contribution of sociodemographic characteristics to HPV vaccination knowledge and uptake were explored using Chi-Square or Fisher test and multivariate logistic. Knowledge about HPV vaccine resulted to be mostly insufficient among enrolled adolescents, with a worrying proportion of them believing that HPV vaccine was expected to prevent HIV/AIDS. Awareness about their vaccination status was poor, and more than half of them were not involved in HPV vaccine uptake deliberation. Girls performed better than boys in relation to knowledge, awareness and engagement. Our results support the hypothesis that HPV vaccine knowledge and uptake can be affected by some gender bias. Improvements in adolescent health education and vaccination strategies are needed to engage and finally protect both genders from HPV.
Background Human Papillomavirus (HPV) infections show an estimated prevalence of 290 millions of cases worldwide, being the most common viral infection related to the reproductive tract and the main cause of cervical cancer. Being HPV vaccination currently recommended for both genders, we assessed knowledge and attitudes regarding HPV prevention among high school students in Udine, Northern Italy. Methods Between April and May 2018, a sexual and reproductive health anonymous questionnaire was proposed to first-year students in five academic, technical and vocational upper secondary schools of Udine. In particular, students were asked about HPV related diseases, whether they were vaccinated against HPV and how that decision was taken. Data were analyzed by school type and gender using Chi Square Test with α = 0.05. Results A total of 747 questionnaires were collected from 990 students; both genders had a mean age of 14.8±0.9 years, 59% of respondents were males. Technical high school students were 42% of the sample, while 30% came from vocational and 28% from academic high schools. Genital warts and cervical cancer were identified as HPV-related by 8% and 20% of students respectively, the latter more frequently in technical institutes (p = 0.0016) and in females (43% vs 13%, p < 0.001). Almost 54% of students did not know if they were immunized against HPV; academic school students and females declared more frequently to have received at least one vaccine dose compared to others (p < 0.001). Almost two thirds of respondents reported to have undergone vaccination due to a parental decision; parents discussed this choice more frequently with academic students (p = 0.0016) and females (22% vs 14%, p < 0.001). Conclusions Girls and technical school students are more informed about HPV, while adherence to immunization schedules is higher in females and those attending academic school. Parents appear to create a supportive environment for females. Key messages The different level of knowledge by gender can be explained by past vaccination campaigns, mainly focused on girls, and by parental proactivity towards females. There is room for improvement in HPV-related knowledge and prevention among both adolescents in general and males in particular as they can play an important role to reduce the burden of HPV.
Issue Despite low healthcare workers (HCWs) vaccination coverage being a risk for hospital outbreaks, vaccine hesitancy is not unusual among HCWs. In Italy vaccinations are strongly recommended for HCWs, but there are few occasions for a dedicated counseling. Aim of the study is to evaluate the effectiveness of a new vaccination service in the academic hospital of Udine (northern Italy) in tackling vaccine hesitancy among HCWs. Description of the problem Available data on HCWs specific antibody titers revealed that in high-risk units, 25% of HCWs were certainly unprotected for at least 1/6 of the vaccine preventable diseases (VPDs): measles, rubella, mumps, varicella, pertussis, hepatitis B; only varicella coverage reached the herd immunity target. Periodic occupational health visit was the only moment to screen for VPDs protection and suggest vaccination, but the following inconvenient procedure of HCWs contacting the vaccination office outside the hospital, often lead to delays or loss. In order to improve vaccination adherence, since June 2019 a dedicated clinic has been set up inside the hospital, making vaccination counseling and administration available every two weeks, with appointments directly given by the occupational doctor. Results From June 2019 to February 2020, a total of 362 appointments were booked for the dedicated vaccination clinic, 69.7% of which actually took place as 252 HCWs actually accessed the service. Hours dedicated to the service activity were 76 hours, distributed over 19 days. Administered vaccination were 322, including 107 MMR (measles, rubella, mumps), 4 MMRV (MMR+varicella), 20 varicella, 64 hepatitis B, 127 DTPa (diphtheria, tetanus, pertussis). Lessons Making the access to vaccination more convenient in term of service location within the hospital and giving the appointment when performing the occupational health visit seems to be helpful in filling the VPDs protection among HCWs gap. Key messages Monitoring immunological status of HCWs and promoting vaccination at occupational health visit would sustain herd immunity protection for susceptible individuals in healthcare settings. The dedicated hospital vaccination clinic and the effective procedure of giving the appointment during the occupational health visit could be helpful in improving HCWs vaccine adherence.
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