Compulsory human papillomavirus (HPV) vaccination of young girls has been proposed as a public health intervention to reduce the threat of the disease. Such a program would entail a symbiotic relationship between scientific interests in reducing mortality and morbidity and philosophical interests in promoting morality. This proposal raises the issue of whether government should use its police powers to restrict liberty and parental autonomy for the purpose of preventing harm to young people. I reviewed the scientific literature that questions the value of a HPV vaccination. Applying a principle-based approach to moral reasoning, I concluded that compulsory HPV vaccinations can be justified on moral, scientific, and public health grounds.
In: Bulletin of the World Health Organization: the international journal of public health = Bulletin de l'Organisation Mondiale de la Santé, Volume 90, Issue 8, p. 623-628
In Lao People's Democratic Republic (PDR), we detected 7 patients infected with Centrocestus formosanus (1��122 adult specimens) after praziquantel treatment and purgation, together with several other trematode species including Opisthorchis viverrini and Haplorchis taichui. The patients were all men, 23��42 yr-of-age. Three subjects were from Vientiane Municipality and 1 each were from Khammouane, Saravane, Champassak, and Xiengkhouang Province. The patients had frequently eaten raw freshwater fish and were experiencing variable degrees of epigastric pain and indigestion accompanied by occasional diarrhea, although the relationship of these symptoms with C. formosanus infection was unclear. Centrocestus formosanus specimens were ovoid, 0.46 mm (0.41��0.52 mm) long, and 0.18 mm (0.16��0.20 mm) wide (n = 10) and were equipped with 32 circumoral spines on the oral sucker. The uterine eggs were 33.2 關m long (31.8��34.9 關m) and 18.5 關m wide (17.4��19.8 關m) (n = 20). Analysis of the nucleotide sequence of the 18S ribosomal RNA gene of our specimens (Laotian isolate) revealed 100% homology with that of an isolate from the United States reported in GenBank. Several species of freshwater fish collected from Xiengkhouang Province revealed a 17.0% prevalence (9 of 53 fish examined) for C. formosanus metacercariae. The results suggest that human C. formosanus infections have been masked by other trematode infections. ; open
Vaccination against human papillomavirus (HPV) is recommended to prevent cervical cancer among women, but the benefits of HPV vaccination for males are less obvious. This study characterized HPV acquisition among male military members by evaluating both seroprevalence at entry into service and seroincidence of HPV infection after ten years of service. At entry, 29 of 200 (14.6%) male service members were positive for HPV serotypes 6, 11, 16, or 18. Of 199 initially seronegative for at least one of the four HPV serotypes, 68 (34.2%) seroconverted to one or more serotypes at ten years; more than one-third of these were seropostive for oncogenic HPV serotypes. This estimate of HPV seroprevalence among male military accessions is higher than that reported among U.S. civilian males. Vaccination to prevent genital warts and cancers resulting from HPV infection may decrease health care system burdens. Further analyses are warranted to understand the potential costs and benefits of a policy to vaccinate male service members.
Analysis of pathogen genome data sequenced from clinical and historical samples has made it possible to perform phylogenetic analyses of sexually transmitted infections on a global scale, and to estimate the diversity, distribution, and coevolutionary host relationships of these pathogens, providing insights into pathogen emergence and disease prevention. Deep-sequenced pathogen genomes from clinical studies and ancient samples yield estimates of within-host and between-host evolutionary rates and provide data on changes in pathogen genomic stability and evolutionary responses. Here we examine three groups of pathogens transmitted mainly through sexual contact between modern humans to provide insight into ancient human behavior and history with their pathogens. Exploring ancient pathogen genomic divergence and the ancient viral-host parallel evolutionary histories will help us to reconstruct the origin of present-day geographical distribution and diversity of clinical pathogen infections, and will hopefully allow us to foresee possible environmentally induced pathogen evolutionary responses. Lastly, we emphasize that ancient pathogen DNA research should be combined with modern clinical pathogen data, and be equitable and provide advantages for all researchers worldwide, e.g., through shared data. ; V.N.P. was funded by the European Society of Clinical Microbiology and Infectious Diseases grant and the Ministry of Health, Government of Catalonia (grant SLT002/16/00496). C.J.H. was funded by the NIHR Cambridge Biomedical Research Centre Anti-Microbial Resistance theme. R.F.R. was funded by a National Geographic Society/Waitt Foundation Scientific Exploration Grant (Nr. W420–15) and the University of Pretoria. S.J.U was funded by Oxford Brookes University. ; http://www.mdpi.com/journal/genes ; am2018 ; Biochemistry ; Genetics ; Microbiology and Plant Pathology
Abstract Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl.
Background: Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods: We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results: Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions: Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl.
In Japan, the serious adverse events after human papillomavirus (HPV) vaccination were widely reported in the media. The Ministry of Health, Labour and Welfare of Japan (MHLW) announced the suspension of the governmental recommendation of HPV vaccine in 2013, and the inoculation rate has since sharply declined. The estimated inoculation rate for each birth fiscal year (FY) announced by the MHLW and the actual numbers for each birth FY surveyed by local governments were very different. In particular, the cumulative vaccination rate of girls born in FY2000 was regarded to be as high as 42.9% by the Council of the MHLW. However, this estimation included a confusion. When the suspension of the governmental recommendation was announced in FY2013, the girls born in FY2000 turned 13 years old, the targeted starting age of the HPV vaccination. The vaccination rate of this generation is considered to be quite low. The numbers were recalculated in this study. This study revealed that the real vaccination rate is only 14.3%. Female individuals born in or after FY2000 have been confirmed to be exposed to the same cervical cancer risk as before the HPV vaccine was introduced in Japan.
The prevalence of human papillomavirus (HPV) infections and their role in cervical cancer have been well documented in numerous articles, but it seems that a study in this field in developing countries and the Middle East, including Iran. It's not done. Therefore, the present study was designed and performed to investigate the frequency and genotyping of human papillomavirus in patients by DNA tracking technique. This study was a population-based study in which the frequency and genotyping of human papillomavirus in patients by tracking technique was designed and performed on 534 men and women living in Tehran by DNA tracking technique. Sequences obtained using the NCBI site were analyzed at (http://www.ncbi.nlm.nih.gov/BLAST/LaserGene) and Bio edit software. So that in three low-risk groups including 6 and 11 genotypes, Intermediate risk includes 26-31-33-35-39-40-42-45-49-51-52-53 genotypes -55-56-58-59-66-63-83 and High risk includes 16 and 18 genotypes were divided. According to the results, the prevalence of the papilloma virus in the study population was 21.16%, of which 19.46% were in the high-risk group, 69.89% were in the intermediate-risk group and 50.43% were in the low-risk group. According to the results of the present study, although the prevalence of HPV in the study population is less than in many countries in the world, it is suggested that conducting epidemiological studies in the country to extract the true prevalence and plan to prevent and control this disease.
Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States of America (USA). Cervical cancer is the most common HPV-related cancer, which leads to approximately 4000 deaths yearly in women. Despite the nationwide availability of the HPV vaccine, the coverage and series-completion rates have been historically low due to multiple barriers. Previous systematic literature reviews emphasize global quantitative studies regarding parents of pediatric populations. This study aimed to evaluate qualitative studies conducted in the USA to characterize the facilitators and barriers to HPV uptake among eligible women. Four databases, including PubMed/MEDLINE, Embase, Scopus, and the Cumulative Index for Nursing and Allied Health Literature (CINAHL), were utilized to search the literature for comprehensive qualitative studies from 2014 to 2023 with pre-selected inclusion criteria. This review was conducted in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After detailed full-text extraction, 26 studies met the inclusion criteria, and two authors extracted the data. Three themes emerged from the data: (1) facilitators perceived by women to uptake the HPV vaccine, (2) barriers perceived by women to uptake the HPV vaccine, and (3) barriers and facilitators perceived by women to uptake the HPV vaccine. These themes highlighted different barriers and facilitators to HPV vaccines uptake, such as the lack of healthcare provider recommendation, cost, and safety concerns as barriers to receiving the vaccine. To change the norms towards HPV vaccine hesitancy, the healthcare team has a important opportunity to impart the knowledge and skills known to elicit behavior change.
A polymerase chain reaction was used to evaluate the occurrence of human papillomavirus (HPV) DNA in urine samples compared with that in urethra and cervix samples simultaneously collected with brushes. Of 138 presumably healthy military conscripts, 12 (8%) had HPV DNA-positive urethra samples and 8 (5%) had HPV DNA-positive urine samples. Both the urine and urethra cell samples of five men were positive, with identical types found in the paired specimens. Seven had HPV DNA-positive urethra samples only, and three had HPV DNA-positive urine samples only. Five of 7 urethra samples from males and 11 of 12 urethra samples from females, who were among patients consulting a clinic for adolescents, were positive for HPV DNA. Among those patients whose urethras were positive for HPV DNA, the corresponding urine samples of 3 of the 5 men and all the 11 women were also positive, with one or two HPV types being in common within the paired samples. Among female patients referred to a colposcopy clinic, 49% (241 of 489) of the cervical cell samples and 38% (187 of 489) of the urine specimens were found to be HPV DNA positive. Of the patients whose cervixes were positive for HPV DNA, 65% (158 of 241) of the simultaneously collected urine samples were also positive for HPV DNA. On the other hand, 84% (158 of 187) of the patients with HPV DNA in their urine also had HPV DNA in their cervical samples. Although not all individuals with genital HPV infections could be identified as HPV positive by analysis of urine samples, at least in epidemiological surveys in which invasive samples are difficult to obtain, such as from children, analysis of urine could be an alternative means of identifying HPV DNA.
BACKGROUND: Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. METHODS: We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). RESULTS: Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. CONCLUSIONS: Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl.
ABSTRACTIn the midst of the Covid‐19 pandemic, ethicists, researchers, and journalists have recommended studies that deliberately infect healthy volunteers with the coronavirus as a scientific means of expediting vaccine development. In this essay, we trace the history of infection challenge experiments and reflect on the Nuremberg Code of 1947, issued in response to brutal human experiments conducted by Nazi investigators in concentration camps. We argue that the Code continues to offer valuable guidance for assessing the ethics of this controversial form of research, with respect particularly to the acceptable limits to research risks and the social value of research necessary to justify exposing human participants to these risks.
