This study examined parental acceptability of the Human Papilloma Virus (HPV) vaccination among Latino parents. The role that acculturation may play in Latino parents' acceptability of the vaccine was also examined. A survey conceptualized using the Health Belief Model and two acculturation measures were administered to participants (N = 130). Approximately 70% of parents endorsed that they would vaccinate their daughters with the HPV vaccine. A regression analysis revealed that perception of susceptibility, perception of seriousness, perception of benefit, and cues to action significantly predicted parental acceptability, with 57% of the variance accounted by these variables. Acculturation was not a significant predictor of parental acceptability. These results indicate that a large proportion of Latino parents are likely to accept the HPV vaccine and that certain Health Belief Model constructs may predict acceptability in this population. It is important for healthcare providers to understand what factors may predict Latino parents' acceptability to the HPV vaccine given the high rates of cervical cancer among Latina women. Recommendations for future research in this area are provided.

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Indiana University-Purdue University Indianapolis (IUPUI) / Human papillomaviruses (HPVs) are one of the most common causes of sexually transmitted disease in the world. HPVs are divided into high-risk (HR) or low-risk (LR) types based on their oncogenic potential. HPVs 16 and 18 are considered HR types and can cause cervical cancer. HPVs 6 and 11 are classified as LR and are associated with condyloma acuminata (genital warts). Viral proteins of both HR and LR HPVs must be able to facilitate a replication competent environment. The E7 proteins of LR and HR HPVs are responsible for maintenance of S-phase activity in infected cells. HR E7 proteins target all pRb family members (pRb, p107 and p130) for degradation. LR E7 does not target pRb or p107 for degradation, but does target p130 for degradation. Immunohistochemistry experiments on HPV 6 infected patient biopsies of condyloma acuminata showed that detection of p130 was decreased in the presence of the whole HPV 6 genome. Further, the effect of HR HPV 16 E7 and LR HPV 6 E7 on p130 intracellular localization and half-life was examined. Experiments were performed using human foreskin keratinocytes transduced with HPV 6 E7, HPV 16 E7 or parental vector. Nuclear/cytoplasmic fractionation and immunofluorescence showed that, in contrast to control and HPV 6 E7-expressing cells, a greater amount of p130 was present in the cytoplasm in the viii presence of HPV 16 E7. The half-life of p130, relative to control cells, was decreased in the cytoplasm in the presence of HPV 6 E7 or HPV 16 E7, but only decreased by HPV 6 E7 in the nucleus. Inhibition of proteasomal degradation extended the half-life of p130, regardless of intracellular localization. Experiments were also conducted to detect E7-binding partners. Cyclin C and cullin 5 were identified as proteins capable of binding to both HPV 6 E7 and HPV 16 E7. Preliminary experiments showed that decreasing protein levels of p600, a binding partner of both HPV 6 E7 and HPV 16 E7, by RNA interference might affect p130 stability. Elucidating the mechanisms of p130 degradation may identify potential targets for preventing degradation of p130 and allowing restoration of cell cycle control.

Thesis (MPH.) -- University of Limpopo, 2020 / The South African government provides human papillomavirus (HPV) vaccination to public school girls for free. The study aimed to investigate knowledge, attitudes and practices towards HPV vaccination, of caregivers of girls aged ≥9 years in grade 4 to 7 attending private schools in South Africa. Objectives included determining levels of knowledge; describing attitudes; describing practices; and investigating levels of knowledge and attitudes of caregivers associated with HPV vaccination coverage in these girls. Turfloop Research Ethics Committee granted ethical clearance. A link to an online survey (Survey Monkey®, USA) was circulated to caregivers via an email to school principals and a Facebook advert. Epi InfoTM was used for data analysis. While 76.5% of caregivers had good knowledge about cervical cancer and HPV vaccination, 45.3% had positive attitudes towards HPV vaccination and 19.4% of the girls were vaccinated. Caregivers with good knowledge were 3.6 (95% CI: 1.6-8.0; p<0.005) times more likely to have vaccinated their daughters/wards, while caregivers with a positive attitude were 5.2 (95% CI: 2.9-9.2; p<0.05) times more likely. The low HPV vaccination uptake is concerning. Results suggest that a positive attitude towards HPV vaccination is a strong predictor of its uptake. / University of Limpopo, Anova Health Institute and National Research Foundation (NRF)

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Healthy People 2020 was launched in December 2010 with a target human papilloma virus (HPV) vaccination rate of 80%. As of 2014, we were well short of this goal, especially among males, for whom the HPV vaccine became recommended in 2011. An estimated 14-20% of adolescent-aged males had completed the vaccine schedule as of 2015. This is particularly problematic in northeast Tennessee, as multiple risk factors for lower vaccination rates are characteristic of the population, including being white and living in the South. Reasons to decline vaccination vary, and usually involve concerns about safety, efficacy, and necessity. Worries about sexual disinhibition from being vaccinated are often cited by opponents. Parents also perceive a lack of benefit from getting the vaccination starting at age 11 before their sons are sexually active. The media and internet are also barriers to appropriate vaccination in males, as previous research has demonstrated that media coverage is more likely to focus on political controversies instead of benefits, and is more likely to emphasize the benefits to females. Research on improving vaccine uptake on males is currently limited. Doctors who appear knowledgeable and are willing to spend time talking about the HPV vaccine for male patients may increase vaccination rates. Other interventions that may also be effective include vaccinating as part of nurse visits or through school programs. Early studies have been mixed on the effect of patient and parent education on vaccine uptake, although a 2015 review demonstrated that most practice- and community-based educational interventions have some positive effect on uptake. The purpose of this project was to improve HPV vaccine uptake among male patients in a family practice residency program through patient and parent education. After informed consent was obtained, the patients and/or their parents were given a handout produced by the CDC highlighting the benefits of vaccination for males. A chart review was done to determine vaccine coverage among males before the intervention instituted in November of 2016. The intervention was completed in August 2017, and a repeat chart review is currently ongoing to determine vaccine coverage in the post-intervention period. Data collection and analysis is ongoing at the time of abstract submission. We expect a statistically significant increase in the number of male patients who have received any doses of vaccine, and in the number who have completed the vaccine series. Future research should involve broadening the intervention to include local family medicine and pediatrician’s offices to increase vaccine uptake in these populations as well.

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Introduction The discovery and continued development of vaccines is arguably one of the most important innovations in human history. Vaccination greatly reduces the worldwide incidence and transmission of diseases, preventing permanent injury and premature death. Mass vaccination campaigns have led to the eradication or partial eradication of severe infectious such as smallpox and polio, have reduced childhood mortality, and has led to an overall increase in average health in the human population globally. Despite the documented benefits of vaccination, vaccine hesitancy is increasing, and the uptake of some vaccines is low. Vaccines have been so successful at preventing disease that portions of the population are now more afraid of the possible side-effects of vaccines then they are of the serious symptoms and maladies that vaccines prevent. Vaccine hesitancy is a serious concern for the global medical community. The incidence of infectious disease is inversely proportional to vaccine uptake; as fewer people are vaccinated against preventable diseases, the frequency at which people get sick increases. A reduction in vaccination rates due to vaccine hesitancy reduces herd immunity, which increases the risk for the whole population, especially immunocompromised individuals who are unable to receive vaccines. Vaccines that protect against high-risk strains of Human Papillomavirus (HPV) have recently been developed and released to the worldwide population. High-risk HPV strains can cause persistent infection and various cancers. Although HPV vaccines have been extensively tested and are recommended by the Centers for Disease Control and Prevention and the World Health Organization, uptake among some demographics is low. Understanding what factors impact HPV vaccine hesitancy can guide the design of effective interventions which can increase vaccine uptake. High HPV uptake will lead to a reduction of HPV associated cancers and reduce the transmission of high-risk subtypes. Research Significance Vaccine hesitancy is a growing challenge for the medical community and could potentially put global health at risk by undermining 200 years of progress towards eliminating infectious diseases. A better understanding of what factors impact vaccine hesitancy allows public health professionals to design better policies and interventions policies and helps primary care providers better address concerns the concerns of their patients. Better understanding of the factors which cause vaccine hesitance can be used to tailor education about vaccines. This leads to higher vaccine uptake and better community health overall. Methodology Electronically distributed surveys and statistical analysis were the primary tools used in this research. Surveys were used to generate data from a sample population, including: demographic factors, attitudes towards vaccination, and intent to vaccinate against HPV. Barriers to HPV vaccine uptake and factors that impact HPV vaccine acceptance were identified through statistical analysis, including confirmatory factor analysis, structural equation modeling, regression and univariate analysis. Findings We found that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Parents who view vaccination positively intend to vaccinate their children against HPV or have already vaccinated their children against HPV. Parents who are somewhat unsure about vaccines are more hesitant about vaccinating their children against HPV. Knowledge about HPV increases intent to vaccinate. We found that traditionally religious parents who felt that religious adherence provided some protection against HPV were more hesitant about HPV vaccinations. We found that both a religious-focused intervention and an education-focused interventions increased parental intent to vaccinate more than a control intervention. Our study of Utah residents confirmed our earlier findings that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Our study also confirmed that knowledge about HPV increases intent to vaccinate. We found that high religious practice negatively impacts parental intent to vaccinate. Cautious sexual attitudes also negatively impact intent to vaccinate against HPV. High religious practice is correlated with cautious sexual attitudes which explains the negative impact of high religious practice on intent to vaccinate. The findings of this research work will be used to inform future religious and educational based interventions in Utah and beyond.