The HPV vaccine (Gardasil) is a significant advancement in women’s health that garnered both positive and negative media coverage. Since public opinion and population uptake of the vaccine can be influenced by media coverage, the purpose of this study was to assess the discussion and presentation of risk information about HPV, cervical cancer and the HPV vaccine in Canadian and U.S. newspapers and news magazines. Using directed content analysis, the reporting of fear-inducing messages about HPV, cervical cancer and the HPV vaccine were compared between Canadian and U.S. top-circulating national newspapers between January 2006—December 2007. Significant differences between countries were found in the number of fear messages about cervical cancer (p < 0.05) but not for HPV or the HPV vaccine. Readability was higher than recommended for the public and emotional tone of the articles was progressively negative. Directed content analysis was also used to assess the discussion of risks, fear-inducing messages about HPV, cervical cancer and the HPV vaccine in four high circulating North American news magazines from January 2006—December 2007. Risk messages about HPV and cervical cancer focused on threatening illness or injury and reporting on the HPV vaccine emphasized it being poorly understood by science. Newspaper and news magazine articles on HPV, cervical cancer and the HPV vaccine included fear-inducing messages. Public health officials and health educators need to be aware of media reporting of fear based risk messages in order to alleviate public anxiety and concern about the HPV vaccine.

The HPV vaccine (Gardasil) is a significant advancement in women’s health that garnered both positive and negative media coverage. Since public opinion and population uptake of the vaccine can be influenced by media coverage, the purpose of this study was to assess the discussion and presentation of risk information about HPV, cervical cancer and the HPV vaccine in Canadian and U.S. newspapers and news magazines. Using directed content analysis, the reporting of fear-inducing messages about HPV, cervical cancer and the HPV vaccine were compared between Canadian and U.S. top-circulating national newspapers between January 2006—December 2007. Significant differences between countries were found in the number of fear messages about cervical cancer (p < 0.05) but not for HPV or the HPV vaccine. Readability was higher than recommended for the public and emotional tone of the articles was progressively negative. Directed content analysis was also used to assess the discussion of risks, fear-inducing messages about HPV, cervical cancer and the HPV vaccine in four high circulating North American news magazines from January 2006—December 2007. Risk messages about HPV and cervical cancer focused on threatening illness or injury and reporting on the HPV vaccine emphasized it being poorly understood by science. Newspaper and news magazine articles on HPV, cervical cancer and the HPV vaccine included fear-inducing messages. Public health officials and health educators need to be aware of media reporting of fear based risk messages in order to alleviate public anxiety and concern about the HPV vaccine.

The most common sexually transmitted infection for both males and females is the human papillomavirus (HPV). HPV is responsible for nearly all cervical cancers. Currently, an HPV vaccine is available; however, HPV vaccination rates for US adolescents are dismal. School nurses serve as the person connecting medical and school communities, and are a critical component in assisting families traverse the medical and educational systems. Thus, there is reason to assume school nurses can be key opinion leaders regarding the HPV vaccine. The purpose of this study was to: (1) explain how the Diffusion of Innovations (DOI) theory explains school nurses' roles as opinion leaders regarding the HPV vaccine; (2) document current literature regarding healthcare providers' perspectives and practice regarding the HPV vaccine; and (3) evaluate school nurses' knowledge, attitudes, perceptions of being an opinion leader and professional practice regarding the HPV vaccine for youth. DOI states opinion leaders influence the rate of an innovation (e.g., the HPV vaccine). We argue school nurses are opinion leaders for the HPV vaccine because of their unique leadership position through their cross-disciplinary understanding of the educational and health systems. The systematic literature review included 28 studies of healthcare providers. The main barrier, vaccine cost, was identified in 12 reports. Additionally, females and older adolescents were more frequently vaccinated than males and younger adolescents. To examine school nurses' knowledge, attitudes, perceptions and professional practice regarding the HPV vaccine, the study included a sample of 413 school nurses. Structural equation modeling revealed knowledge influenced attitudes, attitudes affected perceptions and professional practices, and perceptions predicted professional practice. Furthermore, the perceptions variable was found to be a partial mediator in the model. Practitioners designing programs to engage school nurses in disseminating HPV vaccine education may benefit from questioning whether their programs might be emphasizing non-crucial elements for influencing vaccine dissemination practice (e.g., knowledge) and de-emphasizing influential elements such as attitudes and perceptions.

This thesis explores: (1) how young women make decisions about Human Papillomavirus (HPV) vaccination and (2) how they negotiate and evaluate public health discourses that work to promote a responsible female subjectivity to manage the risks of HPV. Public health professionals have promoted HPV vaccination as a responsible and informed choice for young women, whose sexual practices are considered to put them and their sexual partners “at risk” of HPV. I conducted semi-structured interviews with thirteen young women between the ages of 21 and 28. My interviews with women and the public health literature on HPV vaccination reflect cultural and moral priorities regarding the “right” kinds of female sexuality and individual responsibility to manage sexual and reproductive health risks. Many of the women I interviewed were critical of the identification of their sexual practices as putting them and others “at risk” of HPV and maintained that their “safe” sex practices mitigated these risks. All of the women I interviewed prioritized concerns about protecting their reproductive health from cervical cancer over the risks of HPV when discussing their responsibility to be vaccinated. Based on these interviews, I argue that women‟s decisions about HPV vaccination are practices of self-making, through which they strive to enact identities as responsible young women, who endeavour to protect themselves, their bodies and health from harm. These decisions are complex, dynamic and reflect their ability to make competent, informed decisions that are inextricably bound to their social and material circumstances. / Graduate

Bakgrund Humant papillomvirus (HPV) orsakar vårtor och är en vanligt förekommande könssjukdom världen över. Vaccination mot de vanligaste HPV-typerna som kan orsaka kondylom och leda till cancer ingår sedan 2012 i det allmänna vaccinationsprogrammet för flickor och unga kvinnor. Tidigare forskning visar att unga kvinnor trots låg kunskap om viruset, har en positiv inställning till vaccination. Syfte Att undersöka unga vaccinerade kvinnors kunskap om HPV samt deras kunskap om och inställning till HPV-vaccination. Metod En kvalitativ explorativ studie. The Health Belief Model användes som teoretisk modell. Individuella intervjuer med åtta unga kvinnor som vaccinerats mot HPV. Data analyserades med innehållsanalys. Resultat Totalt genomfördes åtta intervjuer med unga kvinnor födda 1993-1998. Tre kategorier skapades: 1) Bristande kunskap om HPV 2) Tillförlitligt skydd mot cancer samt 3) Vaccinet är tillgängligt. Kunskapen om HPV och HPV-vaccin var låg hos de unga kvinnorna. Den främsta anledningen till att de valde att vaccinera sig var rädsla för cancer, andras inflytande till vaccinering, främst från mödrar, en tilltro till hälso- och sjukvården och till vaccinet samt att vaccinet är tillgängligt. Slutsats Det är tydligt att kunskapen om HPV och vaccinet är låg bland de deltagande unga kvinnorna. Inför framtiden behövs anpassad information till unga kvinnor om viruset och vaccinet för att tillgodose behovet av information. Det är viktigt att unga kvinnor som vaccineras mot HPV har kunskap om vaccinet för att veta hur de skyddar sig mot HPV och att de även ska förstå vikten av att gå på gynekologisk cellprovskontroll som en del av prevention av HPV. / Background Human papillomavirus (HPV) cause warts and is a common sexually transmitted infection worldwide. Vaccination against the most common HPV types that can cause genital warts and cancer is implemented in the national vaccination programme for girls and young women since 2012. Previous research shows that young women, despite low knowledge about the virus, are in favour of the vaccine. Objective To explore young vaccinated women’s knowledge about HPV and knowledge and attitudes towards HPV-vaccination. Method An qualitative explorative study. The Health Belief Model was the  theoretical framework. Individual interviews were conducted with young women vaccinated against HPV. Data were analyzed with content analyses. Results In total eight interviews were undertaken with young women born in 1993-1998. Three categories were revealed through the interviews: 1) Lack of knowledge about HPV 2) Reliable protection against cancer and 3) The vaccine is available. The young women had low knowledge about HPV and HPV vaccine. The main reasons for vaccination were; fear of cancer, influence from others, especially the mothers, trust in the healthcare and the vaccine and the vaccine is available. Conclusion The knowledge of HPV and the vaccine was low among the included women. In the future the iformation about the virus and the vaccine needs to be adapted to the young women to provide the need of information. It is important that young women who are vaccinated against HPV have knowledge about the vaccine to be able to protect themselves against HPV and that they are aware of the importance of attending future cervical cancer screening controls as a part of the prevention against HPV.

Analysis of utilisation and spontaneous adverse events reports related to human papillomavirus vaccines Author: Tereza Schrommová Supervisor: PharmDr. Eva Zimčíková, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University INTRODUCTION: HPV vaccination is one of the most effective types of prevention against the human papillomavirus infection that can lower the probability of its incidence up to 80-90 %. Besides the benefits of vaccination, there can also occur among many individuals certain risks and adverse effects. Spontaneous adverse events reports are used to identify these serious and unexpected adverse effects, their monitoring leads to increasing safety of therapy. Drug consumption is monitored to uncover the ratio of population exposure to certain drug during specific time in specific socioeconomic group. OBJECTIVE: The objective of this diploma was analysis of spontaneous adverse events reports of vaccines against the human papillomavirus that are registered in database of State Institute for Drug Control in the period from May 2007 to October 2017. Another aim of this work was to evaluate consumption of HPV vaccines in the Czech Republic in the period from 2006 to 2019 using data from State Institute for Drug Control again. METHODS:...

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Human Papilloma Viruses (HPVs) are a large family of viruses with a capsid constituted by the L1 and L2 proteins, which bind to receptors of the basal epithelial cells, thus promoting virus entry. The majority of sexually active people become exposed to HPV, which is the most common cause of cervical cancer affecting more than 600.000 women every year. Moreover, every year more than 13.000 new cases of HPV-related cancers, including anal, penile and head and neck cancers, are diagnosed in men. Three vaccines are available based on the L1 capsid protein, which self-assembles and forms virus-like particles (VLPs) when expressed in yeast and insect cells. Although very effective, these vaccines are HPV type-restricted, and their costs limit broad vaccination campaigns, especially in low- and middle- income countries. Recently, vaccine candidates based on the conserved L2 epitope from serotypes 16, 18, 31, 33, 35, 6, 51 and 59 were shown to elicit broadly neutralizing anti-HPV antibodies, reaching a protection around 90% against all the HPV serotypes. During my research activity, we have tested whether E. coli Outer Membrane Vesicles (OMVs) could be successfully decorated with L2 polytopes and whether the engineered OMVs could induce neutralizing antibodies. OMVs represent an attractive vaccine platform for their intrinsic adjuvanticity and their low production costs. We show that strings of L2 epitopes could be efficiently expressed on the surface of the OMVs and a polypeptide constituted by the L2 epitopes from serotypes 18, 33, 35 and 59 provided broad cross-protective activity against a large panel of HPV serotypes as judged by the in vitro pseudovirus neutralization assay. In order to better characterize the vesicle and in perspective of future clinical studies of our HPV candidate vaccine, we also worked on the setting-up of a simple and reproducible production process at laboratory scale ready to be transferred at industrial level.Moreover, we focused our attention on the strategy used for the engineering of the OMVs with the L2 epitopes and in particular on the carrier used for the delivery of the fusion construct in the surface of the vesicle. More in detail, since part of the carrier is a human cancer epitope, we tested whether a similar scaffold, with less homologies to the human gene could maintain the same properties in terms of: i) expression level of the fused epitopes in the OMVs, ii) localization on the surface of the vesicle and iii) 9 immunogenicity and efficiency to stimulate the immune system in order to produce anti L2 antibodies. Considering all the results described in this work combined with the points of strength of the OMV-based vaccine platform, as the simplicity of the production process, the yields of vaccine doses and the low cost/dose, our data provide a very promising prototype of universal anti-HPV vaccine.