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Vaccines
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Vaccine Strategies for HPV-Related Cancers
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Vaccine Strategies for HPV-Related Cancers

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Papillomavirus Vaccines".

Deadline for manuscript submissions: 1 November 2024 | Viewed by 12956

Special Issue Editor

Prof. Dr. Diane M. Harper

E-Mail Website
Guest Editor
1. Departments of Family Medicine and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
2. Department of Biomedical Engineering, U-M College of Engineering, University of Michigan, Ann Arbor, MI, USA
3. Department of Women's and Gender Studies, U-M College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
Interests: HPV associated diseases; screening and prevention of cervical cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Human papillomavirus (HPV) vaccines were purposefully designed to cover HPV 16 and 18, which are associated with about 70% of cervical cancers and about 90% of HPV-associated head & neck and anal cancers. Enough time has elapsed to see early indicators of the reduction in cancers associated with HPV. Other types of HPV will be clinically unmasked as the natural infection types are blocked. Following the change in distribution of HPV types causing the associated cancers will be important to note so that the modeling studies for future prognostic health planning can be modified. HPV vaccine administration appears to be sufficient at one dose for children 9 years of age. Increasing population coverage with a single dose offers more efficiency and equity in vaccine distribution. Understanding person-level and population-level barriers and facilitators to the original vaccine uptake are needed. Separately, the development of pan-HPV vaccines as the next generation vaccine is imperative. Continuing to leave oncogenic HPV types out of the vaccine perpetuates HPV-associated cancer inequities.

Dr. Diane M. Harper
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HPV vaccine uptake
  • single dose immunization
  • clinical unmasking
  • HPV-associated cancers

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Published Papers (10 papers)

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Research

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13 pages, 2104 KiB  
Article
Our Daughters—Ourselves: Evaluating the Impact of Paired Cervical Cancer Screening of Mothers with HPV Vaccination for Daughters to Improve HPV Vaccine Coverage in Bamako, Mali
by Tiffani Crippin, Karamoko Tounkara, Hayley Munir, Eliza Squibb, Caroline Piotrowski, Ousmane A. Koita, Ibrahima Teguété and Anne S. De Groot
Vaccines 2024, 12(9), 1019; https://doi.org/10.3390/vaccines12091019 - 6 Sep 2024
Viewed by 400
Abstract
Cervical cancer (CC) is the second most common cancer in Western Africa, accounting for 12,000 cases and 6000 deaths annually. While vaccination against human papilloma virus (HPV) and CC screenings reduce the incidence and mortality of CC in many developed countries, 90% of [...] Read more.
Cervical cancer (CC) is the second most common cancer in Western Africa, accounting for 12,000 cases and 6000 deaths annually. While vaccination against human papilloma virus (HPV) and CC screenings reduce the incidence and mortality of CC in many developed countries, 90% of CC deaths are in low-income countries. Lack of knowledge about the connection between HPV and CC, lack of access to vaccines and screenings, weak healthcare infrastructure, and stigma related to sexually transmitted diseases are among the factors that contribute to this disparity. Previously, we evaluated the knowledge of HPV and CC in Bamako, Mali, showing that knowledge of the link between HPV and CC was very low (less than 8% of participants) and that less than 3% of women were screened for CC. Subsequent implementation of a community-based education program and support for local clinics resulted in a five-fold increase in CC screening at the five participating clinics in 2015. In this study, we paired CC screenings of mothers with HPV vaccination of their daughters to target out-of-school (OOS) girls whom school-based vaccination campaigns would not reach. Our campaign resulted in a 10.7% increase in HPV vaccination. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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18 pages, 594 KiB  
Article
Multiple Messaging Strategies for Increasing HPV Vaccination Intentions among English- and Spanish-Speaking Parents in the United States and Mexico
by Matthew S. McGlone, Keri K. Stephens, Mian Jia, Carolyn Montagnolo and Yifan Xu
Vaccines 2024, 12(6), 650; https://doi.org/10.3390/vaccines12060650 - 11 Jun 2024
Viewed by 1080
Abstract
The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on English- and Spanish-speaking parents’ reported intention to vaccinate their children for HPV. An online experiment was conducted to examine the impact [...] Read more.
The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on English- and Spanish-speaking parents’ reported intention to vaccinate their children for HPV. An online experiment was conducted to examine the impact of the strategies. In a fractional factorial design, participating parents (N = 1663) were exposed to combinations of influence strategies in text messages presented as reminders they might receive from a healthcare provider about their child’s eligibility for the vaccine series. The results indicated small but significant impacts of agency assignment, enhanced active choice, and deviance regulation marking on parents’ reported vaccination intentions. The study adds to the research literature on HPV vaccination communication in two important respects. First, it demonstrated how incorporating evidence-based influence strategies into reminder messages can increase parents’ vaccination intentions, an important precursor and predictor of actual vaccine uptake. Second, it sets an important precedent by examining the effects of influence strategies on vaccination intentions across different languages. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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21 pages, 3671 KiB  
Article
Preclinical Immunogenicity and Efficacy Studies for Therapeutic Vaccines for Human Papillomavirus-Type-16-Associated Cancer
by Mohsen Mohammadi, Amara Saha, Wynetta Giles-Davis, Zhiquan Xiang, Mikhail Novikov, Mohadeseh Hasanpourghadi and Hildegund C. J. Ertl
Vaccines 2024, 12(6), 616; https://doi.org/10.3390/vaccines12060616 - 4 Jun 2024
Viewed by 1125
Abstract
The objective of this study was to conduct preclinical immunogenicity and efficacy studies with several therapeutic vaccines for human papillomavirus (HPV)-16-associated cancers expressing the early antigens E5, E6, and E7 with or without E2. The viral oncoproteins were either expressed by themselves as [...] Read more.
The objective of this study was to conduct preclinical immunogenicity and efficacy studies with several therapeutic vaccines for human papillomavirus (HPV)-16-associated cancers expressing the early antigens E5, E6, and E7 with or without E2. The viral oncoproteins were either expressed by themselves as fusion proteins or the fusion proteins were inserted genetically into herpes simplex virus (HSV)-1 glycoprotein D (gD) which, upon binding to the herpes virus entry mediator (HVEM), inhibits an early T cell checkpoint mediated by the B and T cell mediator (BTLA). This, in turn, lowers the threshold for T cell activation and augments and broadens CD8+ T cell responses to the antigens. The fusion antigens were expressed by chimpanzee adenovirus (AdC) vectors. Expression of the HPV antigens within gD was essential for vaccine immunogenicity and efficacy against challenge with TC-1 cells, which express E7 and E6 of HPV-16 but neither E5 nor E2. Unexpectedly, inclusion of E2 increased both CD8+ T cell responses to the other oncoproteins of HPV-16 and the effectiveness of the vaccines to cause the regression of sizable TC-1 tumors. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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16 pages, 269 KiB  
Article
Selecting and Tailoring Implementation Strategies to Improve Human Papillomavirus Vaccine Uptake in Zambia: A Nominal Group Technique Approach
by Mwansa Ketty Lubeya, Mulindi Mwanahamuntu, Carla J. Chibwesha, Moses Mukosha and Mary Kawonga
Vaccines 2024, 12(5), 542; https://doi.org/10.3390/vaccines12050542 - 15 May 2024
Viewed by 1074
Abstract
The human papillomavirus (HPV) vaccine is effective in cervical cancer prevention. However, many barriers to uptake exist and strategies to overcome them are needed. Therefore, this study aimed to select and tailor implementation strategies to barriers identified by multiple stakeholders in Zambia. The [...] Read more.
The human papillomavirus (HPV) vaccine is effective in cervical cancer prevention. However, many barriers to uptake exist and strategies to overcome them are needed. Therefore, this study aimed to select and tailor implementation strategies to barriers identified by multiple stakeholders in Zambia. The study was conducted in Lusaka district between January and February 2023. Participants were purposively sampled from three stakeholder groups namely, adolescent girls, parents, and teachers and healthcare workers. With each of the stakeholders’ groups (10–13 participants per group), we used the nominal group technique to gain consensus to tailor feasible and acceptable implementation strategies for mitigating the identified contextual barriers. The identified barriers included low levels of knowledge and awareness about the HPV vaccine, being out of school, poor community sensitisation, lack of parental consent to vaccinate daughters, and myths and misinformation about the HPV vaccine. The lack of knowledge and awareness of the HPV vaccine was a common barrier across the three groups. Tailored strategies included conducting educational meetings and consensus-building meetings, using mass media, changing service sites, re-examining implementation, and involving patients/consumers and their relatives. Our study contributes to the available evidence on the process of selecting and tailoring implementation strategies to overcome contextual barriers. Policymakers should consider these tailored strategies to mitigate barriers and improve HPV vaccine uptake. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
14 pages, 1448 KiB  
Article
Human Papilloma Virus Vaccination and Cervical Screening in the Italian Regions: An Overview of the Current State of the Art
by Angela Bechini, Claudia Cosma, Giulia Di Pisa, Alice Fanfani, Giulia Ionita, Davide Liedl, Carla Lunetta, Linda Martorella, Silvia Mele, Lorenzo Stacchini, Gabriele Vaccaro, Ornella Zuccaro, Stefano Valente, Gian Marco Prandi, Paolo Bonanni and Sara Boccalini
Vaccines 2024, 12(5), 504; https://doi.org/10.3390/vaccines12050504 - 7 May 2024
Viewed by 1243
Abstract
Human Papilloma Virus (HPV) infection and HPV-related cancers can be prevented through vaccinations and mass cervical screening programmes. The Ministry of Health in Italy provides recommendations on primary and secondary prevention of HPV-related diseases, but the 19 Italian regions and 2 autonomous provinces [...] Read more.
Human Papilloma Virus (HPV) infection and HPV-related cancers can be prevented through vaccinations and mass cervical screening programmes. The Ministry of Health in Italy provides recommendations on primary and secondary prevention of HPV-related diseases, but the 19 Italian regions and 2 autonomous provinces have organisational and decision-making autonomy, with differences in the strategies for offering prevention. The aim of this study is to describe the HPV vaccination and cervical screening offered in all Italian regions. Regional official documents up until 31 December 2021 were first identified. Subsequently, primary and secondary prevention experts from each region were interviewed to validate the previously collected data. The National Immunisation Plan (NIP) 2017–2019 recommends HPV vaccination from the age of 11 for both sexes, with a coverage target of 95%. HPV vaccination is offered free of charge or co-payment. All regions have screening programmes for cervical cancer, using PAP or HPV-DNA tests every three to five years. All regions have an electronic registry for vaccination and screening status. All regions have developed awareness-raising campaigns. It is important to harmonise regional policies with the implementation of information systems integration. The collected data could enhance both regional and national public health initiatives, bolstering the resilience of vaccination programs. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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16 pages, 788 KiB  
Article
Understanding Barriers to Human Papillomavirus Vaccination among Parents of 9–10-Year-Old Adolescents: A Qualitative Analysis
by Denny Fe G. Agana-Norman, Monica Martinez Martinez, Manjushree Shanmugasundaram and Abbey B. Berenson
Vaccines 2024, 12(3), 245; https://doi.org/10.3390/vaccines12030245 - 27 Feb 2024
Viewed by 2325
Abstract
HPV vaccination rates remain low among US adolescents, with only 54% completing the series in 2019. The vaccine is recommended at age 11–12 but can be given as early as age 9. Although it has been found that offering the vaccine earlier improves [...] Read more.
HPV vaccination rates remain low among US adolescents, with only 54% completing the series in 2019. The vaccine is recommended at age 11–12 but can be given as early as age 9. Although it has been found that offering the vaccine earlier improves completion rates by age 13, parents remain reluctant to allow their younger children to initiate this vaccine. The purpose of this study was to better understand parental beliefs regarding receipt of the HPV vaccine among their children at ages 9–10. A 40 min phone interview was completed with 21 participants who were asked about their vaccine viewpoints. Even after receiving one-on-one education from a patient navigator, many caretakers expressed inadequate knowledge of the HPV vaccine and limited exposure to both positive and negative influences. The biggest concern was vaccine side effects, often resulting from a lack of medical understanding. Most parents were reluctant to vaccinate their children at a school-based clinic or pharmacy and believed that the government should not mandate HPV vaccination for public school attendance. Our study provides insight into parental beliefs and attitudes about HPV vaccination at age 9–10 years and barriers that need to be addressed. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)

Review

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26 pages, 1838 KiB  
Review
The Clinical Effectiveness of Single-Dose Human Papillomavirus Vaccination
by Wanying Bao, Xinlin He, Yue Huang, Rongyu Liu and Zhengyu Li
Vaccines 2024, 12(9), 956; https://doi.org/10.3390/vaccines12090956 - 23 Aug 2024
Viewed by 736
Abstract
The human papillomavirus (HPV) vaccine was initially approved for a three-dose regimen. Due to resource limitations, budget constraints, low acceptance, and poor adherence, global vaccination coverage is only 15%. A single-dose regimen could simplify logistics, reduce costs, and improve accessibility. However, its clinical [...] Read more.
The human papillomavirus (HPV) vaccine was initially approved for a three-dose regimen. Due to resource limitations, budget constraints, low acceptance, and poor adherence, global vaccination coverage is only 15%. A single-dose regimen could simplify logistics, reduce costs, and improve accessibility. However, its clinical effectiveness remains debatable. This review systematically searched PubMed, Embase, and Cochrane Library, including 42 clinical studies, to assess the effectiveness of a single-dose HPV vaccination for preventing HPV infections, cervical abnormalities, and genital warts. We summarized the effectiveness of bivalent, quadrivalent, and nonavalent vaccines across different age groups and buffer periods, and analyzed the factors contributing to the inconsistency of results. The review also provides insights into designing robust future research to inform single-dose HPV vaccination policies and guidelines, highlighting the need for further research to refine vaccination strategies. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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13 pages, 641 KiB  
Review
Graduate and Health Professional Student Knowledge, Attitudes, Beliefs, and Behavior Related to Human Papillomavirus and Human Papillomavirus Vaccination: A Scoping Review of the Literature
by Joshua Gautreaux, Eric Pittman, Kennedy LaPorte, Jiaxin Yang and Marie Barnard
Vaccines 2024, 12(5), 507; https://doi.org/10.3390/vaccines12050507 - 7 May 2024
Viewed by 1174
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection. Despite a safe and effective vaccine, uptake continues to be suboptimal. Recently, focus has moved to college campuses in an effort to increase vaccination rates. Little is known about the extent of efforts to [...] Read more.
Human papillomavirus (HPV) is a common sexually transmitted infection. Despite a safe and effective vaccine, uptake continues to be suboptimal. Recently, focus has moved to college campuses in an effort to increase vaccination rates. Little is known about the extent of efforts to reach graduate students on college campuses in the United States and the vaccination rates within this subpopulation. This scoping review assessed the literature on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination among graduate and post-baccalaureate professional students in the United States. This review also aims to identify areas for further research to improve institutions’ abilities to create health programming to increase HPV awareness and HPV vaccination coverage on their campuses. Publications focusing on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination in post-baccalaureate students were included. The systematic review of PubMed, CINAHL, and Embase identified 2562 articles, and 56 articles met all inclusion criteria and were included in this scoping review. A majority of the reviewed studies investigated some combination of knowledge, attitudes, behaviors, and beliefs about HPV and the HPV vaccine in students in professional programs such as medicine. Study design approaches were primarily cross-sectional, utilizing web-based survey distribution methods. HPV vaccination status and HPV screening behaviors were primarily measured through participant self-report. There is limited research investigating post-baccalaureate student knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination. There is a need for researchers to further investigate the needs of graduate students to create informative and effective HPV programming. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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15 pages, 317 KiB  
Review
Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors—Opportunity to Address Gaps in Cancer Prevention and Survivorship
by Melissa A. Kluczynski, Elisa M. Rodriguez, Cailey S. McGillicuddy and Nicolas F. Schlecht
Vaccines 2024, 12(2), 114; https://doi.org/10.3390/vaccines12020114 - 24 Jan 2024
Cited by 1 | Viewed by 1648
Abstract
The risks of secondary cancers associated with human papillomavirus (HPV) infection are as much as three times higher for survivors of pediatric, adolescent, and young adult cancer (PYAC) compared to the general population. Despite this, HPV vaccination rates among PYAC survivors remain low. [...] Read more.
The risks of secondary cancers associated with human papillomavirus (HPV) infection are as much as three times higher for survivors of pediatric, adolescent, and young adult cancer (PYAC) compared to the general population. Despite this, HPV vaccination rates among PYAC survivors remain low. Whereas pediatric oncology providers endorse HPV vaccination of PYAC survivors, many lack the resources or opportunities to intervene. The responsibility of HPV vaccination, therefore, falls to primary care providers and practices. This article provides an overview of the challenges with HPV vaccination that are distinct to PYAC survivors and discusses potential strategies to increase HPV vaccine coverage in this population. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)

Other

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9 pages, 18362 KiB  
Brief Report
Commensal HPVs Have Evolved to Be More Immunogenic Compared with High-Risk α-HPVs
by Ranya Guennoun, Anton Alyakin, Hiroshi Higuchi and Shadmehr Demehri
Vaccines 2024, 12(7), 749; https://doi.org/10.3390/vaccines12070749 - 7 Jul 2024
Viewed by 867
Abstract
Commensal human papillomaviruses (HPVs) are responsible for persistent asymptomatic infection in the human population by maintaining low levels of the episomal genome in the stratified epithelia. Herein, we examined the immunogenicity of cutaneotropic HPVs that are commonly found in the skin. Using an [...] Read more.
Commensal human papillomaviruses (HPVs) are responsible for persistent asymptomatic infection in the human population by maintaining low levels of the episomal genome in the stratified epithelia. Herein, we examined the immunogenicity of cutaneotropic HPVs that are commonly found in the skin. Using an in silico platform to determine human leukocyte antigen (HLA)–peptide complex binding affinity, we observed that early genes of cutaneotropic HPV types within the same species can generate multiple conserved, homologous peptides that bind with high affinity to HLA class I alleles. Interestingly, we discovered that commensal β, γ, μ, and ν HPVs contain significantly more immunogenic peptides compared with α-HPVs, which include high-risk, oncogenic HPV types. Our findings indicate that commensal HPV proteins have evolved to generate peptides that better complement their host’s HLA repertoire. Promoting higher control by host T cell immunity in this way could be a mechanism by which HPVs achieve widespread asymptomatic colonization in humans. This work supports the role of commensal HPVs as immunogenic targets within epithelial cells, which may contribute to the immune regulation of the skin and mucosa. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: HPV Vaccination in Pediatric and Young Adult Cancer Survivors – Opportunity to Address Gaps in Cancer Prevention and Survivorship
Author: Schlecht
Highlights: • Despite increased risk for HPV-related secondary cancers among pediatric-and-young-adult cancer (PYAC) survivors, HPV vaccination rates remain low in this population. • Whereas pediatric oncology providers endorse HPV vaccination of PYAC survivors, the responsibility typically remains with primary care providers. • Cancer transition of care models that integrate evidence-based strategies offer an opportunity for increasing HPV vaccination rates among PYAC survivors.

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