HPV Frequently Asked Questions (FAQs) for an Adolescent Audience. Geneva Philips Pan American Health Organization

Transcription

1 HPV Frequently Asked Questions (FAQs) for an Adolescent Audience Geneva Philips Pan American Health Organization

2 Importance of HPV FAQs for an Adolescent Audience Combats HPV knowledge gap Offers basic, straightforward information Encourages girls to demand vaccine Encourages girls to share information Corrects misinformation and misconceptions Serves as basis for communication materials Acts as one step in much larger effort Can be added to over time 1

3 Key Differences: Adolescent vs. Health Care Audiences Adolescent Audience: Shorter/fewer sentences No medical jargon Exact data/numbers not necessary Messaging addressing common fears Health Care Provider Audience: Longer/more sentences Assumes certain level of knowledge Complex ideas (i.e., pathogen; mechanisms of action) Exact data/numbers are necessary 2

4 Main FAQ Takeaways for Adolescents Basic facts about cervical cancer o Ex) Cervical cancer is preventable; caused by HPV Basic facts about HPV vaccine o Ex) The HPV vaccine is safe and effective Why important to be vaccinated o Ex) Almost everybody gets HPV; vaccine prevents the most dangerous cancer-causing types Their role in getting vaccinated o Ex) 2 doses for girls 9-14; consent process (if applicable) 3

5 What causes cervical cancer? Appropriate Messaging for Adolescent Audience Almost all cervical cancers in the world are caused by the human papillomavirus (HPV). HPV is an extremely common virus and almost everybody in the world becomes infected at least once during his or her lifetime. Most infections do not cause any symptoms and will go away on their own, but infection with certain high-risk types of HPV can sometimes worsen over time and develop into cancer. Safe and effective vaccines are available to prevent cancer caused by HPV. Not Appropriate Messaging for Adolescent Audience Cervical cancer is caused by the human papillomavirus (HPV) 99% of the time % of HPV infections are asymptomatic, and most infections will clear spontaneously in 1-2 years, and mild lesions are common in the cervix. However, persistent precancerous conditions with high-risk types create a higher probability of developing cancer. Cervical cancer develops at the transformation zone between squamous and columnar epithelium. Columnar cells change into squamous cells, making them more prone to HPV s negative effects. Within months or years, persistent infections can cause the development of pre-malignant glandular or squamous intraepithelial lesions (SIL), and then to cancer. The time from infection to cancer usually takes years or longer, but it can take less time than that. 4

6 What causes cervical cancer? Appropriate Messaging for Adolescent Audience Almost all cervical cancers in the world are caused by the human papillomavirus (HPV). HPV is an extremely common virus and almost everybody in the world becomes infected at least once during his or her lifetime. Most infections do not cause any symptoms and will go away on their own, but infection with certain high-risk types of HPV can sometimes worsen over time and develop into cancer. Safe and effective vaccines are available to prevent cancer caused by HPV. Not Appropriate Messaging for Adolescent Audience Cervical cancer is caused by the human papillomavirus (HPV) 99% of the time % of HPV infections are asymptomatic, and most infections will clear spontaneously in 1-2 years, and mild lesions are common in the cervix. However, persistent precancerous conditions with high-risk types create a higher probability of developing cancer. Cervical cancer develops at the transformation zone between squamous and columnar epithelium. Columnar cells change into squamous cells, making them more prone to HPV s negative effects. Within months or years, persistent infections can cause the development of pre-malignant glandular or squamous intraepithelial lesions (SIL), and then to cancer. The time from infection to cancer usually takes years or longer, but it can take less time than that. 5

7 Is the vaccine safe? Appropriate Messaging for Adolescent Audience The vaccine has been studied very closely and carefully in many countries since 2002, and has been found safe and effective. Millions of people around the world have been vaccinated without any serious side effects. The most common are soreness, swelling or redness where the shot was given, headaches, or nausea. The vaccine cannot be given to anybody who is seriously allergic to any of its ingredients. Not Appropriate Messaging for Adolescent Audience Millions of doses of the HPV vaccine have been administered globally, and post-marketing study data demonstrate that HPV vaccines are well-tolerated and very safe with many people experiencing no adverse events at all. Adverse events can sometimes occur like any medicine, though the most common are usually mild. These include local soreness; erythema and tumefaction; fever and headaches; nausea; and dizziness. In extremely rare cases (approximately 1.7 cases per million doses), anaphylaxis can occur, and should be treated immediately. People with allergies to any vaccine component should not receive it. Some people may experience post-vaccination syncope. This is common in adolescents after any injection, so it is recommended that vaccine administrators ask their patients to sit during vaccination, and remain seated for 15 minutes following administration. 6

8 Is the vaccine safe? Appropriate Messaging for Adolescent Audience The vaccine has been studied very closely and carefully in many countries since 2002, and has been found safe and effective. Millions of people around the world have been vaccinated without any serious side effects. The most common are soreness, swelling or redness where the shot was given, headaches, or nausea. The vaccine cannot be given to anybody who is seriously allergic to any of its ingredients. Not Appropriate Messaging for Adolescent Audience Millions of doses of the HPV vaccine have been administered globally, and post-marketing study data demonstrate that HPV vaccines are well-tolerated and very safe with many people experiencing no adverse events at all. Adverse events can sometimes occur like any medicine, though the most common are usually mild. These include local soreness; erythema and tumefaction; fever and headaches; nausea; and dizziness. In extremely rare cases (approximately 1.7 cases per million doses), anaphylaxis can occur, and should be treated immediately. People with allergies to any vaccine component should not receive it. Some people may experience post-vaccination syncope. This is common in adolescents after any injection, so it is recommended that vaccine administrators ask their patients to sit during vaccination, and remain seated for 15 minutes following administration. 7

9 Why is it important to be vaccinated against HPV? Appropriate Messaging for Adolescent Audience HPV causes cervical cancer, one of the top killers of women in the world. HPV is extremely common, and anybody who plans to have a family risks infection during their life. The HPV vaccine prevents cervical cancer and other serious diseases, saving the lives of millions of girls and boys across the globe. Being vaccinated now is the best way to stay protected later so you can grow into a healthy adult and one day have your own children. Not Appropriate Messaging for Adolescent Audience HPV is the largest cause of cervical cancer in the world, accounting for 99% of all cervical cancer cases. It is therefore an important cause of morbidity and mortality in women, and an essential global public health priority. Almost 100% of the population becomes infected with HPV at least once during his or her lifetime. There are many types of HPV which infect the skin and mucosa, and while most of these infections go away on their own, infection with certain high-risk types of HPV (i.e., HPV 16, HPV-18) can worsen and develop into cancer. In addition to cervical cancer, HPV can also cause a variety of other health problems in both men and women such as multiple other types of cancer and genital warts. The immune response to natural HPV infection is very weak, so it is essential that girls be vaccinated prior to sexual debut to prevent these health problems from developing. 8

10 Why is it important to be vaccinated against HPV? Appropriate Messaging for Adolescent Audience HPV causes cervical cancer, one of the top killers of women in the world. HPV is extremely common, and anybody who plans to have a family risks infection during their life. The HPV vaccine prevents cervical cancer and other serious diseases, saving the lives of millions of girls and boys across the globe. Being vaccinated now is the best way to stay protected later so you can grow into a healthy adult and one day have your own children. Not Appropriate Messaging for Adolescent Audience HPV is the largest cause of cervical cancer in the world, accounting for 99% of all cervical cancer cases. It is therefore an important cause of morbidity and mortality in women, and an essential global public health priority. Almost 100% of the population becomes infected with HPV at least once during his or her lifetime. There are many types of HPV which infect the skin and mucosa, and while most of these infections go away on their own, infection with certain high-risk types of HPV (i.e., HPV 16, HPV-18) can worsen and develop into cancer. In addition to cervical cancer, HPV can also cause a variety of other health problems in both men and women such as multiple other types of cancer and genital warts. The immune response to natural HPV infection is very weak, so it is essential that girls be vaccinated prior to sexual debut to prevent these health problems from developing. 9

11 Who should be vaccinated, and when? Appropriate Messaging for Adolescent Audience The best age for girls to be vaccinated is 9-14 years old. Girls under 15 years need 2 shots of the HPV vaccine, 6 months apart. Girls aged 15 years or older, or girls whose immune systems are damaged, need 3 shots of the vaccine. Your doctor will remind you when to come back for your next shot. Being vaccinated today can prevent cancer in the future! Not Appropriate Messaging for Adolescent Audience According to SAGE and TAG recommendations, the primary target population for vaccination is girls aged 9-14 years before they become sexually active. Girls are a prioritized population because when there is high coverage in girls (>80%), the risk of HPV infection is reduced in boys as well due to herd protection. Secondary target populations are girls 15 years or males. The currently available vaccines are licensed for use in girls and women aged 9-26 and boys and men aged 9-21 (if male vaccination is included in the country s national immunization program). Any teenage girls (and/or boys) who did not start or finish the HPV vaccine series should be vaccinated now. Men who have sex with men, transgender individuals, and immunocompromised individuals should all be vaccinated up to age 26 if they did not receive the vaccine when they were younger. 10

12 Who should be vaccinated, and when? Appropriate Messaging for Adolescent Audience The best age for girls to be vaccinated is 9-14 years old. Girls under 15 years need 2 shots of the HPV vaccine, 6 months apart. Girls aged 15 years or older, or girls whose immune systems are damaged, need 3 shots of the vaccine. Your doctor will remind you when to come back for your next shot. Being vaccinated today can prevent cancer in the future! Not Appropriate Messaging for Adolescent Audience According to SAGE and TAG recommendations, the primary target population for vaccination is girls aged 9-14 years before they become sexually active. Girls are a prioritized population because when there is high coverage in girls (>80%), the risk of HPV infection is reduced in boys as well due to herd protection. Secondary target populations are girls 15 years or males. The currently available vaccines are licensed for use in girls and women aged 9-26 and boys and men aged 9-21 (if male vaccination is included in the country s national immunization program). Any teenage girls (and/or boys) who did not start or finish the HPV vaccine series should be vaccinated now. Men who have sex with men, transgender individuals, and immunocompromised individuals should all be vaccinated up to age 26 if they did not receive the vaccine when they were younger. 11

13 Uses of Adolescent HPV FAQ Webpages o Ministries of Health o PAHO/WHO Materials for schools, churches, adolescent groups, health centers, etc. o Brochures o Posters o Fact sheets o Games o Quizzes mhealth initiatives o SMS text messages o Social media Training materials o Health workers o Teachers 12

14 Example 1 13

15 Example 2 14

16 Example 3 [Insert 4 or 5 HPV and cervical cancer facts] 15

17 Conclusion Effective communication increases vaccination coverage o Goal to fight cancer and save lives! Understandable language for adolescents o Reinforces verbal and written messages Highlight key messages o Emphasize vaccine as cervical cancer prevention Use in materials adolescents can relate to o Adapt for local needs, languages, and cultures 16

18 Thank you! Sources: Comprehensive cervical cancer control: A guide to essential practice(2nd ed.). Geneva: World Health Organization; Guide to Introducing HPV Vaccine into National Immunization Programmes. Geneva: World Health Organization; 2016 Dec. HPV vaccine communication. Special considerations for a unique vaccine: 2016 update. Geneva: World Health Organization; 2017 (WHO/IVB/16.02). License: CC BY-NC-SA 3.0 IGO. Human papillomavirus vaccines: WHO position paper. Geneva: World Health Organization; 2017 May. 19(92):