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Gynaecological Cancers, Head and Neck Cancer CE/CME accredited

A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

Preventing HPV-associated cancer by maximizing vaccine uptake

  • Downloads including slides are available for this activity in the Toolkit
Learning Objectives

After watching this activity, participants should be better able to:

  • Illustrate the importance of vaccinating children and adolescents against HPV to prevent cancer in adulthood
  • Describe recent guidelines and best practices for HPV vaccine eligibility and administration
  • Appraise the barriers to HPV vaccine uptake in different populations and how they may be overcome

In this activity, three experts discuss the importance of HPV vaccination in preventing malignancies, and consider the barriers to HPV vaccine uptake and share strategies of how to overcome them. This discussion is guided by pre-canvassed questions provided by healthcare professionals involved in HPV vaccination.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

This activity has been designed to meet the educational needs of primary care physicians, physician assistants, nurse practitioners, nurses and pharmacists involved in HPV vaccination.


USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.


Prof. Lynette Denny discloses: Advisory board or panel fees from Vaccitech. Other financial or material support (royalties, patent, etc.) from UptoDate. Speaker’s bureau fees from Roche Diagnostics.

Prof. Eduardo Franco discloses: Advisory board or panel fees from BD Biosciences, Roche, Merck and PathoVax. Grants/research support from Merck. Other financial or material support (royalties, patent, etc.) for a registered patent entitled “DNA methylation markers for early detection of cervical cancer”.

Prof. Daniel Kelly has no financial interests/relationships or affiliations in relation to this activity.

Content reviewer

Sally Alrabaa, MD has no relevant financial relationships to disclose.

Touch Medical Contributors

Sadaf Kazi discloses: Employee of or independent contractor relationship with AS&K Communications-Remedica (Relationship Terminated).

Katrina Lester has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact



This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 31 July 2023. Date credits expire: 31 July 2024.

If you have any questions regarding credit please contact

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Preventing HPV-associated cancer by maximizing vaccine uptake
0.75 CE/CME credit

Question 1/5
The bivalent, quadrivalent and nonavalent HPV vaccines stimulate an immune response against which of the following HPV genotypes?

HPV, human papillomavirus.

There are currently 12 oncogenic HPV genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59.1 Additionally, types 66 and 68 are considered ‘possibly carcinogenic’ and ‘probably carcinogenic’ according to the IARC classification, respectively.2 Pre-HPV vaccination, types 16 and 18 were the most frequent types worldwide, with HPV-16 the most common in all regions.1 HPV genotypes 16 and 18 are responsible for 71% of cervical cancer cases worldwide, 85% of HPV-related head and neck cancers and 87% of all anal cancers.1


HPV, human papillomavirus; IARC, World Health Organization International Agency for Research on Cancer.


  1. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
  2. Schiffman M, et al. Infect Agent Cancer. 2009;4:8.
Question 2/5
How would you explain the rationale for the WHO including girls aged 9–14 years in the primary target group for HPV vaccination?

HPV, human papillomavirus; WHO, World Health Organization.

Although the HPV vaccine is approved for use in adults up to the age of 45 years, HPV vaccination is not routinely recommended for persons older than 26 years because the benefits of the vaccine decline after exposure to HPV infection.1 Due to the high rate of HPV transmission during sexual contact, the HPV vaccination should be given prior to sexual activity.1–3 Furthermore, studies have shown that the highest immune responses to HPV vaccines were observed in girls aged 9–15 years.3


HPV, human papillomavirus.


  1. Kamolratanakul S, Pitisuttithum P. Vaccines (Basel). 2021;9:1413.
  2. Salvadori M. Paediatr Child Health. 2018;23:262–5.
  3. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
Question 3/5
A 27-year-old-male with HIV attends your clinic to discuss receiving the HPV vaccine. Assuming availability of the HPV vaccine in your clinic and based on the WHO guidance, what would you do?

HIV, human immunodeficiency virus; HPV, human papillomavirus; WHO, World Health Organization.

People living with HIV are at increased risk of HPV infection and HPV-related disease, including certain types of malignancies, compared with HIV-negative persons.1 Vaccination of HIV-positive individuals against HPV is recommended by the WHO regardless of age or antiretroviral status.2 HIV often reduces responsiveness to vaccines.1 Therefore, for immunocompromised and HIV-positive people, the WHO recommends administering at least two doses of the HPV vaccine, at least 6 months apart, and three doses if possible.2 Regional practice may vary from the WHO recommendation.


HIV, human immunodeficiency virus; HPV, human papillomavirus; WHO, World Health Organization.


  1. Lacey CJN. Papillomavirus Res. 2019;8:100174.
  2. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
Question 4/5
You are discussing HPV vaccination with a 14-year-old girl and her mother. The mother is reluctant to consent to vaccination due to safety concerns of the HPV vaccine. What counsel would you provide?

HPV, human papillomavirus.

The safety of the HPV vaccine is regularly reviewed by the Global Advisory Committee for Vaccine Safety,1 with data showing that the vaccine is well tolerated in different age groups.1,2 The most common side effects of HPV vaccination are localized to the injection site and include redness, pain and swelling.2,3 These injection site reactions are mild-to-moderate and usually resolve within a few days.3 Mild systemic side effects such as headache, dizziness or gastrointestinal symptoms can also occur.1 Syncope can occur after HPV vaccination and is most common among adolescents and young adults, but can be prevented by observing the vaccine recipient for 15 minutes post-HPV vaccination.3 As with any vaccine, anaphylaxis post-HPV vaccination can occur, but such cases are rare.1,3


HPV, human papillomavirus.


  1. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
  2. Cheng L, et al. Vaccines (Basel). 2020;8:391.
  3. Salvadori M. Paediatr Child Health. 2018;23:262–5.
Question 5/5
You are aware that HPV vaccine hesitancy is high among parents/caregivers of adolescents at your clinic. Which of the following approaches could be undertaken to most successfully counter these individual barriers to HPV vaccine uptake?

HPV, human papillomavirus.

HPV vaccine hesitancy among individuals may be due to safety concerns, poor awareness of the benefits of HPV vaccination, and stigma and misconceptions associated with the vaccine.1–3 These barriers can potentially be overcome with education. A review article analysing quantitative systematic reviews evaluating interventions to increase HPV vaccine uptake and/or intention showed that face-to-face interventions can lead to an increase in HPV vaccine uptake. Printed information and online information were shown to improve intention for HPV vaccination only.4


HPV, human papillomavirus.


  1. Black E, Richmond R. Vaccines (Basel). 2018;6:61.
  2. Oyedeji O, et al. Vaccines (Basel). 2021;9:1360.
  3. Nguyen NY, et al. Ann Glob Health. 2020;86:118.
  4. Bennett C, et al. Sex Transm Infect. 2022;98:599–607.
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