Materiały źródłowe

• #1 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  Human Papillomavirus (HPV) is the initiating force behind multiple epithelial lesions and cancers, predominantly cutaneous and mucosal surfaces. […] The majority of HPV infections are latent, and most clinical lesions present as warts rather than a malignancy. […] It is important to understand that HPV alone does not cause cancer but requires triggers like smoking, folate deficiency, UV light exposure, immunosuppression, and pregnancy. […] HPV is a non-enveloped, double-stranded, circular DNA virus of the Papillomaviridae family. […] Both low-risk and high-risk HPV (sometimes referred to as alpha-papillomaviruses) are considered to be sexually transmitted but may be spread by other forms of intimate contact. […] Evaluation and treatment of HPV infection vary by body site and disease manifestation.

• #1 Chapter 11: Human Papillomavirus | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-11-human-papillomavirus.html

  This chapter discusses pathogenesis, clinical features, epidemiology, vaccination, and surveillance of human papillomavirus, or HPV. […] Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. […] Persistent infections can develop into anogenital warts, precancers, and cervical, anogenital, or oropharyngeal cancers in women and men. […] High-risk or oncogenic HPV types act as carcinogens in the development of cervical cancer and other anogenital cancers. […] High-risk HPV types are detected in 99% of cervical precancers. […] Infection with a high-risk HPV type is considered necessary for the development of cervical cancer but, by itself, is not sufficient to cause cancer. […] In addition to cervical cancer, high-risk HPV infection is associated with less common anogenital cancers, such as cancer of the vulva, vagina, penis, and anus.

• #1 Human papillomavirus | Nursing in Practice

  https://www.nursinginpractice.com/clinical/womens-health/human-papillomavirus/

  Because HPV is passed from one person to another during skin-to-skin contact, wearing a condom will reduce the risk of transmission. However, it does not provide full protection since condoms do not prevent all genital skin-to-skin contact. […] As well as practising safe sex and limiting the number of sexual partners they have, an individual can also protect themselves by not smoking. Smoking has been shown to increase the risk of developing pre-cancer and cancer of the cervix. […] HPV is responsible for 99.7% of cases of cervical cancer. […] The vaccine currently used in schools (Gardasil), protects against four types of HPV: HPV16 and HPV18, which are responsible for more than 70% of worldwide cervical cancer cases; and HPV6 and HPV11, which are responsible for most cases of genital warts.

• #1 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568814/

  The biggest concern with genital warts is the risk of cervical cancer. […] HPV is also known to be associated with anal and head and neck cancers. […] Both the nurse and the pharmacist are in a prime position to educate patients about safe sex, the use of condoms, and the avoidance of multiple sex partners. […] More importantly, patients should be told that if they have genital warts, sexual activity should be avoided until the lesions have been treated or have resolved. […] Long term follow up is essential as recurrence of warts is common. […] Because of the risk of cancer, DNA testing and screening is required in high-risk patients.

• #1 HPV (Human Papillomavirus): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11901-hpv-human-papilloma-virus

  More than 30 strains of the human papillomavirus (HPV) can affect your genitals. These include harmless forms of HPV, like those that cause genital warts. Only some types of HPV are high risk because they can progress to cancer. You can take preventive measures, including the HPV vaccine and getting regular screenings, to reduce your risk. […] HPV is the most common viral sexually transmitted infection (STI) in the United States. Roughly 14 million people get the infection each year. HPV is so common that most sexually active people who aren’t vaccinated against HPV will become infected at some point in their lives. Most never know they have it. […] Some strains of HPV are high-risk and can lead to cancers, like cervical, vulvar and vaginal cancers. Early detection (with a Pap smear or HPV screening) and treatment of precancerous cells can usually prevent this from happening.

• #1 Human papillomavirus | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/reduce-your-risk/get-vaccinated/human-papillomavirus-hpv

  You may have heard about HPV or the human papillomavirus. Its mostly spread by having vaginal or anal sex with someone who has the virus. It also spreads through oral sex and through genital skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms. And its very common. In fact, its more common than all other sexually transmitted infections combined. […] About 75% of sexually active people will get at least one HPV infection in their lifetime. Most of them will never know theyve been infected because HPV often doesnt cause any symptoms. This makes it hard to know exactly when or how the virus was spread. […] Most HPV infections come and go over the course of a few years. While an HPV infection cant be treated, the conditions it causes (such as genital warts) can.

• #1 Human Papillomavirus Infection: Symptoms and Prevention

  https://www.healthline.com/health/human-papillomavirus-infection

  HPV is the most common STI in the world, however, vaccines are available to prevent it. […] Human papillomavirus (HPV) is a viral infection thats passed between people through skin-to-skin contact. […] Some cases of genital HPV infection may not cause any health problems. However, some types of HPV can lead to the development of genital warts and even cancers of the cervix, anus, and throat. […] Because HPV is a skin-to-skin infection, intercourse isnt required for transmission to occur. […] Many people have HPV and dont even know it, which means you can still contract it even if your partner doesnt have any symptoms. […] Regular screenings can help diagnose HPV-related health problems earlier. This can improve outlook and increase chances of survival. […] Some strains of HPV can cause penile, anal, and throat cancer in men.

• #1 Human Papillomavirus: Screening, Testing, and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p152.html

  Vaccination has been demonstrated to reduce the prevalence of vaccine-type HPV in females, anogenital warts, and precancerous cervical lesions. […] Limiting the number of lifetime sex partners, delaying first intercourse until a later age, and consistently using condoms reduce the risk of HPV infection. Smoking and alcohol cessation should be recommended to reduce the risk of HPV persistence and the development of HPV-related malignancies. Vaccination should be recommended to prevent the development of high-grade precancerous cervical lesions in women. […] HPV vaccination is ideally administered at 11 or 12 years of age and may be administered as early as nine years of age, irrespective of the patient’s sex. In immunocompetent individuals immunized before 15 years of age, a two-dose series is indicated. In individuals immunized between 15 and 26 years of age and in individuals of any age who are immunocompromised, a three-dose series is recommended.

• #1 Genital Warts: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/genital-warts/?srsltid=AfmBOopnAQJ00Wn0jDYcs1pB_W5ZJtFKemxkrv0A3cwiPNmmNRQVKWZX

  Condyloma acuminata, or more commonly known as genital warts, is a highly infectious sexually transmitted disease (Centers for Disease Control and Prevention [CDC], 2021). The human papillomavirus (HPV) is the causative virus responsible for genital warts. About 50 different HPV types affect the genital organs, even though there are about 150 total HPV types known (CDC, 2021). Specifically HPV types 6 and 11 are attributed to cause genital warts. […] Genital warts diagnoses are more prevalent in women than men. […] HPV infections can be self-limiting and symptoms can subside within a few months to 2 years without seeking treatment. There is no way to clear or cure HPV, however the warts can be treated. Treatment method can be determined by: […] It is important to note that treatment of genital warts is not a cure. The warts can and often do return, due to the HPV infection that is still present. Treating the wart alone does not clear the actual HPV infection.

• #1 Types of Human Papillomavirus | NYU Langone Health

  https://nyulangone.org/conditions/human-papillomavirus/types

  Human papillomavirus, or HPV, is the most common sexually transmitted infection. HPV doesn’t always cause symptoms, and many people with the virus don’t know they have it. More than 90 percent of all new HPV infections go away or become undetectable within two years, even without treatment. Yet some HPV infections can stay in the body and lead to complications, including genital warts. These warts may be small or large, flat or raised; they may emerge singly or in a cluster and be cauliflower-shaped. They appear most often on the vulva, the outer part of a woman’s genitals, and the penis. HPV infection may also cause more serious conditions, such as certain types of cancer. […] Infection with most low-risk genital HPV strains doesn’t cause symptoms and disappears when the body builds immunity to the virus. These strains have no association with cancer but can lead to genital warts.

• #1 HPV (Human Papillomavirus): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11901-hpv-human-papilloma-virus

  Getting regular Pap smears to screen for cervical cancer is important (usually beginning at age 21). But it’s important to remember that just because you have HPV or cervical dysplasia doesn’t mean you’ll get cancer. […] The virus itself doesn’t turn into cancer. But high-risk strains of HPV infection can cause precancerous cell changes. These cell changes can eventually lead to cancer if they aren’t managed. This process, though, can take years or decades to happen. Screenings, like Pap smears, can help detect these precancerous cells before they turn to cancer. […] The only way to prevent HPV is to abstain from sex. For many people, more realistic goals include reducing the risk of contracting HPV and preventing cervical cancer while still enjoying a healthy sex life. […] You can reduce your risk if you: Get vaccinated against HPV. The HPV vaccine works best if you get it before becoming sexually active (around age 11 or 12). It may protect you from HPV strains you haven’t been exposed to even after becoming sexually active. Talk to your provider about your options. […] Only a small number of people with high-risk HPV will develop abnormal cervical cells that require treatment to prevent the cells from becoming cancer.

• #1 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  If the patient progresses to malignancy (e.g., squamous cell carcinoma, endocervical adenocarcinoma), further resection, chemotherapy, and/or radiation may be required. […] The HPV vaccine covers HPV subtypes 6,11,16,18,31,33,45,52 and 58. […] The effectiveness of the vaccine has been inferred from several studies. […] It has been shown to prevent anal cancer, genital warts, cervical intraepithelial neoplasia, vulvar intraepithelial neoplasia, and anal intraepithelial neoplasia. […] The biggest concern with genital warts is the risk of cervical cancer. […] HPV is also known to be associated with anal and head and neck cancers. […] Long term follow up is essential as recurrence of warts is common. […] Because of the risk of cancer, DNA testing and screening is required in high-risk patients.

• #1 Human Papillomavirus (HPV) | The Well Project

  https://www.thewellproject.org/hiv-information/human-papillomavirus-hpv

  Human papillomavirus (HPV) is the name of a large group of viruses. Certain types of HPV can cause warts on the hands, feet, mouth, or throat. About 30 to 40 types can cause infections in the genital area (the vulva, vagina, penis, buttocks, scrotum, and anus). […] Genital HPV is a very common sexually transmitted infection or disease (STI or STD) worldwide. […] It is very important that people living with HIV who have a cervix get routine cervical screening tests and follow up as needed to find problems before cancer develops. […] Women living with HIV who have HPV are also more likely to have: Difficulty clearing the infection naturally, HPV infections that were once under control and come back again, HPV that responds poorly to standard treatment; multiple therapies using different methods may be needed, Several types or strains of HPV at once, Infection with the „high-risk” HPV types that can cause cancer, Greater vulnerability to developing cervical and anal cancer when living with the „high-risk” types.

• #1 Human Papillomavirus (HPV): Symptoms, Diagnosis and Prevention

  https://www.unitypoint.org/find-a-service/primary-care/vaccinations/human-papillomavirus-hpv-vaccine

  The human papillomavirus virus (HPV) vaccine is extremely effective at preventing infection from high-risk HPV strains known to cause genital warts and several types of cancers in men and women. […] The vaccine works best when children receive it between the ages of 9 and 12 preventing more than 90% of HPV-related cancers as they get older. However, adults up to age 45 can also receive the vaccine. […] HPV in women can be detected during a cervical cancer screening performed by a doctor. This is called a Pap smear (or Pap test). The test looks for abnormal cells or any changes in the cervix that increase your risk for cervical cancer. During a Pap smear, an HPV test detects if HPV is present. […] Pap tests are extremely effective and have significantly reduced cervical cancer diagnoses in the United States.

• #1 HPV (Human Papillomavirus) | MD Anderson Cancer Center

  https://www.mdanderson.org/prevention-screening/manage-your-risk/hpv.html

  HPV screening, including FDA-approved self-collection tests for HPV, can determine if a woman has a cervical HPV infection. […] There is no drug or treatment that can eliminate the HPV virus from the body. However, there are ways to treat HPV-related health problems like precancerous lesions and genital warts. […] Almost all cervical cancers are caused by HPV. […] Because no vaccine prevents all types of HPV that can cause cervical cancer, vaccinated women age 21 to 29 should get cervical cancer screening (Pap tests) every three years. […] Cervical cancer and other HPV-associated cancers can be prevented by getting the HPV vaccine early in life. […] HPV testing is available for women ages 25 and older. […] While screening and early treatment can prevent cervical cancer, there are no widespread screening tests for the other HPV-associated cancers, such as oropharyngeal (throat) cancer and anal cancer. […] The HPV vaccine can help the body recognize and eliminate the virus more effectively. […] The vaccine has been proven again and again to be safe and effective and long lasting.

• #1 HPV infection – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/diagnosis-treatment/drc-20351602

  A healthcare professional might be able to diagnose HPV infection by looking at the warts. […] If medicines don’t work, one of these methods can remove warts: […] A procedure called a colposcopy can remove HPV from the cervix. […] Precancerous lesions need to be removed. Options include freezing, called cryosurgery, and laser surgical removal. […] For HPV infection, questions to ask include: […] Don’t hesitate to ask all the questions you have about HPV infection.

• #1 Human Papillomavirus (HPV): Symptoms, Diagnosis and Prevention

  https://www.unitypoint.org/find-a-service/primary-care/vaccinations/human-papillomavirus-hpv-vaccine

  Women between 30 – 65 years old should have HPV testing and a Pap test once every 5 years. […] A new HPV self-sampling test was approved by the Food and Drug Administration in May 2024 for women ages 25 and up. The test screens for up to 14 types of high-risk HPV strains that can lead to cervical cancer. […] While the majority of cervical cancers are caused by HPV, two to five percent are not. […] HPV testing is not as standardized for men as it is for women. Currently, there’s no HPV test for men approved by the Federal Drug Administration (FDA). […] The Centers for Disease Control and Prevention (CDC) recommends the following HPV vaccine schedule for children: Kids between the ages of 9-14 should get the HPV vaccine. […] Men and women can receive the HPV vaccine until age 45. […] While the vaccine is most effective before you’re sexually active and exposed to HPV, it can still reduce the risk of contracting HPV for people who are already sexually active.

• #1 Human Papillomavirus | HPV Treatment Specialists | NJ Infectious Disease Doctors

  https://idcare.com/infection/human-papillomavirus/

  Human Papillomavirus Treatment […] What is human papillomavirus (HPV)? There are more than 100 types of human papillomaviruses (HPVs) — most are harmless, but about 30 types can put you at risk for cancer. These types of HPV are classified as either low- or high-risk and are passed on through sexual contact with an infected individual. Low-risk HPV can cause genital warts. High-risk HPV, however, can lead to cancers of the cervix, vulva, vagina, and anus in women, or cancers of the penis and anus in men. […] […] How does ID Care diagnose human papillomavirus (HPV)? As experts in all areas of infectious diseases, our team at ID Care can identify and diagnose the HPV infection by examining your warts. Women should have a Pap smear, as this test will detect changes in the cervix that may lead to cancer. In some cases, DNA tests may be performed to recognize the high-risk characteristics of HPV that are linked to a variety of genital cancers. […]

• #1 Human Papillomavirus (HPV) – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/human-papillomavirus-hpv.page

  HPV-related cancers are most treatable when they are diagnosed and treated early. […] Starting at age 21, women and people with a cervix should have routine cervical cancer screening. […] Certain people at higher risk for anal cancer, including men who have sex with men, may need routine anal Pap tests. […] Talk with your primary care provider about your risk and whether you should get tested. […] The best way to prevent HPV is with a vaccine. […] The HPV vaccine protects against nine types of HPV, including the types that cause most cervical cancers. […] The vaccine is up to 99% effective in preventing cervical, vaginal and vulvar abnormalities, which can develop into cancer if left untreated. […] The vaccine also protects against most genital warts and anal cancers. […] Women and people with a cervix who receive the vaccine are less likely to have abnormal Pap tests, cervical pre-cancer and genital warts.

• #1 Nursing Care Plan For Warts – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-warts/

  Warts, medically known as verrucae, are a common dermatological condition caused by the human papillomavirus (HPV). […] By delivering evidence-based nursing care, nurses can enhance the quality of life for individuals with warts, promote skin health, and empower patients with knowledge to manage and prevent future outbreaks effectively. […] Warts, caused by the human papillomavirus (HPV), are common skin growths that require a comprehensive nursing assessment to develop an effective care plan. […] A comprehensive nursing assessment is crucial in understanding the patients unique needs and tailoring a care plan that addresses their physical and emotional concerns while preventing the spread of warts to themselves and others. […] These nursing diagnoses address various aspects of care for patients with warts, considering their physical, emotional, and educational needs.

• #1 Human Papillomavirus (HPV) Nursing CE Course | NursingCE

  https://www.nursingce.com/ceu-courses/human-papillomavirus-nursing-ce-course

  This module explores the prevalence and incidence of human papillomavirus (HPV), current guidelines, and recommendations for screenings and treatment. Healthcare professionals (HCPs) should understand the importance of HPV vaccination and the potential barriers for adolescents and young adults. […] discuss nursing care aimed at preventing and treating HPV and HPV-related cancers. […] HPV can be transmitted via skin contact during vaginal, anal, and oral sexual intercourse. […] Preventing HPV-related cervical cancer can also occur through annual pap smears for women. […] HPV vaccination, which has been available since 2006, has been widely successful in decreasing HPV rates and creating herd immunity. […] Nurses can educate individuals on condom usage in outpatient settings, including schools, pediatric offices, and obstetrics/gynecology clinics.

• #1 Genital Warts: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/genital-warts/?srsltid=AfmBOopnAQJ00Wn0jDYcs1pB_W5ZJtFKemxkrv0A3cwiPNmmNRQVKWZX

  The individual is at risk of the following nursing diagnosis related to genital warts: […] The individual may feel stigmatized due to the diagnosis of genital warts. This can lead to emotional and psychological distress and can have a negative impact on the quality of life, interpersonal, and sexual relationships. […] Interventions should include measures to increase comfort and decrease spreading of warts: […] The individual should be educated on preventive measures including:

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• #1 Human Papillomavirus (HPV) Treatment & Management: Approach Considerations, Considerations in Specific Patient Subgroups, Pharmacologic Therapy

  https://emedicine.medscape.com/article/219110-treatment

  Annual screening and Pap testing are essential for female patients with genital warts, as up to 90% of cervical cancers are caused by HPV. […] Patients with perianal warts, HIV-positive patients, and those with a history of receptive anal intercourse are at increased risk for anal HGSIL. […] Immunosuppressed patients, such as those with AIDS or on immunosuppressive therapy (eg, renal transplant patients), are more susceptible to persistent HPV infection, which can lead to dysplasia and malignancy. […] Both provider-applied treatments and patient-applied treatments are available for HPV disease. […] Podofilox gel or solution is the first-line treatment choice for external genital warts in nonpregnant patients. […] Imiquimod stimulates cytokine production (including interferon alfa) but lacks direct antiviral activity.

• #1 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  Individuals with cutaneous warts have numerous treatment options available, including surgical removal, cryotherapy (freezing the infected tissue), irritant or immunomodulating medications, and laser removal. […] To prevent lower anogenital tract HPV infection by the most common high-risk and low-risk subtypes, the CDC recommends that boys and girls be vaccinated for HPV starting at ages 11 to 12. […] Anogenital and oropharyngeal warts may be treated similarly to cutaneous warts as long as the patient is immunocompetent. […] Cervical HPV-driven lesions may regress without any intervention. […] Young immunocompetent women with dysplasia are usually monitored at shortened intervals through Pap smears, HPV testing, and colposcopic examination. […] Both surgical procedures (LEEP, CKC) involve resection of the cervical os and transformation zone.

• #1 Human Papillomavirus Infection: Symptoms and Prevention

  https://www.healthline.com/health/human-papillomavirus-infection

  Some strains of HPV can cause cervical cancer or cancers of the vagina, anus, or throat. Regular screening can help detect the changes associated with cervical cancer in women. […] Most cases of HPV go away on their own, so theres no treatment for the infection itself. […] Routine screening for HPV and cervical cancer is important for identifying, monitoring, and treating health problems that may result from HPV infection. […] The easiest ways to prevent HPV are to use condoms and to practice safe sex. […] The CDC recommends the HPV vaccine for boys and girls ages 11 or 12. […] If genital warts are widespread, they may make a vaginal delivery difficult. […] Cervical changes can still occur during pregnancy, so you should plan to continue routine screening for cervical cancer and HPV while youre pregnant. […] Routine screening for anal, throat, or penile cancer in men isnt currently recommended.

• #1 Pediatric human papillomavirus (HPV) – Children’s Health Adolescent Medicine

  https://www.childrens.com/specialties-services/conditions/human-papillomavirus-hpv

  In children and adolescents, if there is a concern for a wart, an examination in the office will the first step in the evaluation of this condition. […] The HPV infection is primarily spread through skin-to-skin contact. […] There are several risk factors that increase the chance of a child getting a HPV infection: Having a cut The disease can enter the blood stream through an opening in the skin (like a cut). […] Having a mother with HPV It is possible for a mother to infect her child during vaginal childbirth. […] Being sexually active Those that are sexually active have a greater risk of contracting HPV. Further, the more sexual partners you have, the more likely you are to get HPV. Being with a partner that has had multiple partners also increases your risk. […] Weakened immune system Immune systems can be weakened by HIV/AIDS, immune-suppressing medications (organ transplants) or other reasons. […] This condition can be treated with observation, with various creams or ointments to be placed on the wart, or with surgery. Your provider will help determine what is best for your child.

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  https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer

  Being vaccinated is the best way to prevent HPV infection, cervical cancer and other HPV-related cancers. Screening can detect cervical precancers that can be treated before they develop into cancer. […] HPV vaccines should be given to all girls aged 9-14 years, before they become sexually active. […] After a positive HPV test (or other screening method), a healthcare provider can look for changes on the cervix or precancers that could develop into cervical cancer if left untreated. Treatment of precancers prevents cervical cancer. […] There is currently no treatment for HPV infection. Treatments exist for genital warts, cervical precancers and cervical cancer. […] Treatments for cancers caused by HPV (including cervical cancer) are more effective if diagnosed early. Treatment should begin quickly after diagnosis.

• #1 Chapter 11: Human Papillomavirus | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-11-human-papillomavirus.html

  Medical management is recommended for treatment of specific clinical manifestations of HPV-related disease (e.g., anogenital warts, precancerous lesions, or cancers). […] HPV vaccination does not eliminate the need for cervical cancer screening. […] Vaccination prevents HPV infection, benefitting both the vaccinated person and their future sex partners by preventing spread of HPV. […] HPV vaccination is recommended for females and males at age 11 or 12 years for prevention of HPV infections and HPV-associated diseases, including certain cancers. […] HPV vaccines are administered as a 2- or 3-dose series, depending on age at initiation and medical conditions. […] HPV vaccine is highly immunogenic. […] HPV vaccine is generally well-tolerated. […] HPV vaccines should be maintained at refrigerator temperature between 2C and 8C (36F and 46F). […] HPV infection is not a nationally notifiable condition.

• #1 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] The HPV vaccine is now licensed in the United States for women and men through age 45 years. […] For some women aged 2745 years who are previously unvaccinated, obstetriciangynecologists and other health care professionals may use shared clinical decision making regarding the HPV vaccination, considering the patients risk for acquisition of a new HPV infection and whether the HPV vaccine may provide benefit. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. Studies have shown that physicians recommendations have the strongest influence in the acceptance of HPV vaccination by patients and parents of patients.

• #1 Human Papillomavirus (HPV) Infection – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/hpv.htm

  Approximately 150 types of HPV have been identified, at least 40 of which infect the genital area. The majority of HPV infections are self-limited and are asymptomatic or unrecognized. Persistent oncogenic HPV infection is the strongest risk factor for development of HPV-attributable precancers and cancers. HPV vaccines are not recommended for use in pregnant women. HPV vaccines can be administered regardless of history of anogenital warts, abnormal Pap test or HPV test, or anogenital precancer. HPV vaccination has not been associated with initiation of sexual activity or sexual risk behaviors. Treatments are available for the conditions caused by HPV but not for the virus itself. Having HPV does not make it harder for a woman to get pregnant or carry a pregnancy to term. However, certain precancers or cancers that HPV can cause, and the surgical procedures needed to treat them, can affect a woman’s ability to get pregnant or carry a pregnancy to term. Three HPV vaccines can prevent diseases and cancers caused by HPV. HPV vaccines are safe and effective and are recommended routinely for adolescents aged 11-12 years. Abstaining from sexual activity is the most reliable method for preventing genital HPV infection.

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  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3113

  The human papillomavirus (HPV) is a very common virus. […] There is a vaccine that can protect you against HPV. […] Follow-up care is a key part of your treatment and safety. […] Talk to your doctor about the HPV vaccine. […] Use a condom every time you have sex. […] Be sure to tell your sexual partner or partners that you have HPV. […] Don’t smoke. Smoking increases the risk for cervical problems and cervical cancer. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have vaginal pain during or after sex. […] You have vaginal bleeding when you are not in your menstrual period.

• #1 Human papillomavirus | Nursing in Practice

  https://www.nursinginpractice.com/clinical/womens-health/human-papillomavirus/

  Women need to attend screening to benefit from this. […] As research has shown, practice nurses are a key source of both information and advice for patients about HPV infection, vaccination and testing. […] Primary care nurses have a key role to play in combatting these misunderstandings. […] To conclude, HPV is an extremely common sexually transmitted virus, which has the potential to induce malignant change in those cases where high-risk infection persists. […] There is a lack of knowledge about the virus in the general population and primary care nurses have an important role to play in educating and supporting patients around this issues.

• #1 Cervical Cancer Prevention: The Role of the Nurse and Medical Care in Primary and Secondary Cancer Prevention

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004082/htm

  Objective: Although these days the priority is to fight the Covid-19 pandemic, the importance of human papillomavirus (HPV) infection is not to be neglected. […] Early prevention of infections with HPV is an element of primary prophylaxis against cervical cancer. Vaccines are available that prevent long-lasting oncogenic infections and serotypes of HPV. […] There is a hope that in the future the combination of screening tests with vaccinations against oncogenic strains of HPV will allow reductions in the percentage of those contracting cervical cancer. […] The importance of educational activities should be emphasized in developmental gynecology in the context of oncological prevention. The roles of both doctors and nurses are important here. […] In the context of prophylactic actions in gynaecology for developmental aged children, the risk of cervical cancer appearing can be significantly reduced through vaccinations against highly oncogenic types of HPV and also by conducting regular cervical smears.

• #1 Human Papillomavirus (HPV) Nursing CE Course | NursingCE

  https://www.nursingce.com/ceu-courses/human-papillomavirus-nursing-ce-course

  Treating HPV involves avoiding transmission to other individuals, preventing and eliminating genital warts, monitoring for changes in cervical cellular structure, and limiting psychological distress for patients. […] Nurses should educate patients on the risk of local skin irritation and pain with topical applications. […] Nurses should assess for pain and encourage the patient to report worsening pain or vaginal discharge. […] Nurses can educate patients and their families on the necessity of catching up on their vaccination schedule at medical appointments.

• #1 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] HPV vaccination is effective in the reduction of precancers and cancers related to HPV. Cervical precancers caused by HPV have decreased by 40% among women who have received the HPV vaccine (CDC, 2019). […] Limited knowledge of HPV vaccination has been identified as a barrier to HPV vaccination among Black mothers (Cunningham-Erves et al., 2018). […] The aim of the current study was to explore the effect of an intervention to enhance HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers.

• #1 Human papillomavirus | Nursing in Practice

  https://www.nursinginpractice.com/clinical/womens-health/human-papillomavirus/

  A positive HPV test will result in a referral for colposcopy. […] A HPV test has been added to the first six-month smear test (test of cure) since it has been shown to be more sensitive at detecting CIN than cytology alone. […] If this HPV test is negative, the likelihood of further CIN is low and the woman will be recalled in three years. […] If the HPV test is positive, even if the cytology is normal, the woman will be referred back for colposcopic assessment. […] It is still important that older women continue to attend for cervical screening. […] Despite this, attendance is declining in women aged 55 and older. […] However, as mentioned before it has been proposed that HPV can lie dormant for many years and may have the potential to become reactivated, although the mechanisms for this are not yet understood.

• #1 Nursing Considerations for HPV-Related Oropharynx Malignancies

  https://www.oncnursingnews.com/view/nursing-considerations-for-hpvrelated-oropharynx-malignancies

  HPV-associated oropharyngeal cancer currently is staged using the same tumor, node, metastasis (TNM) staging system as for those with HPV-negative oropharyngeal cancers. […] For example, a stage IV patient with HPV-related cancer has an 80% survival rate, whereas a stage IV smoking-related cancer patient has a 50%-60% survival rate; both are presently considered advanced stage which is recognized as a life-threatening prognosis. […] When the treatment for cancer of the head and neck requires radiation therapy, a thorough dental examination is required prior to radiation treatment. […] A certain amount of dryness will probably persist indefinitely after radiation therapy to the head and neck. The most common problem associated with dry mouth is rampant dental decay and periodontal disease. […] Head and neck cancer therapy remains a difficult challenge for most patients and is exacerbated by the toxicity associated with current treatments.

• #1 Human Papillomavirus (HPV) | Texas DSHS

  https://www.dshs.texas.gov/hivstd/info/hpv

  A doctor or health care provider can treat genital warts. Different treatment options are available to remove the warts. However, these treatments are just to remove the warts. They do not cure you of HPV, and the warts sometimes grow back. […] Most pregnant women with HPV do not have problems. However, active genital warts may cause problems during pregnancy or at birth. In rare cases, HPV can pass from mother to baby during childbirth. A pregnant woman should tell her doctor or health care provider if she or her sex partner(s) have ever had genital warts. Pregnant women should not get the HPV vaccine. […] Get vaccinated. Ask your health care provider and your children’s health care provider about the HPV vaccine. […] Sexually active women and women over 21 should have Pap tests as often as recommended by their health care provider. […] If you think you have genital warts, see your doctor or go to your local STD clinic. To find the clinic closest to you in Texas, visit knowmystatus.org or call 2-1-1. […] If you smoke, ask your doctor for help quitting. Smoking can increase the risk for cancers linked to HPV.

• #1 Human Papillomavirus (HPV)—Understanding this Common Infection

  https://www.ashasexualhealth.org/human_papilloma_virus/

  You can screen (or check) for cervical cancer with a Pap test and/or an HPV test. Ask your healthcare provider which tests are right for you, based on your age and medical history. […] Regular screening will detect virtually all pre-cancerous changes and cervical cancers. […] Cervical cancer is largely preventable if precancerous cell changes are detected and treated early, before cervical cancer develops. […] HPV vaccination can prevent 90% of these cancers by preventing the infections that cause them. […] The HPV vaccine can prevent over 90% of these cancers from ever developing. […] Genital warts are caused by human papillomavirus (HPV). The types of HPV that cause genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or possibly oral sex with someone who has this infection. […] The FDA recently approved HPV testing using self-collected samples. Experts hope allowing people to collect their own samples will increase screening rates.

• #1 Human papillomavirus | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/reduce-your-risk/get-vaccinated/human-papillomavirus-hpv

  Vaccines are available that can protect against the most common types of HPV that cause cancer. The Canadian Cancer Society recommends that people in Canada get vaccinated to reduce their risk of HPV-related cancer. […] HPV vaccines do not treat HPV infections you already have or treat diseases or cancers related to HPV. They help protect against future HPV infection. […] Our recommendation We recommend that children and adults between the ages of 9 and 45 be vaccinated against HPV to help reduce the risk of HPV-related cancers. These include cervical, head and neck, vaginal, vulvar and anal cancers, and precancerous conditions linked to these cancers. HPV vaccination should be used along with, not instead of, cervical cancer screening for people with a cervix. […] HPV testing is most effective for women and people with a cervix who are 30 years of age and older. There is currently no approved test for HPV in men. While HPV infections are very common in women and people with a cervix under 30 years old, most infections go away on their own and are unlikely to result in abnormal cervical changes that could lead to cancer. Testing of young people is more likely to result in unnecessary diagnoses and treatments. […] Research shows that HPV testing is more accurate than the Pap test in finding precancerous changes in the cervix. Provinces and territories are moving towards implementing primary HPV testing as a part of cervical cancer screening.

• #1 HPV Vaccination | MUSC Hollings Cancer Center

  https://hollingscancercenter.musc.edu/outreach/hpv

  Working in conjunction with statewide partners, Hollings Cancer Center has prioritized HPV vaccination as one its top cancer prevention projects. […] An innovative program uses parent ambassadors to help raise HPV vaccination rates. […] This statewide initiative to improve HPV vaccination rates will protect the health of our children. […] School nurse Wendy Judy recommends the safe, effective, and long-lasting HPV vaccine.

• #1 Human Papillomavirus (HPV) Vaccine – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/700_799/0726.html

  The authors concluded that HPV vaccination post-treatment was associated with a significantly reduced risk of CIN2+ recurrence when using unadjusted estimates from observational studies and RCTs. […] The authors concluded that while the therapeutic use of HPV vaccination has shown promise for some JoRRP patients; however, it overall remains uncertain with the currently available data. […] The authors concluded that these findings suggested that HPV vaccination did not provide secondary benefit in patients with previous AGWs. […] The authors concluded that this systematic review found that there is evidence that HPV vaccines may have a role in the treatment of active AGWs.

• #1

  https://www.who.int/news-room/fact-sheets/detail/cervical-cancer

  Cervical cancer is caused by persistent infection with the human papillomavirus (HPV). Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV. […] Prophylactic vaccination against HPV and screening and treatment of pre-cancer lesions are effective strategies to prevent cervical cancer and are very cost-effective. […] HPV vaccination should be given to all girls aged 9-14 years, before they become sexually active. […] Women living with HIV should be screened every 3 years starting at age 25. […] Treatment of precancers is a simple procedure and prevents cervical cancer. […] Cervical cancer can be cured if diagnosed and treated at an early stage of disease. […] Management pathways for invasive cancer care are important tools to ensure that a patient is referred promptly and supported as they navigate the steps to diagnosis and treatment decisions. […] The WHO Global strategy defines elimination as reducing the number of new cases annually to 4 or fewer per 100 000 women and sets three targets to be achieved by the year 2030 to put all countries on the pathway to elimination in the coming decades.

• #2 HPV | Human Papillomavirus | Pap Smear | MedlinePlus

  https://medlineplus.gov/hpv.html

  Human papillomavirus (HPV) is a group of related viruses. They can cause warts on different parts of your body. There are more than 200 types. About 40 of them are spread through direct sexual contact with someone who has the virus. They can also spread through other intimate, skin-to-skin contact. Some of these types can cause cancer. […] Most HPV infections go away on their own and don’t cause cancer. But sometimes the infections last longer. When a high-risk HPV infection lasts for many years, it can lead to cell changes. If these changes are not treated, they may get worse over time and become cancer. […] HPV infections are very common. Nearly all sexually active people are infected with HPV soon after they become sexually active. […] Health care providers can usually diagnose warts by looking at them.

• #2

  https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer

  Human papillomavirus (HPV) is the name of a group of 200 known viruses. They do not cause concerns in most people, but infection with some high-risk types is common and can cause genital warts or cancer. […] Persistent HPV infection with high-risk HPV types is the cause of cervical cancer and is associated with cancers of the vulva, vagina, mouth/throat, penis and anus. […] Prophylactic vaccination against HPV can prevent these cancers. In addition, HPV-screening and treatment of pre-cancer lesions is an effective way to prevent cervical cancer. […] HPV usually goes away on its own without treatment. Some HPV infections cause genital warts. Others can cause abnormal cells to develop, which go on to become cancer. […] Cancers from HPV can be prevented with vaccines. […] Currently, cervical cancer is the only HPV-caused cancer for which screening tests are available. Screening tests are used to check for disease when there are no symptoms. The goal of screening for cervical cancer is to find precancerous cell changes before they become cancer and when treatment can prevent cancer from developing.

• #2 Cancers Linked with HPV | Human Papillomavirus and Cancer | American Cancer Society

  https://www.cancer.org/cancer/risk-prevention/hpv/hpv-and-cancer-info.html

  HPV (human papillomavirus) is known to cause many types of cancer in adults, including cancers of the mouth and throat, cervix, vulva, vagina, penis, and anus. More than 37,000 people get HPV-related cancers in the United States every year. […] Cervical cancer is preventable with the HPV vaccine and regular screening tests. […] Screening tests that are used include the HPV test and Pap test. The HPV test looks for an HPV infection. The Pap test looks for changes in cervical cells caused by HPV infection. […] HPV can cause cancer of the vulva. […] Most cancers of the vagina contain HPV. […] HPV can cause cancer of the penis. […] HPV can cause cancer of the anus in both men and women. […] HPV is found in many oral (mouth) and throat cancers. Most cancers found in the part of the throat behind the mouth are HPV-related.

• #2 Human Papillomavirus (HPV) | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/human-papillomavirus-hpv

  Human Papillomavirus (HPV) is a very common virus that causes genital, oral, and skin infections. The disease spreads through intimate skin-to-skin contact. People of all genders can get HPV and spread it to others without realizing they have the virus. Most people will get an HPV infection in their late teens and early 20s. […] Some types of HPV can cause cancer of the cervix, vagina, vulva, penis, anus, and back of the throat. These types of cancers are preventable with a vaccine against HPV infection. […] HPV is spread through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus, even if they dont have signs or symptoms. […] There are several things you can do to limit the spread of HPV. Get vaccinated, ideally before you become sexually active.

• #2 Pediatric human papillomavirus (HPV) – Children’s Health Adolescent Medicine

  https://www.childrens.com/specialties-services/conditions/human-papillomavirus-hpv

  In children and adolescents, if there is a concern for a wart, an examination in the office will the first step in the evaluation of this condition. […] The HPV infection is primarily spread through skin-to-skin contact. […] There are several risk factors that increase the chance of a child getting a HPV infection: Having a cut The disease can enter the blood stream through an opening in the skin (like a cut). […] Having a mother with HPV It is possible for a mother to infect her child during vaginal childbirth. […] Being sexually active Those that are sexually active have a greater risk of contracting HPV. Further, the more sexual partners you have, the more likely you are to get HPV. Being with a partner that has had multiple partners also increases your risk. […] Weakened immune system Immune systems can be weakened by HIV/AIDS, immune-suppressing medications (organ transplants) or other reasons. […] This condition can be treated with observation, with various creams or ointments to be placed on the wart, or with surgery. Your provider will help determine what is best for your child.

• #2

  https://journals.lww.com/nursing/fulltext/2003/11001/guide_to_care_for_patients__hpv___cervical_cancer.2.aspx

  Human papillomavirus (HPV) causes nearly all cases of cervical cancer. Many types of HPV can be transmitted during sexual activity. […] Although an HPV infection can’t be cured with medicine or other treatments, it may eventually clear up on its own. But a few women have an infection that doesn’t go away, increasing the risk for cervical cancer. […] If you have genital warts, your health care provider may treat them with topical medicine applied to the skin. Or, she may remove them surgically or with cryotherapy (freezing). […] The best way to prevent cervical cancer is to delay the onset of sexual activity and pregnancy, limit the number of your sexual partners, and use a condom each time you have sex. Women who have sexual relations at a young age are believed to be at a higher risk for cervical cancer.

• #2 HPV | Human Papillomavirus | Pap Smear | MedlinePlus

  https://medlineplus.gov/hpv.html

  An HPV infection itself cannot be treated. There are medicines that you can apply to a wart. If they don’t work, your health care provide could freeze, burn, or surgically remove it. […] There are treatments for the cell changes caused by infection with high-risk HPV. They include medicines that you apply to the area that is affected and various surgical procedures. […] Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading HPV. […] Vaccines can protect against several types of HPV, including some that can cause cancer. The vaccines provide the most protection when people get them before they are exposed to the virus. This means that it is best for people to get them before they become sexually active.

• #2 HPV (Human Papillomavirus) | MD Anderson Cancer Center

  https://www.mdanderson.org/prevention-screening/manage-your-risk/hpv.html

  HPV screening, including FDA-approved self-collection tests for HPV, can determine if a woman has a cervical HPV infection. […] There is no drug or treatment that can eliminate the HPV virus from the body. However, there are ways to treat HPV-related health problems like precancerous lesions and genital warts. […] Almost all cervical cancers are caused by HPV. […] Because no vaccine prevents all types of HPV that can cause cervical cancer, vaccinated women age 21 to 29 should get cervical cancer screening (Pap tests) every three years. […] Cervical cancer and other HPV-associated cancers can be prevented by getting the HPV vaccine early in life. […] HPV testing is available for women ages 25 and older. […] While screening and early treatment can prevent cervical cancer, there are no widespread screening tests for the other HPV-associated cancers, such as oropharyngeal (throat) cancer and anal cancer. […] The HPV vaccine can help the body recognize and eliminate the virus more effectively. […] The vaccine has been proven again and again to be safe and effective and long lasting.

• #2 HPV (human papillomavirus) | FDA

  https://www.fda.gov/consumers/womens-health-topics/hpv-human-papillomavirus

  FDA has approved vaccines that prevent certain diseases, including cervical cancer, caused by some types of HPV. Ask your health care provider if you should get the HPV Vaccine. […] There is no cure for the virus (HPV) itself. There are treatments for the health problems that HPV can cause, such as genital warts, cervical changes, and cervical cancer. […] All women should get regular Pap tests. The Pap test looks for cell changes caused by HPV. The test finds cell changes early so the cervix can be treated before the cells turn into cancer. This test can also find cancer in its early stages so it can be treated before it becomes too serious. It is rare to die from cervical cancer if the disease is caught early.

• #2 Human papillomavirus | Nursing in Practice

  https://www.nursinginpractice.com/clinical/womens-health/human-papillomavirus/

  One common misconception about the HPV vaccination is that girls and women who have received the HPV vaccination are no longer at risk of developing cervical cancer. […] Currently, the vaccination in the UK primarily protects against two high-risk HPV types and two low-risk HPV types and there is evidence of some cross-protection against other types. […] Although these two high-risk types are responsible for 70% of cases of cervical cancer, they are not responsible for all cases, therefore vaccinated women will still need to be screened. […] When a woman has an abnormal screening (cytology/smear test) result, she will be referred to colposcopy for assessment and if necessary, treatment in order to prevent the cervical abnormalities progressing into cancer. […] More recently, HPV testing has been introduced alongside cervical screening.

• #2 HPV infection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596

  HPV infections cause almost all cervical cancers. But cervical cancer may take 20 years or longer to develop after an HPV infection. The HPV infection and early cervical cancer typically don’t cause symptoms. Getting vaccinated against HPV infection is the best way to protect against cervical cancer. […] If you or your child has any warts that cause embarrassment, discomfort or pain, seek advice from your healthcare professional. […] Lower the risk of getting genital warts and other HPV-related genital sores by: Having only one sex partner who’s not having sex with anyone else. This is a monogamous relationship. Using a latex condom during sex, which might lower the risk of HPV. […] Gardasil 9 is an HPV vaccine approved by the U.S. Food and Drug Administration and can be used for males and females to protect against cervical cancer and genital warts.

• #2 Human Papillomavirus Infection: Symptoms and Prevention

  https://www.healthline.com/health/human-papillomavirus-infection

  Some strains of HPV can cause cervical cancer or cancers of the vagina, anus, or throat. Regular screening can help detect the changes associated with cervical cancer in women. […] Most cases of HPV go away on their own, so theres no treatment for the infection itself. […] Routine screening for HPV and cervical cancer is important for identifying, monitoring, and treating health problems that may result from HPV infection. […] The easiest ways to prevent HPV are to use condoms and to practice safe sex. […] The CDC recommends the HPV vaccine for boys and girls ages 11 or 12. […] If genital warts are widespread, they may make a vaginal delivery difficult. […] Cervical changes can still occur during pregnancy, so you should plan to continue routine screening for cervical cancer and HPV while youre pregnant. […] Routine screening for anal, throat, or penile cancer in men isnt currently recommended.

• #2 Genital Warts: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/genital-warts/?srsltid=AfmBOopnAQJ00Wn0jDYcs1pB_W5ZJtFKemxkrv0A3cwiPNmmNRQVKWZX

  The individual is at risk of the following nursing diagnosis related to genital warts: […] The individual may feel stigmatized due to the diagnosis of genital warts. This can lead to emotional and psychological distress and can have a negative impact on the quality of life, interpersonal, and sexual relationships. […] Interventions should include measures to increase comfort and decrease spreading of warts: […] The individual should be educated on preventive measures including:

• #2 Human Papillomavirus (HPV): Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.human-papillomavirus-hpv-care-instructions.uh3113

  The human papillomavirus (HPV) is a very common virus. […] Many people who have HPV don’t know that they’re infected. […] If an HPV screening test finds that you have a type of HPV that might lead to cancer, your doctor may suggest more tests. […] Follow-up care is a key part of your treatment and safety. […] Use a condom every time you have sex. […] Be sure to tell your sexual partner or partners that you have HPV. […] Don’t smoke. Smoking increases the risk for cervical problems and cervical cancer. […] Watch closely for changes in your health, and be sure to contact your doctor if you have vaginal pain during or after sex. […] You have vaginal bleeding when you are not in your menstrual period.

• #2 Human papilloma virus (HPV) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/causes-and-risk-factors/hpv

  Finding out you are affected by high-risk HPV can be stressful and difficult to cope with. […] You may feel frustrated that there is no treatment to get rid of the infection. Or angry if it has caused cancer. Some people feel ashamed or embarrassed because HPV infection is related to sex. […] There are no treatments to get rid of HPV infection. In most people, the immune system will get rid of the virus naturally.

• #2 05.01 Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI) | Free NURSING.com Courses

  https://nursing.com/lesson/05-01-nursing-care-and-pathophysiology-for-human-papilloma-virus-hpv-sti

  High recurrence rate. […] Requires annual follow-up to monitor warts. […] Considered high risk due to cancer risk. […] Frequent pap smears. […] Excisions and ablations as necessary. […] Preventable with vaccination. […] Highly contagious. […] Able to prevent spread. […] Sexually transmitted infection. […] Impairs sexual interactions. […] Affects sexual partners. […] Preventative Measures. […] Vaccinations. […] Safe sex practice. […] Once diagnosed, patients partner(s) should be screened. […] Risk of spreading to male partner is lower, but still prominent. […] Maintain annual appointments to monitor latent disease. […] HPV is spread through sexual contact. […] Its the leading cause of both genital warts and cervical cancers. […] HPV lays dormant for 1-8 months after a person is infected.

• #2 Human Papillomavirus (HPV) | The Well Project

  https://www.thewellproject.org/hiv-information/human-papillomavirus-hpv

  If you have sex, it is important to be checked regularly by your healthcare provider for signs of HPV such as genital warts, cervical cancer, and anal cancer. […] Many people living with HIV, especially those with low CD4 cell counts, may not be able to get rid of genital warts using standard treatments. […] Cervical dysplasia is more common in women living with HIV who have advanced HIV disease and low CD4 cell counts. […] Anal dysplasia is more common in women living with HIV than in HIV-negative women. […] For people living with HIV, taking HIV drugs can strengthen the immune system and help anal dysplasia become less severe. […] HPV can be very serious for people living with HIV. Since often there are no symptoms, getting regular exams from your healthcare provider is the best way to be sure that any problems are found and treated early.

• #2 Human Papillomavirus (HPV) Infection – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/hpv.htm

  HPV tests are available for detecting oncogenic types of HPV infection and are used in the context of cervical cancer screening and management or follow-up of abnormal cervical cytology or histology. Treatment is directed to the macroscopic (e.g., genital warts) or pathologic precancerous lesions caused by HPV.

• #2 HPV infection – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/diagnosis-treatment/drc-20351602

  A healthcare professional might be able to diagnose HPV infection by looking at the warts. […] If medicines don’t work, one of these methods can remove warts: […] A procedure called a colposcopy can remove HPV from the cervix. […] Precancerous lesions need to be removed. Options include freezing, called cryosurgery, and laser surgical removal. […] For HPV infection, questions to ask include: […] Don’t hesitate to ask all the questions you have about HPV infection.

• #2 Human Papillomavirus (HPV) Treatment & Management: Approach Considerations, Considerations in Specific Patient Subgroups, Pharmacologic Therapy

  https://emedicine.medscape.com/article/219110-treatment

  The goal of treatment is to remove warts and alleviate any present symptoms. The appearance of warts can cause significant psychosocial distress, and their removal can address cosmetic concerns. […] The primary goal of treatment is to eradicate or reduce symptoms. Treatment is typically reserved for visible warts. […] Common treatments involve direct lesion ablation such as surgical excision, chemical ablation, and cryotherapy. […] If substantial improvement is not seen after three physician-administered treatments or complete clearance is not achieved after six treatments, a different approach should be considered. […] Patients with genital warts are at increased risk for anogenital malignancies. HPV infection is the primary cause of cervical cancer, though most HPV-infected cervixes have a benign outcome.

• #2 HPV (Human Papillomavirus) | Infectious Diseases

  https://health.ucdavis.edu/conditions/infectious-diseases/viral-infections/human-papillomavirus

  Your provider will remove precancers so they dont progress to cancer. We may perform loop electrosurgical excision procedure (LEEP). LEEP uses an electrically charged wire loop to remove abnormal tissue from your cervix. […] You can reduce your risk of human papillomavirus and HPV-related cancers. […] Adolescents (girls and boys) should get the vaccine at age 11 or 12. Everyone through age 26 should receive the vaccine if they havent already been vaccinated. […] Women aged 21 to 29 years old should receive a Pap test every three years. Women 30 to 65 years old should have an HPV or HPV/Pap co-test every five years. […] If you are sexually active, use a condom or dental dam every time you have sex.

• #2 Human Papillomavirus (HPV) | Texas DSHS

  https://www.dshs.texas.gov/hivstd/info/hpv

  A doctor or health care provider can treat genital warts. Different treatment options are available to remove the warts. However, these treatments are just to remove the warts. They do not cure you of HPV, and the warts sometimes grow back. […] Most pregnant women with HPV do not have problems. However, active genital warts may cause problems during pregnancy or at birth. In rare cases, HPV can pass from mother to baby during childbirth. A pregnant woman should tell her doctor or health care provider if she or her sex partner(s) have ever had genital warts. Pregnant women should not get the HPV vaccine. […] Get vaccinated. Ask your health care provider and your children’s health care provider about the HPV vaccine. […] Sexually active women and women over 21 should have Pap tests as often as recommended by their health care provider. […] If you think you have genital warts, see your doctor or go to your local STD clinic. To find the clinic closest to you in Texas, visit knowmystatus.org or call 2-1-1. […] If you smoke, ask your doctor for help quitting. Smoking can increase the risk for cancers linked to HPV.

• #2 Chapter 11: Human Papillomavirus | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-11-human-papillomavirus.html

  Medical management is recommended for treatment of specific clinical manifestations of HPV-related disease (e.g., anogenital warts, precancerous lesions, or cancers). […] HPV vaccination does not eliminate the need for cervical cancer screening. […] Vaccination prevents HPV infection, benefitting both the vaccinated person and their future sex partners by preventing spread of HPV. […] HPV vaccination is recommended for females and males at age 11 or 12 years for prevention of HPV infections and HPV-associated diseases, including certain cancers. […] HPV vaccines are administered as a 2- or 3-dose series, depending on age at initiation and medical conditions. […] HPV vaccine is highly immunogenic. […] HPV vaccine is generally well-tolerated. […] HPV vaccines should be maintained at refrigerator temperature between 2C and 8C (36F and 46F). […] HPV infection is not a nationally notifiable condition.

• #2 GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) for Health Care Professionals

  https://www.merckvaccines.com/gardasil9/

  GARDASIL 9 is a vaccine indicated in females 9 through 45 years of age for the prevention of cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by human papillomavirus (HPV) Types 16, 18, 31, 33, 45, 52, and 58; cervical, vulvar, vaginal, and anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11. […] GARDASIL 9 is indicated in males 9 through 45 years of age for the prevention of anal, oropharyngeal and other head and neck cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58; anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11. […] The oropharyngeal and head and neck cancer indication is approved under accelerated approval based on effectiveness in preventing HPV-related anogenital disease. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial.

• #2 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  Individuals with cutaneous warts have numerous treatment options available, including surgical removal, cryotherapy (freezing the infected tissue), irritant or immunomodulating medications, and laser removal. […] To prevent lower anogenital tract HPV infection by the most common high-risk and low-risk subtypes, the CDC recommends that boys and girls be vaccinated for HPV starting at ages 11 to 12. […] Anogenital and oropharyngeal warts may be treated similarly to cutaneous warts as long as the patient is immunocompetent. […] Cervical HPV-driven lesions may regress without any intervention. […] Young immunocompetent women with dysplasia are usually monitored at shortened intervals through Pap smears, HPV testing, and colposcopic examination. […] Both surgical procedures (LEEP, CKC) involve resection of the cervical os and transformation zone.

• #2 Human papillomavirus (HPV) vaccines: Canadian Immunization Guide – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-9-human-papillomavirus-vaccine.html

  When recommended to receive HPV vaccine, individuals who are considered immunocompromised and/or living with HIV should receive a 3-dose schedule of 9vHPV vaccine. […] HPV vaccination prior to exposure to HPV is recommended to maximize the benefit of the vaccine. […] HPV vaccination after the onset of sexual activity is beneficial because the vaccine recipient is very unlikely to be infected with all HPV types in the vaccine. […] The 9vHPV vaccine can be offered in pregnancy, as pregnant women and pregnant individuals who are unvaccinated against HPV remain at risk of HPV infection and HPV-related morbidity during their pregnancy. […] Immunization with a 3-dose schedule of the 9vHPV vaccine is recommended for immunocompromised individuals including individuals living with HIV. […] HPV vaccine is contraindicated in persons with a history of anaphylaxis after previous administration of the vaccine and in persons with proven immediate or anaphylactic hypersensitivity to any component of the vaccine or its container.

• #2 logo–sylvester

  https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/treatments-and-services/human-papillomavirus-(hpv)

  HPV vaccination is not generally recommended for those older than age 26 because the majority of people have been exposed to the virus by this age. Based on a patients unique risk factors, doctors may recommend that some adults get vaccinated by age 45. […] Pap smear tests are the first line of detection for abnormal (and pre-cancerous) cells in the cervix. Its highly recommended that females (including CIS females and transgender males with a cervix) get a pap smear every three years (or every five years in combination with HPV tests). […] There is currently no screening test available for HPV in men and teenage boys. When genital warts are present on the penis or groin, they may be tested for HPV DNA. […] Nearly all sexually active people are exposed to HPV at some point in their lifetime. The majority of those who are unvaccinated for the virus get infected. Consistently using a condom or dental dam can reduce the chances of getting HPV from partners, even in sexually monogamous relationships. […] When warts caused by HPV are present, they can be removed by a doctor or treated with medications. This can lower the chance of spreading the virus to others, but some risk of transmission remains even when warts arent visible. There is no cure for HPV infection.

• #2 Human Papillomavirus (HPV) Vaccine – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/human-papillomavirus-hpv-vaccine

  The HPV vaccine can be given from 9 years of age and vaccination is recommended for everyone up to age 26, depending on the vaccination schedule in each country. […] Immunocompromised persons, including those with HIV, should receive three doses if possible, and if not, at least two (at an interval of 6 months). […] Getting the HPV vaccine between the ages of 9 and 14 has been shown to be most effective at protecting girls’ health, before they become sexually active and encounter the virus. […] The HPV vaccine is also recommended for boys and can be administered according to the vaccination schedule in each country. […] The HPV vaccine cannot treat or cure existing HPV infections. However, girls who are already sexually active should get the vaccine if they are within the recommended age group. […] All women ages 30 to 49 should be screened by a high-precision test for cervical cancer at least once.

• #2 The Human Papillomavirus (HPV) Vaccine

  https://www.health.ny.gov/diseases/communicable/human_papillomavirus/

  The vaccine is given as a series of two (2) or three (3) shots, depending on when it is started. […] Yes. The HPV vaccine has been administered since 2006 in the United States and even longer in other countries. Studies have shown that it is very safe. […] Common, mild side effects include redness and pain at the injection site, low-grade fever, dizziness, and nausea. […] Anyone who has ever had a life-threatening allergic reaction to any component of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine. […] HPV vaccine is not recommended for pregnant women. Women who are breastfeeding may get the vaccine. […] All private insurance plans regulated by New York State are required to cover the cost of all ACIP-recommended vaccines, including HPV vaccine, for patients through the age of 18.

• #2 Human Papillomavirus: Screening, Testing, and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p152.html

  Vaccination has been demonstrated to reduce the prevalence of vaccine-type HPV in females, anogenital warts, and precancerous cervical lesions. […] Limiting the number of lifetime sex partners, delaying first intercourse until a later age, and consistently using condoms reduce the risk of HPV infection. Smoking and alcohol cessation should be recommended to reduce the risk of HPV persistence and the development of HPV-related malignancies. Vaccination should be recommended to prevent the development of high-grade precancerous cervical lesions in women. […] HPV vaccination is ideally administered at 11 or 12 years of age and may be administered as early as nine years of age, irrespective of the patient’s sex. In immunocompetent individuals immunized before 15 years of age, a two-dose series is indicated. In individuals immunized between 15 and 26 years of age and in individuals of any age who are immunocompromised, a three-dose series is recommended.

• #2 Human Papillomavirus (HPV): Symptoms, Diagnosis and Prevention

  https://www.unitypoint.org/find-a-service/primary-care/vaccinations/human-papillomavirus-hpv-vaccine

  Women between 30 – 65 years old should have HPV testing and a Pap test once every 5 years. […] A new HPV self-sampling test was approved by the Food and Drug Administration in May 2024 for women ages 25 and up. The test screens for up to 14 types of high-risk HPV strains that can lead to cervical cancer. […] While the majority of cervical cancers are caused by HPV, two to five percent are not. […] HPV testing is not as standardized for men as it is for women. Currently, there’s no HPV test for men approved by the Federal Drug Administration (FDA). […] The Centers for Disease Control and Prevention (CDC) recommends the following HPV vaccine schedule for children: Kids between the ages of 9-14 should get the HPV vaccine. […] Men and women can receive the HPV vaccine until age 45. […] While the vaccine is most effective before you’re sexually active and exposed to HPV, it can still reduce the risk of contracting HPV for people who are already sexually active.

• #2 Human Papillomavirus (HPV) Vaccines – NCI

  https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet

  The combination of HPV vaccination and cervical screening can provide the greatest protection against cervical cancer. Also, HPV vaccination reduces the risk of developing cancers caused by HPV at sites other than the cervix. […] Yes. More than 12 years of safety monitoring show that the vaccines have caused no serious side effects. The most common problems have been brief soreness and other local symptoms at the injection site. […] ACIP recommends that people who have an HPV infection and/or an abnormal Pap test result that may indicate an HPV infection should still receive the HPV vaccine if they are in the appropriate age group (9 through 26 years) because the vaccine may protect them against high-risk HPV types that they have not yet acquired. However, these people should be told that the vaccination will not cure them of current HPV infections or treat the abnormal results of their Pap test. […] Yes. Because HPV vaccines do not protect against all HPV types that can cause cancer, women who have been vaccinated are advised to follow the same screening recommendations as unvaccinated women.

• #2 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] HPV vaccination is effective in the reduction of precancers and cancers related to HPV. Cervical precancers caused by HPV have decreased by 40% among women who have received the HPV vaccine (CDC, 2019). […] Limited knowledge of HPV vaccination has been identified as a barrier to HPV vaccination among Black mothers (Cunningham-Erves et al., 2018). […] The aim of the current study was to explore the effect of an intervention to enhance HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers.

• #2 Human Papillomavirus (HPV) Nursing CE Course | NursingCE

  https://www.nursingce.com/ceu-courses/human-papillomavirus-nursing-ce-course

  This module explores the prevalence and incidence of human papillomavirus (HPV), current guidelines, and recommendations for screenings and treatment. Healthcare professionals (HCPs) should understand the importance of HPV vaccination and the potential barriers for adolescents and young adults. […] discuss nursing care aimed at preventing and treating HPV and HPV-related cancers. […] HPV can be transmitted via skin contact during vaginal, anal, and oral sexual intercourse. […] Preventing HPV-related cervical cancer can also occur through annual pap smears for women. […] HPV vaccination, which has been available since 2006, has been widely successful in decreasing HPV rates and creating herd immunity. […] Nurses can educate individuals on condom usage in outpatient settings, including schools, pediatric offices, and obstetrics/gynecology clinics.

• #2 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  The HPV vaccination education content focused on how well the vaccine works, the safety of the vaccine, and the benefits of the vaccine. […] The findings from the current study indicate that nurses could play a significant role in providing quantitative and randomized controlled trials that focus on HPV vaccine education interventions to enhance vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] The current study described the efficacy of an intervention to improve vaccination confidence, attitudes, and beliefs toward HPV vaccination among non-Hispanic Black mothers. […] Future studies should focus on the effect of HPV vaccination education interventions on HPV vaccine uptake among this high-risk population.

• #2 Human papillomavirus | Nursing in Practice

  https://www.nursinginpractice.com/clinical/womens-health/human-papillomavirus/

  Women need to attend screening to benefit from this. […] As research has shown, practice nurses are a key source of both information and advice for patients about HPV infection, vaccination and testing. […] Primary care nurses have a key role to play in combatting these misunderstandings. […] To conclude, HPV is an extremely common sexually transmitted virus, which has the potential to induce malignant change in those cases where high-risk infection persists. […] There is a lack of knowledge about the virus in the general population and primary care nurses have an important role to play in educating and supporting patients around this issues.

• #2 Nursing Care Plan For Warts – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-warts/

  Nursing interventions and care plans can be developed based on these diagnoses to provide holistic care and support for individuals dealing with warts. […] Provide information on the human papillomavirus (HPV), its modes of transmission, and methods to reduce the risk of HPV infection. […] This care plan emphasizes the significance of patient education surrounding the human papillomavirus (HPV), vaccination, and safe practices to minimize the risk of infection and recurrence.

• #2

  https://www.who.int/news-room/fact-sheets/detail/cervical-cancer

  Cervical cancer is caused by persistent infection with the human papillomavirus (HPV). Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV. […] Prophylactic vaccination against HPV and screening and treatment of pre-cancer lesions are effective strategies to prevent cervical cancer and are very cost-effective. […] HPV vaccination should be given to all girls aged 9-14 years, before they become sexually active. […] Women living with HIV should be screened every 3 years starting at age 25. […] Treatment of precancers is a simple procedure and prevents cervical cancer. […] Cervical cancer can be cured if diagnosed and treated at an early stage of disease. […] Management pathways for invasive cancer care are important tools to ensure that a patient is referred promptly and supported as they navigate the steps to diagnosis and treatment decisions. […] The WHO Global strategy defines elimination as reducing the number of new cases annually to 4 or fewer per 100 000 women and sets three targets to be achieved by the year 2030 to put all countries on the pathway to elimination in the coming decades.

• #2 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] The HPV vaccine is now licensed in the United States for women and men through age 45 years. […] For some women aged 2745 years who are previously unvaccinated, obstetriciangynecologists and other health care professionals may use shared clinical decision making regarding the HPV vaccination, considering the patients risk for acquisition of a new HPV infection and whether the HPV vaccine may provide benefit. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. Studies have shown that physicians recommendations have the strongest influence in the acceptance of HPV vaccination by patients and parents of patients.

• #2 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  ABSTRACT: Human papillomavirus (HPV) causes significant morbidity and mortality in women and men. The HPV vaccine significantly reduces the incidence of anogenital cancer and genital warts in women and in men. Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine. […] The Advisory Committee on Immunization Practices and ACOG recommend routine human papillomavirus (HPV) vaccination for girls and boys at the target age of 1112 years (but it may be given from the age of 9 years) as part of the adolescent immunization platform. […] Obstetriciangynecologists and other health care professionals should educate parents in their decision making regarding vaccinations for their daughters and sons.

• #2 Cervical Cancer Prevention: The Role of the Nurse and Medical Care in Primary and Secondary Cancer Prevention

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004082/htm

  The World Health Organization indicates that HPV vaccination should be part of a coordinated and comprehensive strategy for the prevention of cervical cancer and other HPV-induced malignancies. […] Given the rapid increase in HPV infections after the pandemic, which reached almost 20%, it is recommended to strengthen screening for HPV and cervical cancer to limit the spread of HPV infection.

• #2 Human Papillomavirus (HPV) Information Health Care Providers | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/public-health-system-resources-and-services/immunization/hpv-information

  HPV infection can lead to oral cancers. Oropharyngeal cancer in men is rising sharply in recent years. Oral health care providers are in a great position to explain the risks of HPV and oral cancer and empower their patients ages 9 to 26 to get the HPV vaccine. […] Use this toolkit to start recommending HPV vaccine at ages 9 and 10, so it leads to higher rates of finishing the series on time at age 11-12, providing the best cancer prevention for your patients. New research reinforces the recommendation to start offering HPV vaccines at age nine. […] The HPV vaccine is routinely recommended at ages 11 and 12, but young adults through age 26 who have not been vaccinated still need to get the vaccine to protect against HPV-related cancers. […] HPV vaccine is cancer prevention. […] HPV cancers are preventable.

• #2 Cervical Cancer Prevention: The Role of the Nurse and Medical Care in Primary and Secondary Cancer Prevention

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004082/htm

  HPV is transmitted mostly by sexual contact, and infection with HPV is diagnosed mostly in sexually transmitted infections. […] The group with the highest risk of contracting cervical cancer is mainly those women who do not carry out a cervical smear, do not report to gynaecological examinations regularly and are not vaccinated against HPV. […] Proper prophylaxis and early detection of cervical cancer can significantly increase their chances for a long life at full strength and health. […] Taking prophylactic and educational actions is especially important in the gynaecology of developmental aged children. […] Vaccination against HPV reduces the risk of developing precancerous lesions in the form of cervical intraepithelial neoplasia (CIN). […] Health education should be aimed at increasing the level of awareness of the positive role of vaccination, and thus also immunization.

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