#1590 Human papilloma virus vaccination rates in kidney transplant recipients
Authors: Gürsoy Burcu , Altunoglu Alpaslan 
Published: May 2024

Abstract

Background and Aims
Kidney transplant recipients are predisposed to chronic infections and malignancies because they receive chronic immunosuppressive therapy. Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. HPV is a significant cause of cervical, vaginal, vulvar, penile, anal, and head and neck cancers in kidney transplant recipients. HPV vaccine prophylaxis has an important role in preventing HPV-related diseases in renal transplant patients, with a 70-100% rate. Vaccine prophylaxis is recommended before or after kidney transplantation. In our country, HPV vaccination in kidney transplant recipients seems to be a neglected issue. We first determined the HPV vaccination level of the transplant recipients we follow. We compared it with the current guidelines. We aimed to evaluate the adequacy of pretransplant and/or post-transplant vaccinations.

Method
Our study is a cross-sectional survey study. Between March 15 and April 15, 2023, 170 patients who applied to Ankara City Hospital Kidney Transplant outpatient clinic were included in our study. The questionnaire form structured by the researchers was applied to the patients by face-to-face interviews. The questionnaire consisted of questions about the sociodemographic characteristics of the patients, their level of knowledge about human papillomavirus vaccines and their vaccination rates. Data analysis was performed using SPSS 22, with statistical significance set at p &lt; 0.05.

Results
170 patients participated in our study. Participants were between the ages of 18-43 years. 51.8% were male and 48.2% were female. 72.9% were married and 27.1% were single. 78.8% of the patients had an income below 9,000 TL. 34.7% had high school education or higher. The most common reason for transplantation was hypertension with 30.5%. 75.9% of the patients stated that they did not know the necessity of HPV vaccine. Again, 80% of the patients stated that they did not receive information about HPV vaccine before or after transplantation. Among these, 130 patients did not want to get vaccinated, with 79 of them mentioning the cost as the reason for not getting vaccinated. Only 4.1% of the patients had received HPV vaccination before or after transplantation. More than half of those who were vaccinated (57.1%) reported having received the quadrivalent vaccine and had received two doses. It was found that the mean age of patients who received HPV vaccine (32.0 ± 6.83) was statistically significantly younger than the mean age of those who did not (47.3 ± 12.69) (p = 0.034). Those with an education level of high school and above received HPV vaccination at a significantly higher rate than those with a lower education level (p = 0.037). Similarly, in the question about the necessity of HPV vaccination and in the question about whether they received information about HPV vaccines, the rate of those with high school and above education level (32.3%) who answered yes to the question was statistically significantly higher than those with secondary school education level (13.5%) (p = 0.004).

Conclusion
Our study found that both male and female kidney transplant recipients lacked sufficient knowledge about HPV and HPV vaccines, with very low vaccination rates. We believe that the vaccine's age-specific administration in two or three doses, its high cost, and the necessity of payment have negatively affected HPV vaccination rates. HPV, causes various infections and cancers, making it crucial to raise awareness about HPV vaccines. Especially primary health care services should be used more effectively, education programs should be organized and individuals should be directed to vaccination.