• The human papillomavirus vaccine protects against most cervical and anal cancers
• Many parents have safety concerns about having their children vaccinated against HPV
• Experts, however, emphasise that the vaccine is entirely safe

More than a decade of research has shown that the human papillomavirus (HPV) vaccine protects against a host of cancers, yet a new study finds that only half of American teens complete the multiple-shot regimen.

Why? Researchers discovered that many parents still harbour safety concerns about the vaccine, even though it guards against 90% of all cervical and anal cancers.

Using data from the 2017-2018 National Immunization Survey, researchers analysed responses from parents or caregivers of more than 82,000 U.S. teens.

“We wanted to understand the dynamics of HPV vaccination, and why HPV vaccine rates are suboptimal, despite the vaccine being in the market for over 10 years now,” explained study author Kalyani Sonawane, an assistant professor at the University of Texas Health Science Center at Houston.

Safety a main concern

Sonawane and her team concluded that 7.7 million US teens were not vaccinated against HPV in 2018.

The survey responses also revealed that more than half of the parents with unvaccinated teens had no intention of vaccinating them in the future.

“Among those who do not want to vaccinate against HPV, safety emerged as a main concern,” Sonawane said. “A lot of parents of these teenagers who had received zero doses said that the main reason they do not wish to vaccinate their child is because they have safety concerns about the vaccine.”

It is likely that the anti-vaccination movement is contributing to parent hesitancy about the HPV vaccine, according to the researchers.

They also compared the responses between different states, finding that states with the lowest rates of HPV vaccinations, such as Mississippi and Wyoming, also had high parental hesitancy rates.

Sonawane noted that these states could face a high burden of HPV-linked cancers in the future.

The HPV vaccine is a two-dose or three-dose series, depending on when a patient receives the first dose.

Partial HPV vaccination

The US Centers for Disease Control and Prevention recommends two doses of the vaccine if the first dose is given before age 15, or three doses if the series is started between ages 16 and 26.

The second dose is recommended six months to a year after the first, and only the full series ensures protection.

The researchers estimated that 2.2 million teens in the United States have only received a partial HPV vaccination.

Of those teens who only received the first dose of the vaccine, one in four parents said they did not intend to complete the series.

Many of these parents said their teens didn’t get the second dose because their healthcare providers didn’t reach out to them, the researchers found.

“The main reason that emerged among these parents was that they never received a recommendation for their teen,” explained Sonawane. “A lot of times the patients or the provider fail to follow up with the teens and say, ‘Hey, you need the second dose or third dose to complete the HPV vaccine series and to have enough immunity to prevent HPV infection in the future.'”

Most parents do vaccinate kids

Previous research has shown that a provider recommendation is the most reliable way to ensure vaccination, but this study revealed that it might not be enough.

A full six of 10 parents with an unvaccinated teen who had received a recommendation from their provider said they still would not vaccinate. The most common reason was worries about the vaccine’s safety.

The findings were published recently in The Lancet Public Health journal.

Debbie Saslow, director of HPV and gynecologic cancer at the American Cancer Society, pointed out that the study only looked at those who aren’t vaccinated.

Despite the concerns this study raises, she emphasised that many American teens are now vaccinated against HPV.

Role of Facebook

“It’s also important to look at the counterpoint, which is that most parents do vaccinate their kids against HPV,” Saslow said.

Despite the findings that some parents wouldn’t vaccinate their teens even with a provider recommendation, Saslow said the primary approach in HPV vaccine advocacy is working with providers and health systems.

“If a parent says, ‘I read on Facebook that the vaccine has this side effect,’ then the provider has the opportunity to say, ‘Actually, that’s misinformation, and let me explain to you how safe this vaccine is,'” Saslow said. “The provider is most parents’ most trusted source of information, so that’s why we’ve really focused on that.”

Sonawane and her team also stressed the importance of training providers to remind their patients to get vaccinated, and to be prepared with clear answers to debunk any vaccine safety myths.

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• A team studied the connection between neighbourhood characteristics and infection with SARS-CoV-2
• Crowded homes and poverty increased risk of infection
• How densely populated the neighbourhoods were had little effect on the spread of infection

Poverty and crowded living conditions increase the spread of the coronavirus that causes Covid-19, a new study suggests.

Researchers reached that conclusion after testing nearly 400 women who gave birth at two hospitals in New York City during the peak of the Covid-19 outbreak.

“Our study shows that neighbourhood socioeconomic status and household crowding are strongly associated with risk of infection. This may explain why Black and Hispanic people living in these neighbourhoods are disproportionately at risk for contracting the virus,” researcher Dr Alexander Melamed said in a Columbia University news release.

Melamed is an assistant professor of obstetrics and gynaecology at Columbia’s College of Physicians and Surgeons in New York City.

Specifically, Melamed’s team studied the connection between neighbourhood characteristics and infection with the virus that causes Covid-19.

Population density not a big risk

The investigators found that women living in neighbourhoods with crowded households were three times more likely to be infected with the virus.

Poverty was also a factor. Women living in poor neighbourhoods were twice as likely to be infected, although this finding didn’t reach statistical significance because of the small sample size, the researchers said.

Population density, however, didn’t play a part in the risk for infection, they noted.

According to researcher Dr Cynthia Gyamfi-Bannerman, “One may think that because New York City is so dense, there’s little that can slow the spread of the virus, but our study suggests the risk of infection is related to household, rather than urban density.” Gyamfi-Bannerman is a professor of women’s health at Columbia.

“For our pregnant patients, that may mean counselling women about the risk of infection if they are considering bringing in other family members to help during pregnancy or postpartum,” she said.

Melamed added that the findings could help public health officials target preventive measures, such as distributing masks or culturally relevant educational information, to the appropriate neighbourhoods.

The report was published online on June in the Journal of the American Medical Association.

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• Alzheimer’s disease and other forms of dementia are common in senior citizens
• Some people, however, remain sharp well into their 90s and a study wanted to find out why 
• Factors like ‘life satisfaction’ and carrying on working past retirement age seem to help to keep minds sharp 

Some people in their 90s stay sharp whether their brain harbours amyloid protein plaques – a hallmark of Alzheimer’s disease – or not, but why?

That’s the question researchers sought answers for among 100 people without dementia, average age 92, who were followed for up to 14 years. Their answer? A combination of genetic luck and a healthy, fulfilling lifestyle.

“The vast majority of research studies on ageing and Alzheimer’s disease try to understand what factors predict disease and memory impairment. We turned these questions upside-down, asking ‘What seems to protect us from disease and impairment in our 90s?'” said lead researcher Beth Snitz, an associate professor of neurology at the University of Pittsburgh.

“Understanding this kind of resilience may well help identify ways to prevent dementia,” Snitz added.

Mutation linked to lower plaque

The study reinforces some things scientists already knew, such as the importance of good cardiovascular health and building up a “cognitive [mental] reserve. These likely can help buffer against the effects of brain disease or injury later in life,” she said.

Her team also found that people whose scores were normal on thinking and memory tests when the study began were less likely to have problems with their thinking skills, even if they had amyloid protein plaques in their brains (which have been linked to Alzheimer’s disease).

The researchers also found that those with the APOE2 gene mutation, which has been tied to a lower risk of Alzheimer’s disease, were less likely to develop amyloid plaques than people who did not have this gene variant.

In fact, the APOE2 mutation was linked with a six times lower risk of developing plaques, the findings showed.

This mutation, however, is rare, occurring in only 10% of the people in the study. Among those with the mutation, 70% didn’t develop plaques, the study authors noted.

Higher pulse pressure

Some lifestyle factors also affected brain ageing. For example, those who never smoked were over 10 times more likely to keep their thinking skills, even with plaques, than smokers.

Also, high pulse pressure was linked with an increase in plaques. Pulse pressure is the systolic blood pressure (the top number in a blood pressure reading) minus the diastolic pressure (bottom number). Pulse pressure gets higher with age and is a sign of ageing of the blood vessels.

The benefits of APOE2 alleles are well known, as is the link between smoking and poor cardiovascular health, said Dr Sam Gandy, associate director of the Mount Sinai Alzheimer’s Disease Research Center at the Icahn School of Medicine at Mount Sinai in New York City.

Also, the link between poor cardiovascular health and dementia is well-known.

“The pulse pressure story here has emerged lately, as has the apparent risk of overaggressive lowering of the blood pressure in chronic hypertensives [those with chronic high blood pressure], and an apparent association between dementia risk and erratic blood pressure,” he said.

Other studies have found a benefit from exercise in preventing dementia, but this study didn’t look at exercise, Snitz said. They also didn’t look at the effect of maintaining an active social life or mental activities, such as reading, on preventing dementia, she said.

Life satisfaction protective

The investigators did find, however, that having a paying job in your 70s was protective against later memory decline.

“Other studies have shown that continuing to work – or perhaps to keep one’s mind engaged – past conventional retirement age may be cognitively protective,” Snitz said.

“We also found that ‘life satisfaction’ in the 70s was protective against later cognitive decline in the 80s and 90s,” she added.

The report was published online in the journal Neurology.

Maria Corrada, a professor of epidemiology at the Institute for Memory Impairments and Neurological Disorders at the University of California, Irvine, said, “Some of the characteristics found to be related to resistance and resilience to Alzheimer’s pathology can be changed or modified – pulse pressure, smoking, paid work and life satisfaction.”

Achieving these goals may be a way to be resistant or resilient to brain abnormalities associated with Alzheimer’s disease, said Corrada, who co-authored an accompanying journal editorial.

“We believe that there are things we can do with our lifestyle that can help us maintain good cognitive health,” she said.

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• Traditional beliefs associate eating meat with high testosterone levels in men
• Now new research has shown that a largely vegetarian diet makes no difference to testosterone levels
• Researchers, however, emphasise that we need to distinguish between healthy and unhealthy plant-based diets

Images of burly cavemen bringing home meat may have men thinking that steaks and burgers are key to masculinity.

It’s just not true: New research shows that testosterone levels in men who eat vegetable-heavy diets are similar to those in men who wolf down meat.

“We found that a plant-based diet was associated with normal testosterone levels, levels that are the same as occur in men who eat a traditional diet that includes more meat,” said study co-author Dr Ranjith Ramasamy, director of reproductive urology at the University of Miami Health System.

“The old idea that men needed to consume a traditional diet with plenty of meat to have a healthy testosterone level was based on pure conjecture, not based on evidence,” he said in a university news release.

All plant foods aren’t healthy

Ramasamy and his colleagues analysed federal survey data from 191 men, ages 18 to 75. That data included both blood testosterone levels and details of each man’s diet.

Unlike most previous studies, the researchers said they distinguished between healthy and unhealthy plant-based diets.

“You can eat a lot of soda, chips and juice, which are plant foods but aren’t healthy foods,” said study co-author Manish Kuchakulla, a medical student at Miami’s Miller School of Medicine.

Testosterone levels below 300 nanograms per deciliter were considered a deficiency, as per American Urological Association guidelines.

According to the findings, the participants’ diets ended up having little effect on testosterone levels.

Smaller carbon footprint

“Whether a man ate a traditional diet with lots of animal foods, a healthy plant-based diet, or a less healthy plant-based diet simply did not matter. We found no differences,” Kuchakulla said in the release.

Plant-based diets reduce the risks of many health problems, including high blood pressure, heart disease, heart attack, stroke, and many cancers, the researchers noted.

Research has also found that plant-based diets carry a much smaller carbon footprint compared to diets with meat, helping to reduce global warming.

The findings were published recently in the World Journal of Urology.

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