{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:47:11Z","timestamp":1790189231567,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To describe human papillomavirus (HPV) vaccination practices in adolescent girls with systemic lupus erythematosus (SLE) and juvenile idiopathic arthritis (JIA) and to identify barriers to and motivators for vaccination. Methods: Cross-sectional, multicenter study on girls aged 9 to 19 years and their accompanying adults. The measurement criteria were the proportion of girls who were vaccinated against HPV, compliance with the vaccination schedule, factors associated with vaccination, and reasons for vaccination and non-vaccination through a self-administered questionnaire. Results: Seventy-one patients (16 with SLE and 55 with JIA) were included with a mean age of 13 years old (rank 11\u201318). According to parental questioning, 39% of patients were vaccinated against HPV or in progress (44% and 38% of SLE and JIA, respectively). This rate was 82% for the 22 patients \u2265 15 years of age. The vaccine was administered as often by a general practitioner (39%) as by a hospital pediatrician (also 39%). Two factors were significantly associated with vaccination: Older age (OR 53.68, 95% CI 5.85\u2013429.29, p &lt; 0.001) and previous hepatitis B vaccination (OR 4.97, 95% CI 1.03\u201324.01, p = 0.040). Recommendation of the vaccine by a health professional and fear of HPV-related diseases were the main facilitators. Lack of knowledge about the vaccine, lack of recommendation by a health professional, and fear of vaccine side effects were the main barriers. Conclusions: HPV vaccination coverage remains insufficient among patients with autoimmune disease. Education and awareness of health professionals about HPV infections are crucial elements in vaccine acceptance.<\/jats:p>","DOI":"10.3390\/jcm11144137","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T22:57:06Z","timestamp":1658098626000},"page":"4137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Human Papilloma Virus Vaccination in Patients with Rheumatic Diseases in France: A Study of Vaccination Coverage and Drivers of Vaccination"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7909-8199","authenticated-orcid":false,"given":"Emmanuelle","family":"David","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne et Pathologies Vasculaires, Hospices Civils de Lyon, H\u00f4pital Lyon Sud 165 Chemindu Grand Revoyet, 69495 Pierre-B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-3198","authenticated-orcid":false,"given":"Pascal","family":"Roy","sequence":"additional","affiliation":[{"name":"Laboratoire de Biom\u00e9trie et Biologie Evolutive, Equipe Biostatistique-Sant\u00e9, CNRS, 43 Bd du 11 Novembre 1918, CEDEX, 69622 Villeurbanne, France"},{"name":"Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, 162, Avenue Lacassagne, CEDEX 03, 69424 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-5332","authenticated-orcid":false,"given":"Alexandre","family":"Belot","sequence":"additional","affiliation":[{"name":"Reference Centre for Rare Pediatric Rheumatic Diseases RAISE, Service de N\u00e9phrologie, Rhumatologie, Dermatologie P\u00e9diatriques, H\u00f4pital Femme-M\u00e8re-Enfant, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-549X","authenticated-orcid":false,"given":"Pierre","family":"Quartier","sequence":"additional","affiliation":[{"name":"Reference Centre for Rare Pediatric Rheumatic Diseases RAISE, Service D\u2019immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatrique, H\u00f4pital Necker, APHP, Institut IMAGINE, 149 Rue de S\u00e8vres, 75015 Paris, France"},{"name":"Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE, Necker-Enfants Malades Hospital, Universit\u00e9 Paris-Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Bader Meunier","sequence":"additional","affiliation":[{"name":"Reference Centre for Rare Pediatric Rheumatic Diseases RAISE, Service D\u2019immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatrique, H\u00f4pital Necker, APHP, Institut IMAGINE, 149 Rue de S\u00e8vres, 75015 Paris, France"},{"name":"Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE, Necker-Enfants Malades Hospital, Universit\u00e9 Paris-Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence A.","family":"Aeschlimann","sequence":"additional","affiliation":[{"name":"Reference Centre for Rare Pediatric Rheumatic Diseases RAISE, Service D\u2019immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatrique, H\u00f4pital Necker, APHP, Institut IMAGINE, 149 Rue de S\u00e8vres, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Lega","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Pathologies Vasculaires, Hospices Civils de Lyon, H\u00f4pital Lyon Sud 165 Chemindu Grand Revoyet, 69495 Pierre-B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Durieu","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Pathologies Vasculaires, Hospices Civils de Lyon, H\u00f4pital Lyon Sud 165 Chemindu Grand Revoyet, 69495 Pierre-B\u00e9nite, France"},{"name":"INSERM U1290 RESHAPE, Domaine Rockefeller 8 avenue Rockefeller 69373 Lyon CEDEX 08, D\u00e9partement de Formation et de Recherche en Biologie Humaine, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Rousset-Jablonski","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Pathologies Vasculaires, Hospices Civils de Lyon, H\u00f4pital Lyon Sud 165 Chemindu Grand Revoyet, 69495 Pierre-B\u00e9nite, France"},{"name":"INSERM U1290 RESHAPE, Domaine Rockefeller 8 avenue Rockefeller 69373 Lyon CEDEX 08, D\u00e9partement de Formation et de Recherche en Biologie Humaine, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"},{"name":"Centre L\u00e9on-B\u00e9rard, 28 Prom. L\u00e9a et Napol\u00e9on Bullukian, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ajog.2012.09.007","article-title":"Human Papillomavirus: What Every Provider Should Know","volume":"208","author":"Erickson","year":"2013","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00296-012-2426-0","article-title":"Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus","volume":"33","author":"Lyrio","year":"2013","journal-title":"Rheumatol. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"v26","DOI":"10.1093\/rheumatology\/kex523","article-title":"Risk of human papillomavirus infection in women with rheumatic disease: Cervical cancer screening and prevention","volume":"57","author":"Kim","year":"2018","journal-title":"Rheumatol. Oxf. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1572-0241.2007.01582.x","article-title":"Higher incidence of abnormal Pap smears in women with inflammatory bowel disease","volume":"103","author":"Kane","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s10067-010-1606-0","article-title":"Systemic lupus erythematosus, human papillomavirus infection, cervical pre-malignant and malignant lesions: A systematic review","volume":"30","author":"Santana","year":"2011","journal-title":"Clin. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1177\/0961203310372952","article-title":"Are women with lupus at higher risk of HPV infection?","volume":"19","author":"Klumb","year":"2010","journal-title":"Lupus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.autrev.2014.03.001","article-title":"Increased risk of high grade cervical squamous intraepithelial lesions in systemic lupus erythematosus: A meta-analysis of the literature","volume":"13","author":"Zard","year":"2014","journal-title":"Autoimmun. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3619","DOI":"10.1002\/art.20616","article-title":"Increased prevalence of squamous intraepithelial lesions in systemic lupus erythematosus: Association with human papillomavirus infection","volume":"50","author":"Tam","year":"2004","journal-title":"Arthritis Rheum."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s42358-019-0092-6","article-title":"Lower genital tract infections in young female juvenile idiopathic arthritis patients","volume":"59","author":"Ferreira","year":"2019","journal-title":"Adv. Rheumatol. Lond. Engl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/acr.20367","article-title":"Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: A prospective cohort study","volume":"63","author":"Tam","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1002\/art.21029","article-title":"An international cohort study of cancer in systemic lupus erythematosus","volume":"52","author":"Bernatsky","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1177\/0961203313497118","article-title":"Cancer complicating systemic lupus erythematosus\u2014A dichotomy emerging from a nested case-control study","volume":"22","author":"Dey","year":"2013","journal-title":"Lupus"},{"key":"ref_13","unstructured":"HCS (2014). Vaccination des Personnes Immunod\u00e9prim\u00e9es ou Aspl\u00e9niques. Recommandations Actualis\u00e9es, Haut Conseil de la Sant\u00e9 Publique."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3301","DOI":"10.1016\/j.vaccine.2018.04.056","article-title":"Long-term immunogenicity of a quadrivalent human papillomavirus vaccine in systemic lupus erythematosus","volume":"36","author":"Mok","year":"2018","journal-title":"Vaccine"},{"key":"ref_15","first-page":"443","article-title":"Regression of vaccine coverage HPV: A French exception","volume":"45","author":"Rouzier","year":"2017","journal-title":"Gynecol. Obs. Fertil. Senol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.medmal.2014.07.005","article-title":"HPV vaccination is still difficult to implement","volume":"44","author":"Gaudelus","year":"2014","journal-title":"Med. Mal. Infect."},{"key":"ref_17","unstructured":"OEC (2015). ISCED 2011 Operational Manual: Guidelines for Classifying National Education Programmes and Related Qualifications, Organisation for Economic Co-operation and Development."},{"key":"ref_18","unstructured":"Dgs, A.E., Dicom, J.M., Dgs, A.M., and Dicom, J. (2019, May 04). Le Calendrier Vaccinal. Minist\u00e8re Solidar Sant\u00e9. Available online: https:\/\/solidarites-sante.gouv.fr\/prevention-en-sante\/preserver-sa-sante\/vaccination\/calendrier-vaccinal."},{"key":"ref_19","unstructured":"(2021, December 14). Donn\u00e9es de Couverture Vaccinale Papillomavirus Humains (HPV) Par Groupe d\u2019\u00e2ge n.d. Available online: https:\/\/www.santepubliquefrance.fr\/determinants-de-sante\/vaccination\/donnees-de-couverture-vaccinale-papillomavirus-humains-hpv-par-groupe-d-age."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/RHU.0000000000000866","article-title":"Lack of Uptake of Prophylactic Human Papilloma Virus Vaccine Among Women With Systemic Lupus Erythematosus Seen at a Regional Medical Center","volume":"25","author":"Dhar","year":"2018","journal-title":"J. Clin. Rheumatol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Feldman, C.H., Hiraki, L.T., Lii, H., Seeger, J.D., and Kim, S.C. (2015). Human Papillomavirus Vaccine Uptake among Individuals with Systemic Inflammatory Diseases. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0117620"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1093\/rheumatology\/key120","article-title":"Vaccination coverage in systemic lupus erythematosus\u2014A cross-sectional analysis of the German long-term study (LuLa cohort)","volume":"57","author":"Chehab","year":"2018","journal-title":"Rheumatology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1093\/rheumatology\/kes175","article-title":"Vaccination coverage in children with juvenile idiopathic arthritis followed at a paediatric tertiary care centre","volume":"51","author":"Morin","year":"2012","journal-title":"Rheumatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"R84","DOI":"10.1186\/ar3011","article-title":"Provision of preventive health care in systemic lupus erythematosus: Data from a large observational cohort study","volume":"2","author":"Yazdany","year":"2010","journal-title":"Arthritis Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4707","DOI":"10.1016\/j.vaccine.2017.07.042","article-title":"Chronically ill adolescents are also incompletely vaccinated: A cross-sectional study in France","volume":"35","author":"Legrand","year":"2017","journal-title":"Vaccine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1590\/s0004-2803.201900000-26","article-title":"Immunization Status of Patients with Inflammatory Bowel Disease","volume":"56","author":"Strasse","year":"2019","journal-title":"Arq. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.jadohealth.2008.10.143","article-title":"Vaccination coverage among U.S. adolescents, National Immunization Survey-Teen, 2006","volume":"44","author":"Jain","year":"2009","journal-title":"J. Adolesc. Health Publ. Soc. Adolesc. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5243","DOI":"10.1016\/j.vaccine.2013.08.068","article-title":"HPV vaccination among French girls and women aged 14-23 years and the relationship with their mothers\u2019 uptake of Pap smear screening: A study in general practice","volume":"31","author":"Cropet","year":"2013","journal-title":"Vaccine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8390","DOI":"10.1016\/j.vaccine.2011.08.039","article-title":"Like mother, like daughter? Mother\u2019s history of cervical cancer screening and daughter\u2019s Human Papillomavirus vaccine uptake in Flanders (Belgium)","volume":"29","author":"Lefevere","year":"2011","journal-title":"Vaccine"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Haesebaert, J., Lutringer-Magnin, D., Kalecinski, J., Barone, G., Jacquard, A.-C., Leocmach, Y., R\u00e9gnier, Y., Vanhems, Y., Chauvin, F., and Lasset, C. (2014). Disparities of perceptions and practices related to cervical cancer prevention and the acceptability of HPV vaccination according to educational level in a French cross-sectional survey of 18-65 years old women. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0109320"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1080\/21645515.2020.1847583","article-title":"Factors associated with HPV vaccination initiation among United States college students","volume":"17","author":"McLendon","year":"2021","journal-title":"Hum. Vaccines. Immunother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.vaccine.2009.12.063","article-title":"Predictors of HPV vaccine uptake among women aged 19-26: Importance of a physician\u2019s recommendation","volume":"29","author":"Rosenthal","year":"2011","journal-title":"Vaccine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.jpag.2012.05.004","article-title":"Human papillomavirus vaccination in female pediatric cancer survivors","volume":"25","author":"Hoffman","year":"2012","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1158\/1940-6207.CAPR-13-0127","article-title":"Risk factors for non-initiation of the human papillomavirus vaccine among adolescent survivors of childhood cancer","volume":"6","author":"Klosky","year":"2013","journal-title":"Cancer. Prev. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jpag.2016.08.005","article-title":"Human Papillomavirus Vaccination of Adolescents with Chronic Medical Conditions: A National Survey of Pediatric Subspecialists","volume":"30","author":"Hofstetter","year":"2017","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1586\/14760584.2014.930346","article-title":"Should we target patients with autoimmune diseases for HPV vaccine uptake?","volume":"13","author":"Feldman","year":"2014","journal-title":"Expert Rev. Vaccines"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1136\/archdischild-2017-313887","article-title":"HPV vaccination rate in French adolescent girls: An example of vaccine distrust","volume":"103","author":"Schrimpf","year":"2018","journal-title":"Arch. Dis. Child."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1001\/jamapediatrics.2013.2752","article-title":"Barriers to human papillomavirus vaccination among US adolescents: A systematic review of the literature","volume":"168","author":"Holman","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7027","DOI":"10.1016\/j.vaccine.2012.09.066","article-title":"A qualitative study investigating knowledge and attitudes regarding human papillomavirus (HPV) and the HPV vaccine among parents of immunosuppressed children","volume":"30","author":"Seale","year":"2012","journal-title":"Vaccine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jpeds.2015.10.090","article-title":"Parent and Adolescent Views on Barriers to Adolescent Preventive Health Care Utilization","volume":"169","author":"Aalsma","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.3899\/jrheum.130246","article-title":"Immunogenicity of the bivalent human papillomavirus vaccine in adolescents with juvenile systemic lupus erythematosus or juvenile dermatomyositis","volume":"40","author":"Heijstek","year":"2013","journal-title":"J. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ferrer, H.B., Trotter, C., Hickman, M., and Audrey, S. (2014). Barriers and facilitators to HPV vaccination of young women in high-income countries: A qualitative systematic review and evidence synthesis. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-700"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/14\/4137\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:52:02Z","timestamp":1760140322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/14\/4137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,16]]},"references-count":42,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["jcm11144137"],"URL":"https:\/\/doi.org\/10.3390\/jcm11144137","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,16]]}}}