HPV vaccine introduction and implementation in Low- and Middle-Income Countries

• Published in: Vaccine 2022-03, Vol.40, p.A1-A1
• Main Author: Denny, Lynette
• Format: Article
• Language: English
• Subjects: Adolescents; Age; Age groups; Cancer; Cancer screening; Cervical cancer; Cervix; Children; Children & youth; Developing Countries; Female; Girls; High income; Human papillomavirus; Humans; Immunization; Immunization Programs; Income; Medical screening; Nutrition assessment; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Regional planning; Social services; Uterine Cervical Neoplasms - prevention & control; Vaccination; Vaccines; Womens health
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2022.02.074

High-income countries are using a combination of high-quality cervical cancer screening and HPV vaccination in the drive for reduction of cervical cancer incidence and mortality. The WHO call for the Elimination of Cervical Cancer using the three-pronged approach of HPV vaccination (90% of girls immunized against HPV by age 15 years), 70% women screened with a high-quality screening test at ages 35 and 45 years and 90% of women identified with cervical disease receive treatment (90% of women with precancer treated and 90% of women with cervical cancer managed), is expected to be able to eliminate cervical cancer within a century with over 62 million cases of cervical cancer averted by 2120 [3]. Key lessons learned from the introduction of HPV vaccination programs in LMICs include the following: [1] Identification of the target age group – either using a grade-based or age-based approach to identify girls, with grade-based selection being more feasible; [2] School – based delivery strategy enables focus on adolescent children versus young children recruited to EPI programs; [3] Obtaining Political Support and this is evidenced by the African Regional Strategic Plan for Immunization which endorsed HPV vaccination by Ministers of Health in the region and aided HPV vaccination in some countries; [4] Integration of HPV vaccination with existing school health programs where they exist e.g. vision screening, deworming, nutritional assessments, which occur in the right age group for HPV vaccination; [5] Engage multiple stakeholders which range from politicians, Departments of Education, Social Services, faith-based organisations, NPOs and representatives of the communities in which HPV vaccination programs are implemented; [6] Clear and appropriate messaging about HPV vaccination needs to be developed, be culturally sensitive and enabling for parents to make choices for their children.