Human papillomavirus vaccination in low-resource countries: lack of evidence to support vaccinating sexually active women

Vaccines against the human papillomaviruses (HPV) that cause around 70% of cervical cancer cases worldwide are highly efficacious when administered before infection with the viruses, which occurs soon after initiation of sexual activity. Despite recommendations from key public health bodies that the...

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Bibliographic Details
Published in:British journal of cancer 2012-10, Vol.107 (9), p.1445-1450
Main Authors: Tsu, V, Murray, M, Franceschi, S
Format: Article
Language:English
Subjects:
631/67/1858
631/67/2195
692/699/67/1517/1371
692/700/565/251/1567
Adolescent
Adult
Age groups
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Cancer Research
Cervical cancer
Clinical trials
Cost analysis
Cost-Benefit Analysis
Developing Countries
Drug Resistance
Epidemiology
Female
Girls
Human papillomavirus
Humans
Immunization
Industrialized nations
Infections
Infectious diseases
LDCs
Medical research
Medical sciences
Medical screening
mini-review
Minireview
Molecular Medicine
Oncology
Papillomavirus Infections - economics
Papillomavirus Infections - prevention & control
Papillomavirus Infections - virology
Papillomavirus Vaccines - administration & dosage
Papillomavirus Vaccines - economics
Public health
Sexual Behavior
Tumors
Uterine Cervical Neoplasms - economics
Uterine Cervical Neoplasms - prevention & control
Uterine Cervical Neoplasms - virology
Vaccines
Viral diseases
Womens health
Young Adult
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Description
Summary:Vaccines against the human papillomaviruses (HPV) that cause around 70% of cervical cancer cases worldwide are highly efficacious when administered before infection with the viruses, which occurs soon after initiation of sexual activity. Despite recommendations from key public health bodies that the primary target population for HPV vaccination should be young adolescent girls, numerous articles have suggested widening the target age group to include older adolescent girls and adult women. These articles cite evidence of efficacy and cost-effectiveness when making recommendations, and they rarely take into account the difficult resource-allocation issues faced by decision makers in low-income countries. Authors and sponsors of these articles are usually from high-income countries and sometimes include vaccine manufacturers. This review discusses the strengths and weaknesses of several types of evidence offered by these papers in support of vaccination of a broad age range of girls and women. It concludes that the greatest public health benefit and value for resources will come from vaccinating girls before sexual debut and exposure to HPV, particularly in low-resource areas.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.2012.404