Improving human papilloma virus vaccination rates in developing economies. (original) (raw)
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Assessment of eight HPV vaccination programs implemented in lowest income countries
BMC Public Health, 2012
Background: Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP).
Overcoming barriers in HPV vaccination and screening programs
Papillomavirus Research, 2017
The Human Papillomavirus Prevention and Control Board brought together experts to discuss optimizing HPV vaccination and screening programs. Board members reviewed the safety profile of licensed HPV vaccines based on clinical and post-marketing data, reaching a consensus that current safety data is reassuring. Successful vaccination programs used well-coordinated communication campaigns, integrating (social) media to spread awareness. Communication of evidence supporting vaccine effectiveness had beneficial effects on the perception of the vaccine. However, anti-vaccination campaigns have threatened existing programs in many countries. Measurement and monitoring of HPV vaccine confidence over time could help understand the nature and scale of waning confidence, define issues and intervene appropriately using context-specific evidence-based strategies. Finally, a broad group of stakeholders, such as teachers, health care providers and the media should also be provided with accurate information and training to help support prevention efforts through enhanced understanding of the risks and benefits of vaccination. Similarly, while cervical cancer screening through population-based programs is highly effective, barriers to screening exist: awareness in countries with population-based screening programs, access for vulnerable populations, and access and affordability in low-and middle-income countries. Integration of primary and secondary prevention has the potential to accelerate the decrease in cervical cancer incidence.
Progress in HPV vaccination in low- and lower-middle-income countries
International Journal of Gynecology & Obstetrics, 2017
The past 10years have seen remarkable progress in the global scale-up of human papillomavirus(HPV)vaccinations.Forty-threelow-andlower-middle-incomecountries(LLMICs)havegainedexperienceindeliveringthisvaccinetoyoungadolescent girlsthroughpilotprograms,demonstrationprograms,andnationalintroductionsand mostofthesehaveoccurredinthelast4years.TheexperienceofSenegalissummarizedasanillustrativecountrycasestudy.Publicationofnumerousdeliveryexperi-encesandlessonslearnedhasdemonstratedtheacceptabilityandfeasibilityofHPV vaccinationsinLLMICs.Fourareasrequirededicatedactiontoovercomeremaining challengestonationalscaling-up:maintainingmomentumpolitically,planningsuccessfully,securingfinancing,andfosteringsustainability.Advancesinpolicy,programming, andsciencemayhelpacceleratereaching30milliongirlsinLLMICswithHPVvaccine by 2020.
Introduction: Since 2007, HPV vaccine has been available to low and middle income countries (LAMIC) for smallscale 'demonstration projects', or national programmes. We analysed coverage achieved in HPV vaccine demonstration projects and national programmes that had completed at least 6 months of implementation between January 2007-2016. Methods: A mapping exercise identified 45 LAMICs with HPV vaccine delivery experience. Estimates of coverage and factors influencing coverage were obtained from 56 key informant interviews, a systematic published literature search of 5 databases that identified 61 relevant full texts and 188 solicited unpublished documents, including coverage surveys. Coverage achievements were analysed descriptively against country or project/ programme characteristics. Heterogeneity in data, funder requirements, and project/programme design precluded multivariate analysis. Results: Estimates of uptake, schedule completion rates and/or final dose coverage were available from 41 of 45 LAMICs included in the study. Only 17 estimates from 13 countries were from coverage surveys, most were administrative data. Final dose coverage estimates were all over 50% with most between 70% and 90%, and showed no trend over time. The majority of delivery strategies included schools as a vaccination venue. In countries with school enrolment rates below 90%, inclusion of strategies to reach out-of-school girls contributed to obtaining high coverage compared to school-only strategies. There was no correlation between final dose coverage and estimated recurrent financial costs of delivery from cost analyses. Coverage achieved during joint delivery of HPV vaccine combined with another intervention was variable with little/no evaluation of the correlates of success. Conclusions: This is the most comprehensive descriptive analysis of HPV vaccine coverage in LAMICs to date. It is possible to deliver HPV vaccine with excellent coverage in LAMICs. Further good quality data are needed from health facility based delivery strategies and national programmes to aid policymakers to effectively and sustainably scale-up HPV vaccination.
A Systematic Review of Interventions to promote HPV Vaccination Globally
Research Square (Research Square), 2022
Background Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is subomptimal in the United States (U.S.). Previous research have found a variety of intervention strategies (environmental and behavioral) in increasing its uptake. The purpose of the study is to systematically review the literature for interventions to promote HPV vaccination from 2015 to 2020. Methods We updated a systemative review of interventions to promote HPV vaccine uptake globally. We ran key word searches in six bibliographic databases. Audiences, design, level of intervention, components and outcomes were abstracted from the fulltext articles in Excel databases. Results Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed a single level (76.3%). Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twentyseven (33.8%) reported the use of theory in intervention development. Of those reporting HPV vaccine outcomes, postintervention vaccine initiation ranged from 5-99.2%, while series completion ranged from 6.8-93.0%. Facilitators to implementation were use of patient navigators and user-friendly resources, while barriers included costs, time to implement and di culties of integrating interventions into organizational work ow. Conclusions There is a strong need to expand implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults.
Feasibility of HPV vaccination program implementation: A qualitative study
Journal of Community Empowerment for Health, 2022
The implementation of the Human Papillomavirus (HPV) vaccination program is still experiencing obstacles in several developing countries. This setback is related to the lack of knowledge and the high cost of the vaccine so that it affects people's behavior about the HPV vaccine. HPV vaccination in adolescents itself as primary prevention has not been widely conducted by adolescents in Indonesia. The results of previous studies showed that not many teenagers had vaccinated against HPV by using self-financing guarantees such as health savings. The obstacles faced in implementing HPV vaccination are that the vaccine is still expensive and there is lack of knowledge of parents and adolescents about the importance of HPV immunization. This formative research using qualitative methods was conducted to analyze the implementation plan of the HPV vaccination program. Data were collected through focus group discussions (FGD) and in-depth interviews. At the end of each FGD activity or interview, transcription and thematic analysis based on content were done. The FGD participants were ten teachers, while the in-depth interview participants were one school committee. This study found two main themes, namely the scheme of implementing the HPV vaccination program and obstacles to the implementation of HPV vaccination. Schools generally supported the program implementation. However, parents still question the importance of the HPV vaccination for their daughters and consider the vaccine costs expensive. Implementation of the HPV vaccination program must consider the existing program schemes in schools and possible obstacles. The results suggested that for the next HPV vaccination program, the facilitators should provide intense and relevant education to parents about the importance and side effects of HPV immunization, and are expected to build a willingness of parents to vaccinate their daughters and seek vaccination costs, one of which can be through a savings program.
The role of the human papillomavirus (HPV) vaccine in developing countries
International Journal of Dermatology, 2010
Cervical cancer is a preventable health problem, yet is the second most common cancer of women worldwide. More than 80% of cases occur in developing countries, and this is expected to increase to 90% by the year 2020. The five-year survival rate of patients in developing countries is less than 50%, compared to 66% in developed nations. A worldwide HPV vaccine program would significantly reduce the spread of HPV 16 and 18 and lower the incidence of cervical cancer. Mathematical models have determined that vaccinating 66% of the population will decrease the incidence of cervical cancer by 80% over the next 40-60 years. For every five-year delay in a cervical cancer prevention/ detection program, there will be an additional 1.5-2.0 million deaths. The introduction of a vaccination program will be a challenge due to high costs, unknown durability of the vaccine, and the potential for new oncogenic strains to emerge. A global effort will be required to eliminate cervical cancer from developing counties.
Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries
PloS one, 2017
To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery fo...
Human Papilloma Virus and Vaccination in the Andean Region
This book chapter presents human papillomavirus (HPV) and HPV-attributable disease epidemiology, attitudes towards HPV and HPV-attributable diseases, as well as successful school-based and combined clinic-and school-based HPV vaccination programs, in the Latin American Andean region. Despite only 16% of incident cervical cancer cases occurring in the Latin American Countries (LAC) of the Caribbean, Central and South America, LAC have a 38% cervical cancer mortality. School-based HPV vaccination programs in LMIC have achieved herd-immunity sustaining 3-dose vaccination rates greater than 80%. However, 2-dose HPV vaccination programs for under 15-years-old should be more cost effective than 3-dose HPV vaccination programs, while also satisfying WHO vaccination program requirements. Irrespective of affordability, HPV vaccination acceptance is needed for successful HPV vaccination programs. Lack of HPV knowledge and HPV vaccination misinformation provide a basis upon which targeted HPV awareness and preventive health media campaigns can be developed. Optimally, media campaigns should use the internet, radio, and television to address health care providers, parents, and students. Clinics may use additional counseling materials in-house with their clients. Ministries of Education, Finance, and Health cosponsoring HPV vaccination programs can increase national HPV, HPV-related diseases, and HPV vaccination awareness.