Global human papilloma virus vaccine implementation: An update

Abstract

Human papillomavirus (HPV) infections continue to be one of the most common sexually transmitted infections worldwide. The oncogenic potential of this virus was well established in anogenital malignancies and oropharyngeal cancers. Even though a fall in cervical cancer rates has been reported worldwide, the subsequent rise in HPV-associated head and neck cancers among men and women have been reported from developed countries, necessitating the vaccination of adolescent boys as well. The objective of this narrative review is to provide an update on the current status of HPV vaccination worldwide. This will be helpful for clinicians in counseling parents and guardians as this vaccine mainly targets sexually naïve preadolescents. An electronic search of the databases was carried out to retrieve information concerning HPV vaccine implementation between July 2006 and 2017, with special emphasis on the current viewpoints, controversies and ethical issues. Globally, 74 countries have implemented the HPV vaccine in the national immunization schedule, and this vaccine is listed as an essential medicine by WHO. About 60% of the low- and lower-middle-income countries have implemented the vaccine with financial assistance from Gavi and WHO. The HPV vaccine is a safe vaccine with no serious adverse effects as per the data available from developed nations as well as low/lower middle/upper middle-income countries. However, long-term follow-up is essential to substantiate the impact of the vaccination programs in cancer prevention.

The Role of Human Papillomavirus in Cervical Cancer

“…Then it takes into account the transfer of viral particles, occurring mainly through sexual contact, and even statistics on head and neck cancer, or penis in men affected by the oncogenic HPV infection [22]. 12 years after the introduction of HPV vaccines recommended by WHO (the World Health Organization), the vaccine prophylaxis program functions in 74 countries, without confirming the occurrence of any side effects of the preparation [23]. In Poland, vaccinations against HPV are recommended, but they are not financed from the budget of the Ministry of Health.…”

Antibody persistence after a single dose of quadrivalent HPV vaccine and the effect of a dose of nonavalent vaccine given 3-8 years later – an exploratory study

“…Subsequently, 2-dose schedules were approved and are presently used in most jurisdictions which implemented an HPV vaccination program. 4,5 Reports from different countries systematically show higher vaccine uptake for the first dose when compared to the second or the third vaccine dose. [6][7][8] Although the differences per dose uptake vary in time and among jurisdictions, on average 4-7% of those who received the first dose do not return for the second dose on schedule.…”

Determinants of attitudes and beliefs toward human papillomavirus infection, cervical cancer and human papillomavirus vaccine among parents of adolescent girls in Mysore, India

“…HPV types 16 and 18 cause most cervical and anal cancers, while type 6 and 11 cause 90% of genital warts . Three vaccines are currently approved to prevent HPV infection: Gardasil, Gardasil 9 and Cervarix . All prevent infections with HPV types 16 and 18.…”

“…All prevent infections with HPV types 16 and 18. Gardasil also prevents infection with HPV types 6 and 11 and Gardasil 9 prevents infection with HPV types 6, 11, 31, 33, 45, 52 and 58 …”

“…Although studies have shown that HPV vaccines are safe and effective, research suggests that beliefs about HPV infection, cervical cancer and HPV vaccination have been a major obstacle to increasing vaccination coverage . Understanding the determinants of these beliefs would help inform current efforts to increase immunization rates .…”