Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

Levin, Carol; Minh, Hoang Van; Odaga, John; Rout, Swampa Sarit; Nguyen, Diep; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D. Scott

doi:10.2471/blt.12.113837

Cited by 71 publications

(74 citation statements)

References 18 publications

(24 reference statements)

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“…program funding to track populations for subsequent doses, especially in rural areas where the majority of the population may still reside [23,24,27,28,30]. If two doses of HPV vaccine were enough then these challenges could be reduced and the financial resources required for delivery of three doses [31] could be reprogrammed to meet additional health needs. A two-dose schedule may also facilitate easier integration of HPV vaccine with other services, such as twice-yearly deworming programs, thereby further reducing health-worker burden for vaccine delivery [23].…”

Section: Discussionmentioning

confidence: 97%

“…However, completion of all three doses can be challenging [22][23][24][25][27][28][29], with variable three-dose completion rates of 18-33% in the US [22], 48-85% in Canada [22], 61-90% in Uganda [23], 68-88% in India [23], 83-99% in Vietnam [23], and 44-77% in Australia [26], depending upon year of measurement, age, delivery strategy, and/or geographic location. The feasibility of delivering HPV vaccine is challenged by needing to administer three doses within six months [23,[27][28][29], mobilizing health workers for delivery [24], coordinating with schools for school-based immunizations [22][23][24][27][28][29][30], and financing the costs of delivery [24,31]. If fewer than three doses of HPV vaccine afforded protection, identified barriers to three-dose vaccine implementation, including costs of vaccine procurement and delivery, could be reduced.…”

Section: Introductionmentioning

confidence: 97%

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Immunogenicity of bivalent HPV vaccine among partially vaccinated young adolescent girls in Uganda

LaMontagne

Mugisha²,

Pan

et al. 2014

Vaccine

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Immunogenicity of bivalent HPV vaccine among partially vaccinated young adolescent girls in Uganda

LaMontagne

Mugisha²,

Pan

et al. 2014

Vaccine

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“…Albeit more costly, school-based delivery mechanisms achieved substantially higher coverage rates (82.6–88.9%) than delivery through integrated approaches (60.7%). No coverage estimate was provided among the population in which HPV vaccination was delivered via health facilities only (Levin et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Obel

McKenzie²,

Buenconsejo-Lum³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Objective To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

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“…The findings from the coverage, acceptability, and cost evaluations have been published elsewhere. 8,9,10,11 The objective of the feasibility study in this paper was to assess whether school-based delivery selecting girls by grade or community based-delivery through the CDP program selecting girls by age was the best strategy for HPV vaccine delivery in the Ugandan context.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of delivering HPV vaccine to girls aged 10 to 15 years in Uganda

Mugisha¹,

LaMontagne²,

Ar³

et al. 2015

Afr H. Sci.

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Background: Cervical cancer is a leading cause of mortality among women in Uganda. The availability of the human papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. The Government of Uganda conducted a demonstration project exploring the feasibility of two delivery strategies. Objective: To explore the feasibility of two HPV vaccine delivery strategies: 1) a stand-alone school-based strategy that selected girls based on their enrolment in grade 5 (known as the "grade-based" strategy; and 2) an age-based strategy that delivered the HPV vaccine based on the girls' age (10-year-olds). This strategy combined the delivery of the vaccine with the distribution of deworming medication and vitamin A through an existing Child Days Plus program. Methods: A qualitative study that explored the feasibility of the two delivery strategies from the perspective of health workers, district leaders, and staff of the Uganda National Expanded Programme on Immunization, utilizing in-depth interviews and focus group discussions. Results: Coverage data showed that more girls (88%) were vaccinated using the grade-based strategy and completed all three doses compared to those (73%) vaccinated using the age-based strategy. Health workers and teachers indicated that determining vaccination eligibility was easier by grade than by age and there were minor disruptions to health services and school programs during vaccinations, as reported by health workers and teachers using the grade-based strategy. Conclusion: HPV vaccine delivery at schools using grade eligibility was more feasible than selecting girls by age. Lessons learned in Uganda could be relevant for countries considering implementing HPV vaccinations.

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Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

Cited by 71 publications

References 18 publications

Immunogenicity of bivalent HPV vaccine among partially vaccinated young adolescent girls in Uganda

Immunogenicity of bivalent HPV vaccine among partially vaccinated young adolescent girls in Uganda

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Feasibility of delivering HPV vaccine to girls aged 10 to 15 years in Uganda

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