Esfuerzos realizados en Puerto Rico hacia la consolidación de políticas públicas para la prevención de cánceres asociados al VPH

Abstract

El propósito de este informe especial es describir cronológicamente los eventos que contribuyeron al desarrollo y aprobación de la legislación e implementación del requisito escolar de vacunación en Puerto Rico (PR), con el fin de prevenir el VPH y los cánceres asociados a este. A partir del 2010, PR inició las aprobaciones de políticas públicas con el objetivo de mejorar el registro de casos de los cánceres y la cobertura de la vacuna contra el VPH a través de los planes médicos en adolescentes de 11 a 18 años. En el 2014, los esfuerzos científicos y comunitarios lograron documentar la magnitud de las enfermedades causadas por el VPH, y desarrollar en conjunto, estrategias de prevención y promoción de la vacuna contra el VPH. En agosto de 2018, PR logró ser uno de los primeros cuatro territorios de los Estados Unidos de América en implementar la vacuna contra el VPH como requisito escolar con el fin de disminuir la incidencia de cánceres asociados al VPH en la isla. En el 2019 se garantizó por ley que todo proveedor de vacunación debe reportar al Registro de Inmunización. El caso de PR demuestra que el desarrollo de políticas públicas junto con colaboraciones entre coaliciones académicas, científicas y comunitarias, logran cambios poblacionales y resultados medibles dirigidos a la prevención de VPH. Países con una problemática de salud pública similar podrían adoptar esfuerzos similares a los presentados, y alinearlos al objetivo de la Organización Mundial de la Salud: erradicación del cáncer cervical para 2030.

Attitudes towards HPV and COVID school-entry policies among adults living in Puerto Rico

“…In our study, we found -as expected- that most participants knew about COVID vaccines. Also, participants reported a higher level of COVID vaccine knowledge than for the HPV vaccine, even though, HPV vaccines have been accessible since 2006 in the USA and PR, 6 and HPV vaccination has been a school entry requirement in PR since 2018. Thus, the impact of the COVID pandemic has led to higher public perceived knowledge and promotion of the COVID vaccine, in contrast to HPV vaccines, for which education efforts have targeted a specific age group (9 to 26 years old)—the individuals who benefit the most from the vaccine.…”

“…This law was later expanded in 2012 to include boys. 6 Most recently, on August 2018, the PR Secretary of Health added the HPV vaccine to the list of required vaccines for school entrance among children aged 11 and 12 years. 7 In the 2019–2020 academic period, the school HPV vaccine requirement was expanded to children between 11 to 14 years old and later broadened its reach in 2020–2021 to students up to 16 years of age.…”

“…Prior to and during the implementation period, the PR Department of Health, the academia, health care professionals, and community coalitions were actively promoting the HPV vaccine. 6 However, concerns about vaccine safety, violation of patient autonomy, and lack of education about HPV and vaccines were documented by the PR media before implementing the HPV school-entry requirement. 8 Despite the reluctance to the HPV vaccine by some community groups, recent analyses by this team from the PR Immunization Registry comparing the period between 2017 (a pre-policy year) to 2019 (post-policy), identified 54% increase in initial HPV vaccination among children aged 11 and 12 (58.3% in 2017 to 89.8% in 2019).…”

Human papillomavirus vaccine initiation and up-to-date vaccine coverage for adolescents after the implementation of school-entry policy in Puerto Rico

“…To address low HPV vaccination coverage rates, five states and territories/jurisdictions in the U.S. have adopted a school-entry requirement for HPV vaccine (Virginia in 2008; the District of Columbia in 2009; Rhode Island in 2015; Puerto Rico (PR) in 2018 and Hawaii in 2020) [14][15][16]. The efforts made to implement the policy in Puerto Rico and how it was enacted can be found elsewhere [17,18]. However, policies in these five states/territories are different [19].…”