Global Delivery of Human Papillomavirus Vaccines

Abstract

• School-based approaches to HPV vaccine delivery have generally been very successful in both LMICs and high-income countries.• Clinic-or office-based delivery strategies have been evaluated, with some countries showing limited success (e.g., the U.S.) and others having greater success (e.g., Denmark).• Community outreach approaches have shown some success in HPV vaccine uptake, particularly in reaching children not in school P a g e | 3

Progress in HPV vaccination in low‐ and lower‐middle‐income countries

“…In 2016 Gavi made a one‐time offer of catalytic support to 13 countries (of which seven have been approved) that “graduated” from eligibility for Gavi support prior to 2013. By and large, countries are targeting vaccinations to a younger age, frequently aged 9 or 10 years, and choosing to use primary schools as a location for vaccination given that the largest proportion of the eligible population is attending school . These programs have been able to achieve levels of vaccine coverage comparable with those observed in high‐income countries—predominantly 70% or greater …”

“…A consistent learning from the past 10 years of HPV vaccine delivery in LLMICs is that poor planning negatively impacts programs. Examples of poor groundwork include not coordinating with the education sector for school‐based vaccinations; not allowing sufficient time for the planning process itself; and not adequately sensitizing national level stakeholders, community leaders, and parents of eligible girls . Confusion in the eligibility criteria and application of those criteria during vaccinations was also noted as a challenge .…”

Universal HPV Vaccination – a Global Prerogative

“…There are still a large number of LMICs with no vaccination programmes. 62 According to the Program for Appropriate Technology in Health (PATH), since 2007, more than 1,625,000 girls in LMICs have participated in HPV vaccine programmes, with 800,000 completing a full vaccine schedule. Forty-one countries (84%) reported coverage of 70% or higher; no project or programme had coverage of less than <50% (in comparison to USA's 39.7% uptake).…”

Role of HPV Vaccination in Fighting Cervical Cancer

“…While not all countries currently put HPV vaccines as their national health program. As of December 2015 globally there were an estimated 80 national HPV vaccination programs and 37 pilot programs, mostly from developed countries (28,29) . Even in a high-income country like Hong Kong(China), the high price of HPV vaccines is still a major barrier (4) .…”