Human papillomavirus vaccination: Good clinical practice recommendations from the Federation of Obstetric and Gynecological Societies of India

Abstract

Human papillomavirus (HPV) vaccination offers an excellent prospect for the primary prevention of cervical cancer. The bivalent and quadrivalent vaccines are both available in India. The nonavalent vaccine is licensed but not yet available. However, there still remain controversies regarding the vaccination of older women, immunocompromised females and other special groups. To provide recommendations for HPV vaccination in India. The Federation of Obstetric and Gynecological Societies of India (FOGSI) convened an expert group on cervical cancer prevention to formulate good clinical practice recommendations (GCPR) with respect to vaccine efficacy and safety, target groups, optimal timing and dosing schedules. HPV vaccines are licensed for females aged 9–45 years in India and have been seen to be safe and effective. FOGSI recommends HPV vaccination of all girls <15 years of age as the best target group, in whom two‐doses at an interval of 6 months, extendable to 18 months, are recommended. Three‐doses are recommended in girls >15 years of age, immunocompromised persons and sexual assault survivors. Older women and women with abnormal screening results may be vaccinated with an understanding that vaccination does not protect against already acquired infections and screening has to continue. Single‐dose vaccination results are promising. Increased awareness is required to reduce vaccine hesitancy. HPV vaccination should be the priority to achieve the elimination of cervical cancer. The introduction of affordable HPV vaccines and reduced dose schedules will improve coverage.

Knowledge, attitudes, and practices among Indonesian urban communities regarding HPV infection, cervical cancer, and HPV vaccination

“…In India, the government targeted the 9–14 years old age group but is licensed to use for 9–45 years old patients with two-dose for girls <15 years and three doses for women ≥15 years, immunocompromised patients, patients catching up on vaccination, and in older age (≥26 years). India has a similar policy with Indonesia where HPV vaccine is not prioritized for males due to the restricted budget and consideration of CC burden still being higher among females [ 89 , 90 ]. Contrary, Australia has become the first country to offer the quadrivalent HPV vaccine for males aged 9–26 years within the school-based Australian National Immunisation Program for girls and boys aged 12–13 years in a 2-dose schedule [ 90 ].…”

Recommendations for the prevention, screening, diagnosis, staging, and management of cervical cancer in areas with limited resources: Report from the International Gynecological Cancer Society consensus meeting

“…For example, NCCN guidelines have been adapted to specific world regions, such as the Middle East and North Africa ( 18 ) or Asia ( 19 ), and usually within defined disease settings ( 18 ). Another option for individual countries facing resource limitation is to develop their own guidelines and consensus panels, a strategy that has been adopted, for example, in India ( 15 , 20 ). In this current work, we have taken advantage of a large number of specialists from several countries gathering for an international meeting, in order to organize a panel that could provide consensus recommendations for topics previously identified as relevant in cervical and also in vulvar cancer (data not shown here).…”

Efficacy and immunogenicity of AS04‐HPV‐16/18 vaccine in females with existing cervical HR‐HPV infection at first vaccination: A pooled analysis of four large clinical trials worldwide

“…1 Although the HPV vaccines primarily target adolescent girls before their sexual debut, 2 in recent years, catch-up vaccination to young adults is increasingly conferred worldwide. [3][4][5][6][7] Therefore, in sexually active females, demands for vaccination remain and even increase.…”