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experience of implementing HPV vaccination

Yung-Taek Ouh, Jae Kwan Lee
Eradication of cervical cancer involves the expansion of human papillomavirus (HPV) vaccine coverage and the development of efficient screening guidelines that take vaccination into account. In Korea, the HPV National Immunization Program was launched in 2016 and is expected to shift the prevalence of HPV genotypes in the country, among other effects. The experiences of another countries that implement national immunization programs should be applied to Korea. If HPV vaccines spread nationwide with broader coverage, after a few decades, cervical intraepithelial lesions or invasive cancer should become a rare disease, leading to a predictable decrease in the positive predictive value of cervical screening cytology...
May 2018: Obstetrics & Gynecology Science
Karen Canfell, Marion Saville, Michael Caruana, Val Gebski, Jessica Darlington-Brown, Julia Brotherton, Stella Heley, Philip E Castle
INTRODUCTION: Australia's National Cervical Screening Program (NCSP) currently recommends 2-year cytology in women aged 18-69 years. Following a review of the NCSP prompted by the implementation of human papillomavirus (HPV) vaccination, the programme will transition in 2017 to 5-year primary HPV screening with partial genotyping for HPV16/18 in women aged 25-74 years. Compass is a sentinel experience for the renewed NCSP and the first prospectively randomised trial of primary HPV screening compared with cytology to be conducted in a population with high uptake of HPV vaccination...
January 26, 2018: BMJ Open
Katherine E Gallagher, Natasha Howard, Severin Kabakama, Sandra Mounier-Jack, Helen E D Burchett, D Scott LaMontagne, Deborah Watson-Jones
INTRODUCTION: Since 2007, HPV vaccine has been available to low and middle income countries (LAMIC) for small-scale 'demonstration projects', or national programmes. We analysed coverage achieved in HPV vaccine demonstration projects and national programmes that had completed at least 6 months of implementation between January 2007-2016. METHODS: A mapping exercise identified 45 LAMICs with HPV vaccine delivery experience. Estimates of coverage and factors influencing coverage were obtained from 56 key informant interviews, a systematic published literature search of 5 databases that identified 61 relevant full texts and 188 solicited unpublished documents, including coverage surveys...
December 2017: Papillomavirus Research
Carine Dochez, Rosemary J Burnett, Symplice Mbola Mbassi, Fred Were, Andrew Musyoki, Daisy Trovoada, M Jeffrey Mphahlele
Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility based), socio-behavioural issues, and the opportunity to deliver other health interventions alongside HPV vaccination...
December 2017: Papillomavirus Research
Natasha Howard, Katherine E Gallagher, Sandra Mounier-Jack, Helen E D Burchett, Severin Kabakama, D Scott LaMontagne, Deborah Watson-Jones
Since 2007, low and middle-income countries (LMICs) have gained experience delivering HPV vaccines through HPV vaccination pilots, demonstration projects and national programmes. This commentary summarises lessons from HPV vaccination experiences in 45 LMICs and what works for HPV vaccination introduction. Methods included a systematic literature review, unpublished document review, and key informant interviews. Data were extracted from 61 peer-reviewed articles, 11 conference abstracts, 188 technical reports, and 56 interviews, with quantitative data analysed descriptively and qualitative data analysed thematically...
December 2017: Papillomavirus Research
Siobhan Botwright, Taylor Holroyd, Shreya Nanda, Paul Bloem, Ulla K Griffiths, Anissa Sidibe, Raymond C W Hutubessy
From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool...
2017: PloS One
Lai-Yang Lee, Suzanne M Garland
We currently have the knowledge and experience to prevent much of human papillomavirus (HPV)-related disease burden globally. In many countries where prophylactic HPV vaccination programs have been adopted as highly effective public health programs with good vaccine coverage, we are already seeing, in real-world settings, reduction of vaccine-related HPV-type infections, genital warts and cervical pre-cancers with potential reductions in vulvar, vaginal and anal pre-cancers. Moreover, we are seeing a change in cervical screening paradigms, as HPV-based screening programs now have strong evidence to support their use as more sensitive ways to detect underlying cervical abnormalities, as compared with conventional cervical cytology...
2017: F1000Research
Maria Grandahl, Margareta Larsson, Tanja Tydén, Christina Stenhammar
The aim was to investigate school nurses' attitudes towards, and experiences of vaccination against human papillomavirus (HPV), and compare the results with a similar study three years earlier. School nurses (n = 736) from all counties in Sweden completed a questionnaire in spring 2016, four years after the implementation of the national HPV vaccination programme, and three years after the previous survey. Overall, the school nurses had more favourable attitudes towards the HPV vaccination programme compared to the study in 2013 (p = 0...
2017: PloS One
Collette Venturas, Kanayo Umeh
BACKGROUND: Worldwide, Zambia has the highest cervical cancer incidence rates (58.4/100,000 per year) and mortality rates (36.2/100,000 per year). The human papilloma virus (HPV) vaccine is considered a vital preventative measure against cervical cancer, particularly in sub-Saharan countries, such as Zambia. Past research suggests health professionals' experiences with HPV vaccination rollout can have practical implications for effective delivery. OBJECTIVE: To explore health professionals' perspectives on the HPV vaccination programme in Zambia...
April 4, 2017: Vaccine
Joseph E Tota, James Bentley, Jennifer Blake, François Coutlée, Máire A Duggan, Alex Ferenczy, Eduardo L Franco, Michael Fung-Kee-Fung, Walter Gotlieb, Marie-Hélène Mayrand, Meg McLachlin, Joan Murphy, Gina Ogilvie, Sam Ratnam
Since being introduced in the 1940s, cervical cytology - despite its limitations - has had unequivocal success in reducing cervical cancer burden in many countries. However, we now know that infection with human papillomavirus (HPV) is a necessary cause of cervical cancer and there is overwhelming evidence from large-scale clinical trials, feasibility studies and real-world experience that supports the introduction of molecular testing for HPV as the primary technology in cervical cancer screening (i.e., "HPV primary screening")...
May 2017: Preventive Medicine
Karin Hardt, Paolo Bonanni, Susan King, Jose Ignacio Santos, Mostafa El-Hodhod, Gregory D Zimet, Scott Preiss
Successful immunisation programmes generally result from high vaccine effectiveness and adequate uptake of vaccines. In the development of new vaccination strategies, the structure and strength of the local healthcare system is a key consideration. In high income countries, existing infrastructures are usually used, while in less developed countries, the capacity for introducing new vaccines may need to be strengthened, particularly for vaccines administered beyond early childhood, such as the measles or human papillomavirus (HPV) vaccine...
December 20, 2016: Vaccine
Joël Ladner, Marie-Hélène Besson, Etienne Audureau, Mariana Rodrigues, Joseph Saba
BACKGROUND: Cervical cancer is the greatest cause of age-weighted years of life lost in the developing world. Human papillomavirus (HPV) infection is associated with a high proportion of cervical cancers, and HPV vaccination may help to reduce the incidence of cancer. The aim of the study was to identify barriers, obstacles, and strategies and to analyze key concerns and lessons learned with respect to the implementation of HPV vaccination program in low- and middle-income countries. METHODS: The Gardasil Access Program (GAP) is a donation program established to enable organizations and institutions in eligible low-resource countries to gain operational experience designing and implementing HPV vaccination programs...
October 13, 2016: BMC Health Services Research
Obinna I Ekwunife, James F O'Mahony, Andreas Gerber Grote, Christoph Mosch, Tatjana Paeck, Stefan K Lhachimi
BACKGROUND: Low- and middle-income countries (LMICs) face a number of challenges in implementing cervical cancer prevention programmes that do not apply in high-income countries. OBJECTIVE: This review assessed how context-specific challenges of implementing cervical cancer prevention strategies in LMICs were accounted for in existing cost-effectiveness analysis (CEA) models of human papillomavirus (HPV) vaccination. METHODS: The databases of MEDLINE, EMBASE, NHS Economic Evaluation Database, EconLit, Web of Science, and the Center for the Evaluation of Value and Risk in Health (CEA) Registry were searched for studies published from 2006 to 2015...
January 2017: PharmacoEconomics
Alfredo Aguilar, Joseph A Pinto, Jhajaira Araujo, Williams Fajardo, Leny Bravo, Luis Pinillos, Carlos Vallejos
Cervical cancer is the leading malignant neoplasm in Peruvian women. This malignancy is a public health problem and several efforts were previously performed to develop cancer control plans. Geographical, cultural, structural, infrastructural and procedural barriers can limit the implementation of such strategies. Several previous studies have characterized human papilloma virus (HPV) epidemiology, where prevalence of high-risk HPV in adult females is ~12% and the prevalence in cervical cancer is 90-95%. The predominant barriers for the control of cervical cancer are lack of specialists in remote villages, education/cultural issues, loss of patients in follow-up, lack of access to HPV testing and lack of compliance for HPV vaccination...
August 2016: Molecular and Clinical Oncology
H Patel, K Austin-Smith, S M Sherman, D Tincello, E L Moss
Background: The incorporation of Human papillomavirus (HPV) testing into the English cervical screening programme has been met with fear and anxiety. Healthcare professionals need to be adequately informed about HPV to help alleviate patient concerns. The aim of this study was to evaluate the HPV training provided to practice nurses (PNs) and determine their level of HPV knowledge. Method: A web-based survey was distributed to 147 General Practice surgeries in the Leicester, Leicestershire and Rutland regions, between May and July 2015...
September 1, 2017: Journal of Public Health
N Howard, S Mounier-Jack, K E Gallagher, S Kabakama, U K Griffiths, M Feletto, D S LaMontagne, H E D Burchett, D Watson-Jones
Demonstration projects or pilots of new public health interventions aim to build learning and capacity to inform country-wide implementation. Authors examined the value of HPV vaccination demonstration projects and initial national programmes in low-income and lower-middle-income countries, including potential drawbacks and how value for national scale-up might be increased. Data from a systematic review and key informant interviews, analyzed thematically, included 55 demonstration projects and 8 national programmes implemented between 2007-2015 (89 years' experience)...
September 2016: Human Vaccines & Immunotherapeutics
S F La Vincente, D Mielnik, K Jenkins, F Bingwor, L Volavola, H Marshall, P Druavesi, F M Russell, K Lokuge, E K Mulholland
BACKGROUND: In 2008 Fiji implemented a nationwide Human Papillomavirus (HPV) vaccine campaign targeting all girls aged 9-12 years through the existing school-based immunisation program. Parents of vaccine-eligible girls were asked to provide written consent for vaccination. The purpose of this study was to describe parents' knowledge, experiences and satisfaction with the campaign, the extent to which information needs for vaccine decision-making were met, and what factors were associated with vaccine consent...
2015: BMC Public Health
Riccardo A Audisio, Giancarlo Icardi, Andrea M Isidori, Carlo A Liverani, Alberto Lombardi, Luciano Mariani, Francesco Saverio Mennini, David A Mitchell, Andrea Peracino, Sergio Pecorelli, Giovanni Rezza, Carlo Signorelli, Giovanni Vitali Rosati, Gian Vincenzo Zuccotti
BACKGROUND: The story of Human Papillomavirus vaccination demands reflection not only for its public health impact on the prophylactic management of HPV disease, but also for its relevant economic and social outcomes. Greater than ever data confirm the efficacy and support the urge for effective vaccination plans for both genders before sexual debut. METHODS: A review of previous experience in gender-restricted vaccination programs has demonstrated a lower effectiveness...
January 2016: Critical Reviews in Oncology/hematology
Celina M Hanson, Linda Eckert, Paul Bloem, Tania Cernuschi
Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV) vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction...
May 20, 2015: Vaccines
Hanna Seitz, Lis Ribeiro-Müller, Elena Canali, Angelo Bolchi, Massimo Tommasino, Simone Ottonello, Martin Müller
Current prophylactic virus-like particle (VLP) human papillomavirus (HPV) vaccines are based on the L1 major capsid protein and provide robust but virus type-restricted protection. Moreover, VLP vaccines have a high production cost, require cold-chain storage, and are thus not readily implementable in developing countries, which endure 85% of the cervical cancer-related death burden worldwide. In contrast with L1, immunization with minor capsid protein L2 elicits broad cross-neutralization, and we previously showed that insertion of a peptide spanning amino acids 20-38 of L2 into bacterial thioredoxin (Trx) greatly enhances its immunogenicity...
October 2015: Cancer Prevention Research
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