WHO pushes for inclusion of HPV vaccination in national immunization programs

The World Health Organization (WHO) reported that 80 percent of women in developing countries are affected with cervical cancer.  The disease is often prevalent in countries where cervical cancer screening and treatment systems are weak or non-existent.

The provision of human papillomavirus (HPV) vaccine is regarded as an important initiative to significantly reduce the global burden of cervical cancer. For decades, the widespread use of HPV vaccine alone has been proven to reduce cervical cancer deaths by 50 percent. Depending on immunization coverage and additional cross-protection against certain types of HPV, an even higher rate of 71 percent decrease in deaths can be achieved worldwide.

The decrease in the number of deaths brought by vaccination led the WHO to recommend the inclusion of routine HPV vaccination in national immunization programs with the following key considerations: 1) prevention of cervical cancer or other HPV-related diseases, or both, constitutes a public health priority; 2) vaccine introduction is programmatically feasible; 3) sustainable financing can be secured; 4) cost-effectiveness of vaccination strategies in the country or region is considered; and 5) HPV vaccination is targeted to adolescent girls prior to sexual debut.

From the public health perspective, the most efficient population target for HPV vaccination is young, adolescent girls. “The primary target population for vaccination should be selected based on the age of initiation of sexual activity and the feasibility of reaching young, adolescent girls through schools, health-care facilities or community-based settings. The primary target population is girls within the age range of 9-10 years through 13 years,” said the WHO.

In low-income countries, the WHO does not recommend that sexually active women be vaccinated since both vaccines show much lower effectiveness after HPV infection. Vaccinating boys is also deemed not as cost-effective as focusing on adolescent girls. It is recommended to focus resources on reaching more girls for HPV vaccination rather than split resources between girls and boys. “Though boys can become infected with HPV and other HPV-associated disease such as penile, anal and oral cancers or genital warts, only seven percent of cancers occur in men.”

Although the HPV vaccine is expected to significantly reduce the incidence of cervical cancer, it will not replace cervical cancer screening. “A comprehensive approach which uses vaccination in partnership with screening will maximize effectiveness,” said WHO.