Limits...
Gavi HPV Programs: Application to Implementation.

Hanson CM, Eckert L, Bloem P, Cernuschi T - Vaccines (Basel) (2015)

Bottom Line: Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high.Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year.Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

View Article: PubMed Central - PubMed

Affiliation: Gavi The Vaccine Alliance Secretariat, 2 Chemin des Mines, Geneva 10 CH-1211, Switzerland. cmh558@nyu.edu.

ABSTRACT
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. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

No MeSH data available.


Related in: MedlinePlus

Global map showing HPV vaccination experience in Gavi eligible and non-eligible countries. As of 1 January 2015, only three Gavi eligible countries have introduced HPV nationally, Bhutan, Lesotho and Rwanda. The majority of Gavi eligible countries have not had experience with HPV vaccination. Few Gavi eligible countries have had pilots previous to the development of the Gavi HPV demo program and without Gavi support.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4494350&req=5

vaccines-03-00408-f002: Global map showing HPV vaccination experience in Gavi eligible and non-eligible countries. As of 1 January 2015, only three Gavi eligible countries have introduced HPV nationally, Bhutan, Lesotho and Rwanda. The majority of Gavi eligible countries have not had experience with HPV vaccination. Few Gavi eligible countries have had pilots previous to the development of the Gavi HPV demo program and without Gavi support.

Mentions: Normally, for other routine vaccines, Gavi funds countries for national introduction. For national HPV vaccine support, Gavi not only requires countries to meet the Gross National Income per capita (GNIpc) of US $1580 and a Diphtheria-Tetanus-Pertussis third dose (DTP3) coverage of at least 70% as for all other vaccines, but to have also demonstrated the ability to deliver a multi-dose vaccine to at least 50% of a target population of 9–13 year old girls in an average district size [17]. In the case of HPV vaccines, Gavi through its partners, the WHO, BMGF, PATH, UNICEF, and UNFPA, designed an additional support pathway in the form of a demonstration project (Figure 1). This pathway would give countries the opportunity to gain experience with the HPV vaccine, since many Gavi eligible countries have not had experience with HPV vaccinations (Figure 2) or other multi-dose vaccinations in this age group. Also, immediate national introduction without prior experience presents distinct challenges in delivering vaccines to young adolescents, a cohort not normally serviced by routine immunization nor by many other health interventions [18,19]. Additionally, the vaccine protects against a sexually transmitted virus about which many communities have little knowledge especially it’s link to cervical cancer [20]. Finally, experiences from many countries in diverse geographic locations have demonstrated that the initial HPV vaccination efforts provide excellent opportunities to learn effective communication strategies and improve delivery methods thereby increasing vaccine coverage [21,22]. All of these “lessons learned” then inform national policymaking, and can be leveraged for national scale-up. By contrast, in some countries that did not conduct pilots; low initial vaccine acceptability could be linked to implementation challenges that may have been prevented [23,24].


Gavi HPV Programs: Application to Implementation.

Hanson CM, Eckert L, Bloem P, Cernuschi T - Vaccines (Basel) (2015)

Global map showing HPV vaccination experience in Gavi eligible and non-eligible countries. As of 1 January 2015, only three Gavi eligible countries have introduced HPV nationally, Bhutan, Lesotho and Rwanda. The majority of Gavi eligible countries have not had experience with HPV vaccination. Few Gavi eligible countries have had pilots previous to the development of the Gavi HPV demo program and without Gavi support.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494350&req=5

vaccines-03-00408-f002: Global map showing HPV vaccination experience in Gavi eligible and non-eligible countries. As of 1 January 2015, only three Gavi eligible countries have introduced HPV nationally, Bhutan, Lesotho and Rwanda. The majority of Gavi eligible countries have not had experience with HPV vaccination. Few Gavi eligible countries have had pilots previous to the development of the Gavi HPV demo program and without Gavi support.
Mentions: Normally, for other routine vaccines, Gavi funds countries for national introduction. For national HPV vaccine support, Gavi not only requires countries to meet the Gross National Income per capita (GNIpc) of US $1580 and a Diphtheria-Tetanus-Pertussis third dose (DTP3) coverage of at least 70% as for all other vaccines, but to have also demonstrated the ability to deliver a multi-dose vaccine to at least 50% of a target population of 9–13 year old girls in an average district size [17]. In the case of HPV vaccines, Gavi through its partners, the WHO, BMGF, PATH, UNICEF, and UNFPA, designed an additional support pathway in the form of a demonstration project (Figure 1). This pathway would give countries the opportunity to gain experience with the HPV vaccine, since many Gavi eligible countries have not had experience with HPV vaccinations (Figure 2) or other multi-dose vaccinations in this age group. Also, immediate national introduction without prior experience presents distinct challenges in delivering vaccines to young adolescents, a cohort not normally serviced by routine immunization nor by many other health interventions [18,19]. Additionally, the vaccine protects against a sexually transmitted virus about which many communities have little knowledge especially it’s link to cervical cancer [20]. Finally, experiences from many countries in diverse geographic locations have demonstrated that the initial HPV vaccination efforts provide excellent opportunities to learn effective communication strategies and improve delivery methods thereby increasing vaccine coverage [21,22]. All of these “lessons learned” then inform national policymaking, and can be leveraged for national scale-up. By contrast, in some countries that did not conduct pilots; low initial vaccine acceptability could be linked to implementation challenges that may have been prevented [23,24].

Bottom Line: Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high.Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year.Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

View Article: PubMed Central - PubMed

Affiliation: Gavi The Vaccine Alliance Secretariat, 2 Chemin des Mines, Geneva 10 CH-1211, Switzerland. cmh558@nyu.edu.

ABSTRACT
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. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

No MeSH data available.


Related in: MedlinePlus