An alert to Latin America: Current human papillomavirus vaccination trends highlight key barriers to successful implementation

Nogueira-Rodrigues, Angélica; Bukowski, Alexandra; Paulino, Eduardo; Louis, Jessica St.; Barrichello, Adriana; Sternberg, Cinthya; Gifoni, Markus; Luciani, Silvana; Goss, Paul E.

doi:10.1002/cncr.30647

Cited by 20 publications

(21 citation statements)

References 26 publications

(39 reference statements)

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“…16 An article regarding vaccination rates in Latin America confirms this trend. 17 Furthermore, because the vaccine is not therapeutic and patients who will be diagnosed with CC in the next 15 years are already HPV infected, Papanicolau test screening method adherence must also be reinforced.…”

Section: Discussionmentioning

confidence: 99%

Panorama of Gynecologic Cancer in Brazil

Paulino

Melo

Silva-Filho

et al. 2020

JCO Global Oncology

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PURPOSE Little is known, or has been published previously, regarding consolidated data on the epidemiology of gynecologic cancers (GC) in Brazil. This article describes the incidence, morbidity, and mortality of women in Brazil affected with GC between the years of 2000 and 2017. METHODS Incidence, morbidity, and mortality data from patients with a diagnosis of one out of the five most common GC, cervical (CC), uterine (UC), ovarian (OC), vulvar (VvC), and vaginal (VgC), were obtained from three governmental sources of data. RESULTS From 2000 to 2015 CC, OC, and VgC incidence rates (IRs) decreased, whereas the IRs for UC and VvC remained relatively stable. Data from 382,932 women with GC were analyzed. Most patients presented with locally advanced or advanced disease at diagnosis: 60.1% of patients with CC, 31.2% of patients with UC, 67.2% of patients with OC, 45.2% of patients with VvC, and 67.0% of patients with VgC. Time from diagnosis to first treatment was ≥ 60 days in 58.0% of patients with CC, 58.5% of patients with UC, 27.0% of patients with OC, 55.3% of patients with VvC, and 52.7% of patients with VgC. Regarding mortality rates (MRs), with the exception of CC, UC, and VvC, which showed a slight decrease, MRs remained stable between 2000 and 2017. CONCLUSION A comparison with international data indicates that Brazilian patients are diagnosed with more advanced disease and face a longer delay between diagnosis and first treatment. Despite advances in screening and treatment, GC mortality has not decreased satisfactorily in this country.

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Section: Discussionmentioning

confidence: 99%

Panorama of Gynecologic Cancer in Brazil

Paulino

Melo

Silva-Filho

et al. 2020

JCO Global Oncology

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“…Consequently whilst some countries have delivered to over 70–80% of the target population (117) others have fared less well with some countries either failing to implement a programme, or experiencing interruption to programs due to widespread movements aimed at discrediting the vaccine (118). Some countries have had their previously high coverage eroded to below 30% (119).…”

Section: Societal and Policy Issues In Gonococcal Vaccine Deploymentmentioning

confidence: 99%

Exploitation of Neisseria meningitidis Group B OMV Vaccines Against N. gonorrhoeae to Inform the Development and Deployment of Effective Gonorrhea Vaccines

Petousis‐Harris

Radcliff

2019

Front. Immunol.

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Have potential clues to an effective gonorrhea vaccine been lurking in international disease surveillance data for decades? While no clinically effective vaccines against gonorrhea have been developed we present direct and indirect evidence that a vaccine is not only possible, but may already exist. Experience from Cuba, New Zealand, and Canada suggest that vaccines containing Group B Neisseria meningitides outer membrane vesicles (OMV) developed to control type-specific meningococcal disease may also prevent a significant proportion of gonorrhea. The mechanisms for this phenomenon have not yet been elucidated but we present some strategies for unraveling potential cross protective antigens and effector immune responses by exploiting stored sera from clinical trials and individuals primed with a meningococcal group B OMV vaccine (MeNZB). Elucidating these will contribute to the ongoing development of high efficacy vaccine options for gonorrhea. While the vaccine used in New Zealand, where the strongest empirical evidence has been gathered, is no longer available, the OMV has been included in the multi component recombinant meningococcal vaccine 4CMenB (Bexsero) which is now licensed and used in numerous countries. Several lines of evidence suggest it has the potential to affect gonorrhea prevalence. A vaccine to control gonorrhea does not need to be perfect and modeling supports that even a moderately efficacious vaccine could make a significant impact in disease prevalence. How might we use an off the shelf vaccine to reduce the burden of gonorrhea? What are some of the potential societal barriers in a world where vaccine hesitancy is growing? We summarize the evidence and consider some of the remaining questions.

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“…A la fecha, los países que cuentan con programas de vacunación contra el VPH en las Américas son Argentina, Antigua, Barbados, Belize, Brasil, Bermuda, Chile, Islas Caimanes, Colombia, Ecuador, Guyana, Honduras, México, Panamá, Paraguay, Perú, Puerto Rico, Saba, St. Maarten, Suriname, Trinidad y Tobago y Uruguay. Otros países, tales como Venezuela, aunque tiene incluida la vacuna en su programa nacional, no cuenta con la disponibilidad actualmente 18 . Si bien, luego de que Brasil introdujera la vacuna obligatoria en 2014, la Organización Panamericana de la Salud afirmó que más de 80% de las niñas americanas tendrían acceso a la vacuna, esta afirmación se basa en el porcentaje de niñas viviendo en los países con programas de vacunación, y no en quienes efectivamente reciben la vacuna.…”

Section: Discussionunclassified

“…Los datos muestran que la vacuna ha tenido una cobertura preocupantemente baja, con una adherencia menor a la esperada, sobre todo en las dosis posteriores a la primera, según el esquema utilizado. El caso más alarmante es el de Colombia, que obtuvo 97,5% de inoculación de la primera dosis y 20,4% en la segunda, disminución que aparentemente responde al reporte de casos con efectos adversos en el país 18 . De este modo se observa que el éxito de la inmunización no sólo responde a la efectividad de la vacuna misma, y tampoco al hecho de recibirla de forma gratuita, sino que la información y la educación para la salud deben constituir un paso esencial para mejorar su aceptabilidad, disminuir las creencias erróneas, y mitigar las prácticas sexistas asociadas a la salud de la mujer en la región.…”

Section: Discussionunclassified

Implementación de la vacunación contra el virus papiloma humano en Chile: una mirada desde los determinantes sociales de la salud “ingreso” y “género”

González

2017

Rev. méd. Chile

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Cervical cancer is the fourth most common neoplasm in women worldwide and its incidence is associated with profound social inequities. In Chile, it is the second cause of death in women of reproductive age. The Chilean clinical guideline identifies the vaccine against Human Papillomavirus (HPV) as the main preventive measure. Since 2014, the Ministry of Health has implemented free immunization against HPV for girls and female adolescents. This article critically analyzes this public policy from the viewpoint of health equity, using as framework the Social Determinants of Health Model. Specifically, we address the structural determinants of income and gender, which act as material and social barriers for achieving immunization, affecting protection against cervical cancer. These barriers correspond to the high cost of the vaccine, and social attitudes/cultural beliefs towards sexual behavior in Latin America and Chile that affect the acceptability of vaccination. The Social Determinants of Health Model constitutes a useful tool for identifying health inequities and understanding public policy from an equity viewpoint that complements the biomedical and epidemiological understanding of disease. In this topic, the initiative aims to strengthen the idea of health as a human right and health promotion as an essential function of public health policy.

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An alert to Latin America: Current human papillomavirus vaccination trends highlight key barriers to successful implementation

Cited by 20 publications

References 26 publications

Panorama of Gynecologic Cancer in Brazil

Panorama of Gynecologic Cancer in Brazil

Exploitation of Neisseria meningitidis Group B OMV Vaccines Against N. gonorrhoeae to Inform the Development and Deployment of Effective Gonorrhea Vaccines

Implementación de la vacunación contra el virus papiloma humano en Chile: una mirada desde los determinantes sociales de la salud “ingreso” y “género”

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An alert to Latin America: Current human papillomavirus vaccination trends highlight key barriers to successful implementation

Cited by 20 publications

References 26 publications

Panorama of Gynecologic Cancer in Brazil

Panorama of Gynecologic Cancer in Brazil

Exploitation of Neisseria meningitidis Group B OMV Vaccines Against N. gonorrhoeae to Inform the Development and Deployment of Effective Gonorrhea Vaccines

Implementación de la vacunación contra el virus papiloma humano en Chile: una mirada desde los determinantes sociales de la salud &#8220;ingreso&#8221; y &#8220;género&#8221;

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Implementación de la vacunación contra el virus papiloma humano en Chile: una mirada desde los determinantes sociales de la salud “ingreso” y “género”