Chapter 15: HPV vaccine use in the developing world

Kane, Mark; Sherris, Jacqueline; Coursaget, Pierre; Aguado, Teresa; Cutts, Felicity

doi:10.1016/j.vaccine.2006.05.128

Cited by 81 publications

(67 citation statements)

References 14 publications

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“…It is thus anticipated that for some time after introduction, access to vaccination will also reflect the different opportunities related to socioeconomic status. Previous experience with the introduction of the hepatitis B virus vaccine in developing countries has documented that vaccine cost is an essential component of a successful introduction and a determinant of the time to introduction in may parts of the world (Kane et al, 2006). Figure 3 shows a speculative anticipation on the age and social groups that are likely to first receive HPV vaccines in developed and developing countries, outside the organised Phase IV trials and demonstration projects.…”

Section: The Size Of the Problem And The Size Of The Solutionmentioning

confidence: 99%

HPV and cervical cancer: screening or vaccination?

2008

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Following the demonstration of the superior validity of human papillomavirus (HPV) tests in screening for cervical cancer and the arrival of highly efficacious HPV 16 and 18 vaccines, cervical cancer prevention enters a time of sustainable introduction in developing countries. Multidisciplinary efforts and novel protocols are being developed, and challenging situations are being faced to make cervical cancer, still the number two cancer in women worldwide, an eradicable condition. The provocative title proposed by the editors of the British Journal of Cancer could have at first sight, a quick and intuitive answer: we will need both. We need human papillomavirus (HPV) vaccines to significantly reduce the health care burden currently required for cervical cancer prevention, and we need screening because of the limitations of current HPV vaccines both in their lack of therapeutic effect (thus not protecting women with an ongoing neoplastic processes) and in their limited number of HPV types (thus leaving to evolve some 25 -30% of cervical cancer cases related to HPV types other than 16 or 18). However, the answer only applies in scenarios in which screening is already developed and reasonably efficient. In populations without adequate screening, one could equally argue that HPV vaccines at affordable prices are the only realistic option. While these arrive, more efficient screening schemes, for example with low-cost HPV tests, requiring fewer visits or strategies involving rapid intervention like 'screen and treat' protocols, remain the only option for currently living adult women. Moreover, should polyvalent vaccines (including some five -eight HPV types) result in extending protection against more than 90% þ of the oncogenic HPV types, vaccination alone would be the answer for both scenarios. Thus, a complex answer to an apparent straightforward question. PHASE III HPV VACCINATION TRIALSWith the publication of the key short-term results of the two major Phase III trials of HPV vaccines, the perspective of tackling cervical cancer prevention with vaccination has been unambiguously open. While recognising the limitations of the still moderate (5 -6 years) follow-up in a few tens of thousand young women, two vaccines to date have shown high efficacy, safety, immunogenicity, long-term duration of protection and a strong suggestions of induction of immune memory (Harper et al, 2006;Garland et al, 2007;Paavonen et al, 2007; The Future II Study Group, 2007).A number of clinically relevant issues remain to be fully described, including the magnitude and the HPV spectrum included in the cross protection effect, and the long-term effects of each of the HPV vaccines on cancer protection and safety. However, to solve these questions, it is unavoidable to continue the studies for additional follow-up time and the organisation of large Phase IV studies, some of which are already in place.The currently available vaccines offer full protection to HPV 16-and 18-naïve women for these two HPV types that cause an estimated 70% of ce...

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Section: The Size Of the Problem And The Size Of The Solutionmentioning

confidence: 99%

HPV and cervical cancer: screening or vaccination?

2008

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“…There is no dispute that the HPV immunization would most greatly benefit developing countries like Malaysia, and other poor countries, where women are deprived of access to effective screening and treatment programs [6]. Challenges associated with the introduction of the new vaccine in these countries include the administration cost, dissemination and access to vaccines, and social cultural aspects of immunization of a sexually transmitted infection (STI) vaccine [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Challenges associated with the introduction of the new vaccine in these countries include the administration cost, dissemination and access to vaccines, and social cultural aspects of immunization of a sexually transmitted infection (STI) vaccine [6,7]. Numerous studies have demonstrated that public awareness of HPV, perceived risks of HPV infection, and knowledge of potential health consequences of HPV infection are low [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

Wong

2010

Int.J. Behav. Med.

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Background The incidence of cervical cancer in developing countries is high and even higher among women in rural areas in these countries. Purpose The purpose of this study is to assess the knowledge and attitudes towards human papillomavirus (HPV), HPV vaccination, and cervical cancer among young women in rural settings in a Southeast Asia country. Methods A convenience sample of ethnically diverse young rural women in Malaysia was surveyed. Participants were interviewed using a standard questionnaire. Results Among the participants (N=449), knowledge of HPV, HPV vaccination, cervical screening, and cervical cancer risk factors was extremely poor. The mean total knowledge score (14 items) was 2.37 (SD±1.97). Although many had never heard of the newly released HPV vaccine, two-thirds professed an intention to receive the HPV vaccine. Intention to receive the vaccine was significantly associated with knowledge of cervical screening and cervical cancer risk factors (OR 1.17; 95% CI 1.03-1.33; P=0.013). Reasons for vaccine refusal were doubts about safety and efficacy of the new vaccine (27.4%), perceived embarrassment at receiving an STI vaccine (20.7%), and perception of not being at risk of HPV infection (20.0%). Conclusions Providing HPV education to the rural residents is a high priority.

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“…As of 2009, 177 (92%) of the world's countries had introduced routine HB vaccine for infants in their national immunization programs (1). The second success is the availability of human papillomavirus (HPV) vaccine to prevent cervical and other HPV-related cancers, which is now included in the national immunization programs of most industrial countries and will be used, it is hoped, in developing countries within the next few years (2). High global coverage of these 2 vaccines will prevent more than 1 million cancer deaths per year (3).…”

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confidence: 99%

Preventing Cancer with Vaccines: Progress in the Global Control of Cancer

Kane¹

2012

Cancer Prevention Research

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The cancer control community is largely unaware of great advances in the control of major human cancers with vaccines, including the dramatic control of hepatocellular (liver) cancer with hepatitis B virus (HBV) vaccine, now used routinely in more than 90% of countries. The biotechnology revolution has given us a new generation of highly effective vaccines against major global killers, global funding for immunization is orders of magnitude higher than ever before, and the vaccine delivery infrastructure has improved very significantly even in the poorest countries. Liver cancer is the greatest cause of cancer deaths in men of sub-Saharan Africa and much of Asia. Even in highly endemic countries such as China, the prevalence of HB surface antigen carriers has fallen from 10% to 1%-2% in immunized cohorts of children, and liver cancer has already fallen dramatically in Taiwanese children. The Global Alliance for Vaccines and Immunization (now called the GAVI Alliance) has greatly expedited this success by providing HBV vaccine free for five years in most of the world's 72 poorest countries. HBV vaccination can serve as a model for the global control of human papillomavirus (HPV)-related cervical and other cancers with HPV vaccines. Cervical cancer is the greatest cause of cancer death in women in many developing countries; HPV vaccines are highly effective in preventing HPV infection and precancerous lesions in women, and the quadrivalent vaccine also prevents genital warts in men and women and precancerous anal lesions in men. HPV is causing a growing proportion of oropharyngeal cancers, and HPV-related noncervical cancers (penile, anal, and oropharyngeal) may exceed the incidence of cervical cancer within a decade in industrial countries, where cervical screening is effective, causing reevaluation of male HPV immunization. In developing countries, few women are screened for cervical precancerous lesions, making immunization even more important. Currently, 26 primarily industrial countries routinely immunize girls with HPV vaccine, and GAVI will begin to accept applications in 2012 to fund vaccine in developing countries that can deliver the vaccine and if GAVI can negotiate an acceptable price (one manufacturer has already offered a price of $5 per dose). Cancer Prev Res; 5(1); 24-29. Ó2012 AACR.As populations around the world benefit from declines of infectious disease mortality and of maternal and infant deaths, many more people will live to the age in which chronic diseases and cancer become increasingly important. Focusing on smoking prevention, safe food and water, radiation, screening, and environmental and occupational exposures, the cancer control and prevention community has largely been unaware of the increasing role that vaccines play in the prevention of cancer. Vaccines probably have had the largest role of medical and public health approaches in controlling infectious diseases (Table 1). The first great success in the area of cancer control is the control of chronic hepatitis B (HB) infecti...

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Chapter 15: HPV vaccine use in the developing world

Cited by 81 publications

References 14 publications

HPV and cervical cancer: screening or vaccination?

HPV and cervical cancer: screening or vaccination?

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

Preventing Cancer with Vaccines: Progress in the Global Control of Cancer

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