HPV Vaccine: Integrative Review of National and International Guidelines

Abstract

HPV (Human Papillomavirus) is an adenovirus of the Papillomaviridae family with approximately 200 subtypes (subdivided into low and high oncogenic risk groups), responsible for almost 99% of cervical cancers. Worldwide, there are more than 570,000 new cases and more than 311,000 women die each year from cervical cancer; for Brazil, the estimate is of more than 16,000 new cases per year. It is known that cervical cancer is one of the most easily preventable forms of cancer, as there is a highly effective vaccine against HPV. However, the morbidity and mortality rates correlated with human papillomavirus are still concerning, especially in less developed countries. In 2020, the WHO (World Health Organization) presented three goals to achieve by 2030 the worldwide extermination of cervical cancer; among these goals is vaccination. Is the world preparing for this battle? The present work is an integrative review, comparing national and international guidelines for HPV vaccination published in the last five years in the consulted databases, using the descriptors "cervical cancer", "prevention" and "guideline" and the boolean operator "and", from which nine articles were selected. The study made it possible to compare international and national guidelines for vaccination against HPV, showing that developed countries implemented the HPV vaccine longer ago and follow the WHO recommendations more rigorously and effectively than underdeveloped or developing countries. Adopting a single dose as a strategy, as suggested by the WHO in April 2022, could be an important step towards increasing coverage and providing protection for a greater number of girls who do not have access to HPV immunization.

Current HPV Vaccination Strategies in Brazil

“…In April 2022, the WHO Immunization Strategies Advisory Group (SAGE) suggest that single-dose scheme may be useful to achieve universal vaccine coverage in less developed countries, contributing to the goal of eliminating deaths from cervical cancer [27].…”

“…In Brazil, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO) suggests, at this time, maintaining the recommendation of the two-dose vaccine schedule (with an interval of 6 to 12 months between doses), because there is no lack of vaccines against HPV and wait for more evidence to support a change in the calendar and, at the same time, to intensify the actions integrated measures to improve vaccination coverage for adolescents in our country, especially with school-based vaccination, combined with a national campaign to raise awareness among the population, in order to achieve the goals established by the WHO [27].…”