Implementation of HPV vaccination pilot project in Kazakhstan: Successes and challenges.

Abstract

e13056 Background: Cervical cancer (CC) is the second most frequent cancer of women after breast cancer. Prophylactic vaccines for human papillomavirus (HPV) are being introduced in many countries more than 10 years ago. The standardized incidence of СС in Kazakhstan (KZ) in 2017 was 17.1 per 100,000 women. From 2013 to 2016, there was a pilot project of school-based HPV vaccination of adolescent girls in four districts of KZ. Vaccination was carried out with two vaccines (Gardasil and Cervarix) on the choice of parents in a three-dose regimen. Due to the high rejection of vaccination, this program was completed in 2016. Aim of study was to analyze the results of HPV vaccination in KZ. Methods: The results of vaccination of adolescent girls from 9 to 15 years old were evaluated. We analyzed database registry of Kazakhstani vaccinated girls to evaluate vaccine coverage in four district of KZ. Results: A total 11,648 adolescent girls were fully vaccinated during the pilot program for 2013-2016. The average age of the vaccinated is 12.67 ± 1.04. In 2013, immunization was performed for 1,816 girls aged 11–13 years. In 2014, the age range of the target group was expanded to 15 years. The number of vaccinated girls increased to 5,699 adolescent girls. 7,136 girls were fully vaccinated in 2015. 10,004 girls have not received full doses of vaccine. Overall coverage rates of fully vaccinated were 14.8%. The majority of coverage results was stastically similar except for Almaty, where coverage was higher than the average coverage (17.9% vs. 14.8%, p < 0.05). Conclusions: Pilot project of vaccination in Kazakhstan was declared unsuccessful. This situation is associated with a lack of information campaigns on vaccination. This findings highlights the need for phased implementation of vaccination through an educational campaign of parents.

Knowledge and attitudes of mothers toward HPV vaccination: A cross-sectional study in Kazakhstan

“… 20 , 21 An attempt at HPV vaccine implementation was made in 2013; however, the program was shortly closed after negative media coverage and concerns raised by parents. 22 This was similar to what was seen in Japan, where reports of vaccine side effects dampened the success of the program, reducing the coverage to less than 1%. 23 Parental hesitancy toward the HPV vaccine is a major determinant of the vaccination program’s low coverage, as parental permission is a prerequisite for vaccine administration among children and adolescents in many countries, as living with a vaccine-hesitant parent lowers the likelihood of a teen receiving a vaccination by almost 70%.…”

“…11 The first attempt to implement the HPV vaccination in Kazakhstan in 2013 failed, and the program was discontinued. [20][21][22] In Kazakhstan, parental consent is required for medical interventions for children under 18 years. Parental understanding of HPV vaccination's importance and effectiveness plays a crucial role in their decision-making about the vaccination of their children.…”

Актуальные Аспекты Международного Опыта Внедрения Вакцинации Против Вируса Папилломы Человека

“…В Казахстане вакцинация против ВПЧ была инициирована в рамках пилотного проекта в 2014 году, но была прекращена в 2017 году из-за массовых отказов родителей вследствие широкого распространения сообщений в СМИ страны о побочных эффектах вакцинации. Охват вакцинацией в среднем составил 14,8% [10]. Успешное включение вакцины в национальную программу вакцинации требует решения ряда вопросов.…”

“…Қазақстанда АПВ-ға қарсы вакцинация 2014 жылы пилоттық жоба аясында басталды, бірақ 2017 жылы ата-аналардың жаппай бас тартуына байланысты елдегі БАҚ-та вакцинацияның жанама әсерлері туралы хабарламалардың кеңінен таралуына байланысты тоқтатылды. Вакцинациямен қамту орташа есеппен 14,8% құрады [10]. Вакцинаны ұлттық вакцинация бағдарламасына сәтті енгізу бірқатар мәселелерді шешуді талап етеді.…”

Exploring HPV vaccine knowledge, attitudes, barriers and information sources among parents, health professionals and teachers in Kazakhstan: a mixed-methods study protocol

“…In terms of reliability, the media and medical doctors are considered the most dependable sources, whereas information obtained from friends is associated with lower levels 31. In Kazakhstan, HPV vaccination was initiated as a pilot project in four sub-national regions in 2014 but was discontinued in 2017 due to widespread media reports about potential/perceived side effects of the vaccination followed by mass parental refusal 32. However, the Ministry of Health of Kazakhstan has announced plans to re-introduce HPV vaccination in the coming years 33.…”