The introduction of HPV vaccination is facing many challenges. The article published by Pollack et al. in the January issue of the Bulletin of the World Health Organization, besides providing useful information about the disease and the vaccine, discusses these challenges. Possible integration into EPI is also analyzed.
The abstract is reproduced here below and access to the full text is at :
http://www.who.int/bulletin/volumes/85/1/06-034397.pdf
Some countries are already planning for vaccine introduction. Through a broad partnetship PATH Cervical Cancer Project is already helping four countries, India, Peru, Uganda and Vietnam, to conduct clinical and operations research. Studies will look at a variety of vaccine introduction questions.
The following two-page fact sheet from PATH CCV Project provides further details:
http://www.technet21.org/pdf_file/PATH-CCVProjectFactSheet.pdf
Finally, in "The Ethics and Politics of Compulsory HPV Vaccination" published in the New England Journal of Medicine, James Colgrove examines political and ethical questions surrounding the proposed compulsory vaccination of 11- and 12-year-old schoolgirls in the US. He states that "A critical question is whether achieving a higher level of coverage justifies the infringement on parental autonomy that compulsory vaccination inevitably entails."
The article can be downloaded from:
http://www.technet21.org/pdf_file/HPV-IntroEthics.pdf
This issue may be considered less relevant to many developing countries at this point but may likely catch up with them rapidly under a different disguise....remember the OPV issues.
Thanks to Robert Davis and Evelyn Chege for this information.
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"Ensuring access to HPV vaccines through integrated services: a reproductive health perspective"
by Amy E Pollack, Miranda Balkin, Lindsay
Edouard, Felicity Cutts, Nathalie Broutet
In 2006, a quadrivalent human papillomavirus (HPV) vaccine was licensed, and another vaccine may be licensed soon. Little is known about the practical considerations involved in designing and implementing cervical cancer prevention programmes that include vaccination as a primary means of prevention. Although the vaccine may ultimately be indicated for both males and females, young girls, or girls and women aged 9–25 years, will be the initial candidates for the vaccine. This paper describes avenues for service delivery of HPV vaccines and critical information gaps that must be bridged in order to inform future sexual and reproductive health programming. It proposes the role that the sexual and reproductive health community, together with immunization and cancer control programmes, could have in supporting the introduction of HPV vaccines within the context of current health systems.
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