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WHO Releases HPV Vaccine Recommendations

JUN 21, 2017 | KRISTI ROSA
The World Health Organization (WHO) recently released a Position Paper regarding recommendations for vaccination against the most common sexually transmitted infection in the United States: human papillomavirus (HPV).

Because HPV-related diseases, such as cervical cancer, are a global health concern, WHO recommends that HPV vaccines should be “included in national immunization programs.” Cervical cancer accounts for a staggering majority (84%) of HPV-associated cancers, and therefore, “should remain the priority for HPV immunization,” the authors write. The best way to prevent cervical cancer? Immunizing girls before they are sexually active. All of the available HPV vaccines—the bivalent, quadrivalent, and nonavalent—are all “excellent” when it comes to “safety, efficacy, and effectiveness profiles.”

WHO recommends that HPV vaccines should be incorporated into a “coordinated and comprehensive strategy.” In the paper, the authors note that this strategy will include the following components:
  • Education on behaviors that might increase HPV risk
  • Training healthcare workers and providing critical information to women regarding screening, diagnosis, and treatment of precancerous legions and cancer
  • Increasing access to screening and treatment (as well as treatment for invasive cancer)
Although vaccination will serve as a “primary preventive intervention,” authors note that, later on in their lives, individuals will still need to go for screening, “since the existing vaccines do not protect against all high-risk HPV types and will have limited impact on disease in women older than the vaccine eligible group(s).” WHO also suggests linking HPV vaccination with other vaccinations typically administered at the same age (such as tetanus). The authors also recommend incorporating vaccination into programs that are specifically targeting younger individuals. On a global scale, WHO calls for “all countries to proceed with nationwide introduction of HPV vaccination.” In the paper, study authors write that countries should use approaches that are:
  • Compatible with their delivery infrastructure and cold chain capacity
  • Affordable, cost-effective, and sustainable
  • Capable of achieving the highest possible coverage
The primary population target for HPV vaccination is girls between the age of 9 and 14, who are not yet sexually active. In fact, authors write that “Vaccination strategies should initially prioritize high coverage in this priority population.” The secondary population target? Females over 15 years of age, or males. WHO recommends that this population receive vaccination only when “feasible, affordable, [and] cost-effective,” and, if it doesn’t avert resources away from targeting the primary population. Furthermore, WHO recommends a vaccination strategy that targets “multiple age cohorts of girls aged between 9 and 18 years.” They feel that this “would result in faster and greater population impact than vaccination of single age cohorts, due to the estimated increase in direct protection and herd immunity.”

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