KAMPALA: The World Health Organisation (WHO) shows in its latest statement that a single-dose human papillomavirus (HPV) vaccine works as well as three doses in protecting girls from the virus that causes cervical cancer.
The development, which comes at a time when many countries, including Uganda, are struggling to have girls finish their three-dose vaccine, was reached in a Strategic Advisory Group of Experts on Immunization (SAGE) meeting where data compiled over the past years was reviewed.
SAGE now recommends that dose schedules be updated to have one or two-dose schedules for the primary target of girls aged 9–14, one or two-dose schedules for young women aged 15-20, and two doses with a 6-month interval for women older than 21.
Often referred to as the “silent killer” and almost entirely preventable, cervical cancer is the fourth most common cancer in women, with more than 85 percent of the disease burden in low-resource countries. Cervical cancer is the most common cancer in Uganda, and it kills the most women. In 2020, there will be 6,959 cervical cancer cases and 4,607 deaths.
The new SAGE recommendation is underpinned by concerns over the slow introduction of the HPV vaccine into immunization programs and overall low population coverage, especially in poorer countries. More than 95 per cent of cervical cancers are caused by sexually transmitted HPV.
“The HPV vaccine is highly effective for the prevention of HPV serotypes 16 and 18, which cause 70 percent of cervical cancer,” said Dr. Alejandro Cravioto, SAGE Chair, urging all countries to introduce HPV vaccines and prioritize multi-age cohort catch-up of missed and older cohorts of girls.
A lot of people say that the new recommendations will let more girls and women get vaccinated, which will help them stay healthy for a long time.
However, the experts said immuno-compromised individuals, including those living with HIV, should continue taking their three-dose jab, or if not available, at least opt for two, as they didn’t find conclusive evidence regarding the efficacy of a single dose in this group.
With vaccines, there’s a general belief that cervical cancer can be eliminated as a public health concern if challenges, including access to vaccines, are handled. In 2020, for instance, the Cervical Cancer Elimination Initiative was launched to address several challenges, including the inequity in vaccine access.
This single-dose recommendation, WHO notes, has the potential to help countries move faster toward achieving the goal of having 90 per cent of girls vaccinated by the age of 15 by 2030. Globally, the uptake of the life-saving vaccine has been slow, and coverage in countries is much lower than the 90 per cent target.
Consequently, in 2020, global coverage with two doses was only 13 per cent. HPV vaccines haven’t been used as much as they should because of supply problems and the costs of giving two doses to older girls who aren’t usually vaccinated as part of childhood vaccination programs.
“A single-dose HPV vaccination schedule could offer new options for our program in delivery, procurement, help with storage issues, and hopefully increase coverage of fully immunized girls.” An expert on immunizations at PATH tells a document about what a single-dose HPV vaccine schedule might look like in Uganda. “We haven’t been able to get enough people to get the second dose, and those resources for follow-up could be used somewhere else.”