1887
  1. Home
  2. Eurosurveillance
  3. Volume 26, Issue 50, 16/Dec/2021
  4. Article
Perspective Open Access
Like 0
Download

Abstract

While many European Union/European Economic Area (EU/EEA) countries recently expanded human papillomavirus (HPV) vaccination to boys, HPV vaccine supply is currently limited for girls in low- and middle-income countries (LMIC) that are severely affected by HPV.

Globally, about 50% of countries have introduced HPV vaccination. Some LMIC with high burden of cervical cancer have not yet introduced HPV vaccination, or are reaching suboptimal vaccination coverage. While WHO issued a call for cervical cancer elimination in 2018, a global shortage of HPV vaccines is currently predicted to last at least until 2024.

We reviewed national policies of EU/EEA countries and recommendations of the World Health Organization (WHO) Strategic Advisory Group of Experts on immunisation to discuss current challenges and dose-sparing options. Several EU/EEA countries have extended HPV vaccination to boys and the European Cancer Organisation has issued a resolution for elimination of all HPV-associated cancers in both sexes. The European Centre for Disease Prevention and Control concluded in its 2020 guidance that cost-effectiveness of extending routine vaccination to boys depends on several context-specific factors. The extension of HPV vaccination to boys in EU/EEA countries may affect global availability of vaccines. Temporary dose-sparing options could be considered during the COVID-19 post-pandemic period.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.50.2001659
2021-12-16
2024-04-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.50.2001659
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/50/eurosurv-26-50-8.html?itemId=/content/10.2807/1560-7917.ES.2021.26.50.2001659&mimeType=html&fmt=ahah

References

  1. de Martel C, Georges D, Bray F, Ferlay J, Clifford GM. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020;8(2):e180-90.  https://doi.org/10.1016/S2214-109X(19)30488-7  PMID: 31862245 
  2. United States Centers for Disease Control and Prevention (CDC). Cancers Caused by HPV. Atlanta: CDC. 2021. Available from: https://www.cdc.gov/hpv/parents/cancer.html.
  3. Drolet M, Bénard É, Pérez N, Brisson M, et al. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019;394(10197):497-509.  https://doi.org/10.1016/S0140-6736(19)30298-3  PMID: 31255301 
  4. Arbyn M, Xu L. Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials. Expert Rev Vaccines. 2018;17(12):1085-91.  https://doi.org/10.1080/14760584.2018.1548282  PMID: 30495978 
  5. World Health Organization (WHO). Global market study: HPV. Geneva: WHO; 2018. Available from: https://apps.who.int/iris/handle/10665/311275
  6. Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191-203.  https://doi.org/10.1016/S2214-109X(19)30482-6  PMID: 31812369 
  7. World Health Organization (WHO). WHO Director-General calls for all countries to take action to help end the suffering caused by cervical cancer. 19 May 2018. Available from: https://www.who.int/reproductivehealth/call-to-action-elimination-cervical-cancer/en/
  8. American Cancer Society. American Cancer society launches campaign to eliminate cervical cancer. 6 Jun 2018. Available from: http://pressroom.cancer.org/HPVcancerfreelaunch
  9. European Cancer Organisation. Resolution on HPV cancer elimination passed. 19 Nov 2019. Available from: https://www.europeancancer.org/resources/177:resolutions-on-hpv-cancer-elimination.html
  10. European Commission (EC). Europe's beating cancer plan. Brussels: EC; 2021. Available from: https://ec.europa.eu/commission/presscorner/detail/es/QANDA_20_153
  11. World Health Organization (WHO). Immunization agenda 2030: a global strategy to leave no one behind. Geneva: WHO; 2020. Available from: https://cdn.who.int/media/docs/default-source/immunization/strategy/ia2030/ia2030-draft-4-wha_b8850379-1fce-4847-bfd1-5d2c9d9e32f8.pdf?sfvrsn=5389656e_66&download=true
  12. European Centre for Disease Prevention and Control (ECDC). Guidance for the introduction of HPV vaccines in EU countries. Stockholm: ECDC; 2008. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/0801_GUI_Introduction_of_HPV_Vaccines_in_EU.pdf
  13. European Centre for Disease Prevention and Control (ECDC). Introduction of HPV vaccines in European Union countries – an update. Stockholm: ECDC; 2012. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/20120905_GUI_HPV_vaccine_update.pdf
  14. European Centre for Disease Prevention and Control (ECDC). Guidance on HPV vaccination in EU countries: focus on boys, people living with HIV and 9-valent HPV vaccine introduction. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Guidance-on-HPV-vaccination-in-EU-countries2020-03-30.pdf
  15. Ng SS, Hutubessy R, Chaiyakunapruk N. Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-Valent vaccine, gender-neutral and multiple age cohort vaccination. Vaccine. 2018;36(19):2529-44.  https://doi.org/10.1016/j.vaccine.2018.03.024  PMID: 29625764 
  16. European Centre for Disease Prevention and Control (ECDC). Human papillomavirus infection: recommended vaccinations. Stockholm: ECDC; 2020. [Accessed: 10 Jan 2021] Available from: https://vaccine-schedule.ecdc.europa.eu/Scheduler/ByDisease?SelectedDiseaseId=38&SelectedCountryIdByDisease=-1
  17. UK Health Security Agency (UKHSA). Rubella: the green book, chapter 28. London: UKHSA; 2013. Available from: https://www.gov.uk/government/publications/rubella-the-green-book-chapter-28
  18. Grandahl M, Nevéus T. Barriers towards HPV vaccinations for boys and young men: a narrative review. Viruses. 2021;13(8):1644.  https://doi.org/10.3390/v13081644  PMID: 34452508 
  19. Eurostat. Population by age and sex. 5 Jul 2021. Luxembourg: Eurostat; 2021. Available from: https://ec.europa.eu/eurostat/databrowser/view/DEMO_PJAN__custom_412242/default/table?lang=en
  20. Arie S. HPV: WHO calls for countries to suspend vaccination of boys. BMJ. 2019;367:l6765.  https://doi.org/10.1136/bmj.l6765  PMID: 31792022 
  21. Hull R, Mbele M, Makhafola T, Hicks C, Wang SM, Reis RM, et al. Cervical cancer in low and middle-income countries. Oncol Lett. 2020;20(3):2058-74.  https://doi.org/10.3892/ol.2020.11754  PMID: 32782524 
  22. Gavi, The Vaccine Alliance. Human papillomavirus vaccine support. Geneva: Gavi; 2021. [Accessed: 3 Dec 2021]. Available from: https://www.gavi.org/types-support/vaccine-support/human-papillomavirus
  23. Brisson M, Kim JJ, Canfell K, Drolet M, Gingras G, Burger EA, et al. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395(10224):575-90.  https://doi.org/10.1016/S0140-6736(20)30068-4  PMID: 32007141 
  24. World Health Organization (WHO). Meeting of the strategic advisory group of experts on immunisation, October 2019: conclusions and recommendations. Wkly Epidemiol Rec. 2019;94(47):541-60.
  25. Kreimer AR, Herrero R, Sampson JN, Porras C, Lowy DR, Schiller JT, et al. Evidence for single-dose protection by the bivalent HPV vaccine-Review of the Costa Rica HPV vaccine trial and future research studies. Vaccine. 2018;36(32 Pt A) 32 Pt A;4774-82.  PMID: 29366703 
  26. Sankaranarayanan R, Joshi S, Muwonge R, Esmy PO, Basu P, Prabhu P, et al. Indian HPV vaccine study group. Can a single dose of human papillomavirus (HPV) vaccine prevent cervical cancer? Early findings from an Indian study. Vaccine. 2018;36(32 Pt A) 32 Pt A;4783-91.  PMID: 29551226 
  27. Brotherton JM, Budd A, Rompotis C, Bartlett N, Malloy MJ, Andersen RL, et al. Is one dose of human papillomavirus vaccine as effective as three?: A national cohort analysis. Papillomavirus Res. 2019;8:100177.  https://doi.org/10.1016/j.pvr.2019.100177  PMID: 31319173 
  28. Verdoodt F, Dehlendorff C, Kjaer SK. Dose-related effectiveness of quadrivalent human papillomavirus vaccine against cervical intraepithelial neoplasia: A Danish nationwide cohort study. Clin Infect Dis. 2020;70(4):608-14. PMID: 30892587 
  29. Sonawane K, Nyitray AG, Nemutlu GS, Swartz MD, Chhatwal J, Deshmukh AA. Prevalence of human papillomavirus infection by number of vaccine doses among US women. JAMA Netw Open. 2019;2(12):e1918571.  https://doi.org/10.1001/jamanetworkopen.2019.18571  PMID: 31880792 
  30. Whitworth HS, Gallagher KE, Howard N, Mounier-Jack S, Mbwanji G, Kreimer AR, et al. Efficacy and immunogenicity of a single dose of human papillomavirus vaccine compared to no vaccination or standard three and two-dose vaccination regimens: A systematic review of evidence from clinical trials. Vaccine. 2020;38(6):1302-14.  https://doi.org/10.1016/j.vaccine.2019.12.017  PMID: 31870572 
  31. Institut National de Sante’ Publique du Quebec (INSPQ). Comite' sur l'immunisation du Quebec. Advisory report on the human papillomavirus (HPV) vaccination schedule. Quebec: INSPQ; 2018. Available from: https://www.inspq.qc.ca/sites/default/files/publications/2458_papillomavirus_vaccination_schedule.pdf
  32. Gilca V, Sauvageau C, Panicker G, De Serres G, Ouakki M, Unger ER. Immunogenicity and safety of a mixed vaccination schedule with one dose of nonavalent and one dose of bivalent HPV vaccine versus two doses of nonavalent vaccine - A randomized clinical trial. Vaccine. 2018;36(46):7017-24.  https://doi.org/10.1016/j.vaccine.2018.09.057  PMID: 30314913 
  33. Daniels V, Saxena K, Roberts C, Kothari S, Corman S, Yao L, et al. Impact of reduced human papillomavirus vaccination coverage rates due to COVID-19 in the United States: A model based analysis. Vaccine. 2021;39(20):2731-5.  https://doi.org/10.1016/j.vaccine.2021.04.003  PMID: 33875269 
Human papillomavirus vaccination in the European Union/European Economic Area and globally: a moral dilemma
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Edoardo+Colzani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Colzani Edoardo</a>, <a href="/search?value1=Kari+Johansen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Johansen Kari</a>, <a href="/search?value1=Helen+Johnson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Johnson Helen</a>, <a href="/search?value1=Lucia+Pastore+Celentano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pastore Celentano Lucia</a></span>. Human papillomavirus vaccination in the European Union/European Economic Area and globally: a moral dilemma. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(50):pii=2001659. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.50.2001659" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.50.2001659</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 09 Sept 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 15 Jul 2021 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.50.2001659
/content/10.2807/1560-7917.ES.2021.26.50.2001659
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error