Human papilloma virus vaccination: impact and recommendations across the world

Abstract

Human papilloma virus (HPV) vaccination has been implemented in several countries for about the past 7 years, mainly in the adolescent female population, with varying coverage results. Although the impact of immunization on cervical and other HPV-related cancers will be evident in the next decades, a marked decrease of prevalent HPV infections, precancerous lesions and genital warts is already dramatic in the vaccinated cohorts, and also in their sexual partners, thus providing clear evidence of the effectiveness of HPV vaccination, including a herd-protection effect. Today, recommendations and implementation of universal HPV vaccination for adolescent girls are a public-health priority in all countries of the world. Countries with limited resources are presently involved in demonstration projects and, in some cases, have launched national programmes with the help of international agencies and alliances. Extension of immunization offer to young women and to adolescent male subjects has become an important additional opportunity for several countries, with a special focus needed on homosexual men with HIV infection who are at particularly increased risk of HPV-related diseases. Public-health authorities are confronted with the need to enlarge HPV-vaccination offer to all target groups, especially pre-adolescent girls, so that they can be saved from dreadful cancers by reaching high immunization coverage.

Keywords: coverage; human papilloma virus; impact; recommendations; vaccination.

Figure 1.

Countries with human papilloma virus vaccine in the national immunization programme and planned introductions, 2013 (source: World Health Organization). Introduced: Argentina, Australia, Austria, Belgium, Bhutan, Brazil, Brunei Darussalam, Canada, Colombia, Cook Islands, Czech Republic, Denmark, Fiji, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Japan, Kiribati, Latvia, Lesotho, Luxembourg, Macedonia, Malaysia, Marshall Islands, Mexico, Micronesia (Federated States of), the Netherlands, New Zealand, Norway, Palau, Panama, Paraguay, Portugal, Rwanda, San Marino, Singapore, Slovenia, Spain, Sweden, Switzerland, Trinidad and Tobago, Uganda, UK, USA, Uruguay. Partial introduction: Brazil, Kiribati, Uganda. 2013 planned introductions: Kazakhstan, Libya, Suriname, Vanuatu. Peru introduced the vaccine in 2011, then it was suspended, possible re-introduction in the next 2 years. Some countries are running demonstration projects. They are not included.

Figure 2.

Countries introducing human papilloma virus vaccination with the support of the Global Alliance for Vaccines and Immunization, 2014.