Heffernan Margaret E, Garland Suzanne M, Kane Mark A
Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Carlton, Vic. 3053, Australia.
Sex Health. 2010 Sep;7(3):383-90. doi: 10.1071/SH09134.
Worldwide, prophylactic vaccines against two major human cancers are now commercially available: hepatitis B virus (HBV) vaccines (first licensed in 1982) against primary hepatocellular carcinoma and human papillomavirus (HPV) vaccines (first licensed 2006) against cervical cancer. Initial implementation strategies for HBV vaccination were not successful in preventing disease in the community: it took 15 years for significant global reduction in the burden of this disease.
We compare and contrast HBV vaccine experiences to challenges for successful global HPV vaccination strategies, and make recommendations accordingly.
Lessons from HBV immunisation for successful outcomes with HPV immunisation showed that several factors need to be met: (i) the engagement of key stakeholders in all aspects of planning and delivery of HPV vaccine strategies; (ii) understanding the specific characteristics of targeted population groups; (iii) global cooperation and support with WHO recommendations; (iv) Government supported mass immunization programs and cooperation between public and private entities; (v) affordable HPV vaccines for some regions; (vi) culturally appropriate and diverse public education programs in targeted health promotion strategies; (vii) pro-active health providers and parents in encouraging adolescents to undertake HPV vaccination; and (vii) eventual immunisation of infants.
The key to success will be affordable, readily deliverable HPV vaccines to young girls as universal campaigns.
在全球范围内,针对两种主要人类癌症的预防性疫苗现已上市:用于预防原发性肝细胞癌的乙型肝炎病毒(HBV)疫苗(1982年首次获批)和用于预防宫颈癌的人乳头瘤病毒(HPV)疫苗(2006年首次获批)。HBV疫苗的初始实施策略在社区预防疾病方面并不成功:全球范围内该疾病负担显著降低花了15年时间。
我们将HBV疫苗的经验与全球HPV疫苗成功接种策略所面临的挑战进行比较和对比,并据此提出建议。
HBV免疫接种对HPV免疫接种成功结果的经验教训表明,需要满足几个因素:(i)关键利益相关者参与HPV疫苗策略规划和实施的各个方面;(ii)了解目标人群的具体特征;(iii)全球合作并支持世卫组织的建议;(iv)政府支持的大规模免疫计划以及公共和私营实体之间的合作;(v)为一些地区提供价格可承受的HPV疫苗;(vi)在有针对性的健康促进策略中开展符合文化特点且多样化的公众教育计划;(vii)积极主动的医疗服务提供者和家长鼓励青少年接种HPV疫苗;以及(viii)最终实现婴儿免疫接种。
成功的关键将是作为普及运动为年轻女孩提供价格可承受、易于接种的HPV疫苗。