Haruyama Rei, Okawa Sumiyo, Akaba Hiroki, Obara Hiromi, Fujita Noriko
Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
Vaccines (Basel). 2021 Nov 18;9(11):1355. doi: 10.3390/vaccines9111355.
The World Health Organization's Western Pacific Region is responsible for one-fourth of the global cervical cancer burden, and nearly 90% of that burden is concentrated in middle-income countries (MICs). Applying a conceptual model of implementation of population-based interventions, we synthesized the current implementation status of human papillomavirus (HPV) vaccination and national plans that form the basis of its implementation in 17 MICs. We gathered information from a range of governmental documents, published studies, and global databases. For all available national cancer-related plans and immunization plans, we examined the description of HPV vaccination. We found that, as of July 2021, only four countries (24%) had a mature HPV vaccination program with a high first-dose coverage; three (18%) had introduced HPV vaccination, but needed further efforts to scale it up, seven (41%) had not been able to introduce it after conducting demonstration projects, and three (18%) did not have any experience in HPV vaccination. In the national plans, most of the countries recognized the importance of HPV vaccination, but only 10 (59%) provided an implementation strategy on how it would be introduced or scaled up. Countries with a mature program were more likely to have their implementation strategy detailed in their national cancer control plan. Successful implementation of HPV vaccination requires overcoming known challenges and having a clear national plan. Positioning HPV vaccination clearly in the overall national cancer control plan may be key to accelerating its nationwide implementation.
世界卫生组织西太平洋区域承担着全球四分之一的宫颈癌负担，其中近90%的负担集中在中等收入国家。应用基于人群干预措施实施的概念模型，我们综合了17个中等收入国家人乳头瘤病毒（HPV）疫苗接种的当前实施状况以及构成其实施基础的国家计划。我们从一系列政府文件、已发表的研究和全球数据库中收集信息。对于所有可用的国家癌症相关计划和免疫计划，我们审查了HPV疫苗接种的描述。我们发现，截至2021年7月，只有四个国家（24%）拥有成熟的HPV疫苗接种计划且首剂接种覆盖率高；三个国家（18%）已引入HPV疫苗接种，但需要进一步努力扩大规模；七个国家（41%）在开展示范项目后未能引入；三个国家（18%）没有HPV疫苗接种经验。在国家计划中，大多数国家认识到HPV疫苗接种的重要性，但只有10个国家（59%）提供了关于如何引入或扩大接种规模的实施策略。拥有成熟计划的国家更有可能在其国家癌症控制计划中详细阐述其实施策略。成功实施HPV疫苗接种需要克服已知挑战并制定明确的国家计划。将HPV疫苗接种明确纳入国家总体癌症控制计划可能是加速其在全国范围内实施的关键。
