全球视角下影响 HPV 疫苗引入和中低收入国家推广的决定因素。

Global perspectives of determinants influencing HPV vaccine introduction and scale-up in low- and middle-income countries.

机构信息

International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Jhpiego, A Johns Hopkins University Affiliate, Baltimore, Maryland, United States of America.

出版信息

PLoS One. 2024 Jan 16;19(1):e0291990. doi: 10.1371/journal.pone.0291990. eCollection 2024.

Abstract

Achieving WHO cervical cancer elimination goals will necessitate efforts to increase HPV vaccine access and coverage in low-and-middle-income countries (LMICs). Although LMICs account for the majority of cervical cancer cases globally, scale-up of HPV vaccine programs and progress toward coverage targets in LMICs has been largely insufficient. Understanding the barriers and facilitators that stakeholders face in the introduction and scale-up of HPV vaccination programs will be pivotal in ensuring that LMICs are equipped to optimize the implementation of HPV vaccination programs. This qualitative study interviewed 13 global stakeholders categorized as either academic partners or global immunization partners to ascertain perspectives regarding factors affecting the introduction and scale-up of HPV vaccination programs in LMICs. Global stakeholders were selected as their perspectives have not been as readily highlighted within the literature despite their key role in HPV vaccination programming. The results of this investigation identified upstream (e.g., financial considerations, vaccine prioritization, global supply, capacity and delivery, and vaccine accessibility, equity, and ethics) and downstream (e.g., vaccine acceptability and hesitancy, communications, advocacy, and social mobilization) determinants that impact program introduction and scale-up and confirmed that strong political commitment and governance are significant in garnering support for HPV vaccines. As LMICs introduce HPV vaccines into their national immunization programs and develop plans for scaling up vaccination efforts, strategic approaches to communications and advocacy will also be needed to successfully meet coverage targets.

摘要

实现世界卫生组织(WHO)消除宫颈癌的目标需要努力增加中低收入国家(LMICs)的 HPV 疫苗可及性和覆盖率。尽管 LMICs 占全球宫颈癌病例的大多数,但 HPV 疫苗项目的扩大和 LMICs 实现覆盖目标的进展在很大程度上仍然不足。了解利益相关者在引入和扩大 HPV 疫苗接种项目方面面临的障碍和促进因素,对于确保 LMICs 有能力优化 HPV 疫苗接种项目的实施至关重要。这项定性研究采访了 13 位全球利益相关者,他们分为学术合作伙伴或全球免疫伙伴,以确定他们对影响 LMICs 引入和扩大 HPV 疫苗接种项目的因素的看法。选择全球利益相关者是因为尽管他们在 HPV 疫苗接种规划中发挥着关键作用,但他们的观点在文献中并没有得到充分强调。这项调查的结果确定了影响项目引入和扩大的上游(如财务考虑、疫苗优先排序、全球供应、能力和交付以及疫苗可及性、公平性和道德)和下游(如疫苗可接受性和犹豫、沟通、宣传和社会动员)决定因素,并证实了强有力的政治承诺和治理对于争取 HPV 疫苗的支持至关重要。随着 LMICs 将 HPV 疫苗纳入国家免疫规划并制定扩大疫苗接种工作的计划,还需要采取战略性的沟通和宣传方法,以成功实现覆盖目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8ee/10791006/95b2023acaef/pone.0291990.g001.jpg

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