Global reduction of cervical cancer with human papillomavirus vaccines: insights from the hepatitis B virus vaccine experience
Margaret E. Heffernan A B F , Suzanne M. Garland A C D and Mark A. Kane EA Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Carlton, Vic. 3053, Australia.
B School of Management, RMIT University, Level 16, 239 Bourke Street, Melbourne, Vic. 3000, Australia.
C Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Vic. 3052, Australia.
D Murdoch Children’s Research Institute, University of Melbourne, Vic. 3052, Australia.
E Consultant, Mercer Island, Seattle, WA 98040, USA.
F Corresponding author. Email: margaret.heffernan@rmit.edu.au
Sexual Health 7(3) 383-390 https://doi.org/10.1071/SH09134
Submitted: 1 December 2009 Accepted: 6 April 2010 Published: 19 August 2010
Abstract
Background: 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. Methods: We compare and contrast HBV vaccine experiences to challenges for successful global HPV vaccination strategies, and make recommendations accordingly. Results: 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. Conclusions: The key to success will be affordable, readily deliverable HPV vaccines to young girls as universal campaigns.
Additional keywords: hepatitis B, human papillomavirus, prophylactic vaccines.
[1] Bosch FX, Qiao YL, Castellsague X. The epidemiology of human papillomavirus infection and its association with cervical cancer. Int J Gyn Obs 2006; 94 S8–21.
| Crossref | GoogleScholarGoogle Scholar | [verified May 2010].
[21] Senior K. Global aspirations for HPV vaccination. Lancet Infect Dis 2008; 8 150.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 3 March 2010].
[27] Bilous J, Eggers R, Gasse F, Jarrett S, Lydon P, Magan A, et al. A new global immunisation vision and strategy. Lancet 2006; 367 1464–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 3 March 2010].
[29] Larcher VF, Bourne J, Aitken C, Jeffries D, Hodes D. Overcoming barriers to hepatitis B immunisation by a dedicated hepatitis B immunisation service/commentary. Arch Dis Child 2001; 84 114–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 3 March 2010].
[32] Ni YH, Chen DS. Hepatitis B vaccination in children: the Taiwan experience. Pathol Biol 2010; ▪ ▪–▪.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 4 March 2010].
[41]
[42] Biellik R, Levin C, Mugisha E, LaMontagne DS, Bingham A, Kaipilyawar S, et al. Health systems and immunization financing for human papillomavirus vaccine introduction in low-resource settings. Vaccine 2009; 27 6203–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[43] Cameron JC, Wallace LA, Ahmed S, Duff R. HPV vaccine: positive insights from universal adolescent HepB vaccination. J Epidemiol Community Health 2007; 61 1018–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[44] Cooper A, Yusuf H, Rodewald L, Malik T, Pollard R, Pickering L. Attitudes, practices, and preferences of pediatricians regarding initiation of hepatitis B immunization at birth. Pediatrics 2001; 108 e98.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[45] Tjalma WAA, Van Damme P. Is the public enough aware to accept a vaccination program against human papillomavirus? Vaccine 2005; 23 3231.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[46] Sherris J, Friedman A, Wittet S, Davies P, Steben M, Saraiya M. Education, training and communication for HPV vaccines. Vaccine 2006; 24 Ch 25.
| Crossref | GoogleScholarGoogle Scholar |
[47] Woodruff BA, Unti L, Coyle K, Boyer-Chuanroong L. Parents’ attitudes toward school-based hepatitis B vaccination of their children. Pediatrics 1996; 98 410–3.
| PubMed |
[48] Lippman A. Human papillomavirus (HPV) vaccination and the development of public policies. J Epidemiol Community Health 2008; 62 570–1.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[49] Pitts MK, Dyson SJ, Rosenthal DA, Garland SM. Knowledge and awareness of human papillomavirus (HPV): attitudes towards HPV vaccination among a representative sample of women in Victoria, Australia. Sex Health 2007; 4 177–80.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[50] Garland SM, Brotherton JML, Skinner SR, Pitts M, Saville M, Mola G, et al. Human papillomavirus and cervical cancer in Australasia and Oceania: risk-factors, epidemiology and prevention. Vaccine 2008; 26 M80–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[51] Hinds A, Cameron JC. Acceptability of universal HepB vaccination among school pupils and parents. Comm Disease and Pub Health 2004; 7 278–82.
[52] Lawrence MH, Goldstein MA. Hepatitis B immunization in adolescents. J Adolesc Health 1995; 17 234–43.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[53] Brotherton JM, Deeks SL, Campbell-Lloyd S, Misrachi A, Passaris I, Peterson K, et al. Interim estimates of human papillomavirus vaccination coverage in the school-based program in Australia. Commun Dis Intell 2008; 32 457–61.
| PubMed |
[54] Olshen E, Woods ER, Austin SB, Luskin M, Bauchner H. Parental acceptance of the HPV vaccine. J Adolesc Health 2005; 36 248–51.
| Crossref | GoogleScholarGoogle Scholar |
[55] Goldstein ST, Cassidy WM, Hodgson W, Mahoney FJ. Factors associated with student participation in a school-based hepatitis B immunization program. J Sch Health 2001; 71 184–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[56] Meheus A. Teenagers’ lifestyle and the risk of exposure to hepatitis B virus. Vaccine 2000; 18(S1): S26–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[57] Slonim AB, Roberto AI, Downing CR, Adams I, Fasano N, Davis-Satterla L, et al. Adolescents’ knowledge, beliefs, and behaviours regarding hepatitis B: insights and implications for programs targeting vaccine-preventable diseases. J Adolesc Health 2005; 36 178–86.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[58] Middleman AB, Guajardo AD, Sunwoo E, Sansaricq M. Parent knowledge and attitudes about school-based hepatitis B immunization programmes. (Health Service Applications). J Sch Health 2002; 72 348–51.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[59] Smith AM, Rissel C, Richters J, Grulich A, De Visser RO. Sex in Australia: reflections and recommendations for future research. ANZ J Pub Health 2003; 27 251–6.
[60] Middleman AB. Race/ethnicity and gender disparities in the utilization of a school-based hepatitis B immunization initiative. J Adolesc Health 2004; 34 414–9.
| PubMed |
[61] McPhee SJ, Nguyen T, Euler GL, Mock J, Wong C, Lam T, et al. Successful promotion of hepatitis B vaccinations among Vietnamese-American children ages 3 to 18: results of a controlled trial. Pediatrics 2003; 111 1278–88.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[62] Moore-Caldwell SY, Werner MJ, Powell L, Greene JW. Hepatitis B vaccination in adolescents: knowledge, perceived risk, and compliance. J Adolesc Health 1997; 20 294–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[63] Tung CS, Middleman AB. An evaluation of school-level factors used in a successful school-based hepatitis B immunization initiative. J Adolesc Health 2005; 37 61–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[64] Shefer A, Markowitz L, Deeks S, Tam T, Irwin K, Garland SM, et al. Early experience with human papillomavirus vaccine introduction in the United States, Canada and Australia. Vaccine 2008; 26 K68–75.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[65] Fairley C, Hocking J, Gurrin LC, Chen MY, Donovan B, Bradshaw CS. Rapid decline in presentation of genital warts after the implementation of a national quadrivalent human papillomavirus vaccination programme for young women. Sex Transm Infect 2009; 85 499–502.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[66] Garland SM. Can cervical cancer be eradicated by prophylactic HPV vaccination? Challenges to vaccine implementation. Indian J Med Res 2009; 130 311–21.
| PubMed |
[67] Newall AT, Brotherton JML, Quinn HE, McIntyre PB, Backhouse J, Gilbert L, et al. Population seroprevalence of human papillomavirus types 6, 11, 16, and 18 in men, women, and children in Australia. Clin Infect Dis 2008; 46 1647–55.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[68] Garland SM. Can cervical cancer be eradicated by prophylactic HPV vaccination? Challenges to vaccine implementation. Indian J Med Res 2009; 130 311–21.
| PubMed |
[69] Weekly Epidemiological Record (WER) 118: Human papillomavirus vaccines: WHO position paper. WHO 2009; 84 117–32.
