HPV VACCINATION

Dr Frida Mghamba

2nd East Africa WE CAN Summit

11th September 2014

Outline

• Introduction

• Comprehensive approach for cervical cancer prevention and control

• HPV vaccination Demonstration project

• Lesson learned in HPV vaccination

• Role of GAVI and WHO

Introduction• Cervical cancer is the abnormal uncontrolled

growth of cells in the cervix.

• The cells of the cervix change in a way that leads to abnormal growth and invasion of other tissues or organs of the body.

• Nearly all cervical cancers are caused by HPV infection.

• There are more than 40 HPV types that can

infect the genital areas of males and females

• The HPV types 16 and 18 account for about 70% of all HPV cervical cancers worldwide

Comprehensive Approach to cervical cancer prevention and control

• Primary prevention– Education: delay age of first sexual

intercourse, use condoms, limit number of partners, avoid tobacco use

– HPV vaccines

• Secondary prevention: early detection– Screening: Identify and treat precancerous

lesions before they progress to cervical cancer

– Early diagnosis: Identify and treat early cancer while chance of cure is still good (reduces cervical cancer mortality)

• Tertiary prevention: treatment and palliative care

HPV vaccination• HPV vaccination is the primary preventive method for

cervical cancers caused by HPV infection.

• It prevents women from acquiring HPV infection in the first instance, so there is no risk of an infection progressing to cervical cancer later in life.

• The vaccine is recommended by WHO for ages 9-13 years.

• The HPV vaccine is safe , very effective and provides complete immunity after two doses six months apart.

•

HPV vaccination demonstration project

• HPV demonstration project aims to demonstrate how the HPV vaccine targeting girls aged 9-13 years can be delivered in routine setting and its implication on coverage feasibility, acceptability and cost.

• Target age group for the HPV vaccination is school-going girls, school-based vaccination is one of the vaccination strategies adopted to achieve the best coverage rates.

• Data from the MOEVT show that girls with 9-13 years 95% are in grade IV therefore this programme target all girls in class IV with age 9 and above.

• The girls out of school due to various reasons was vaccinated with age of 9years..

RESULT OF HPV VACCINATION

• 1st round of HPV vaccination was conducted on 5th to 9th May this year in Kilimanjaro region

• Total number of girls vaccinated in school was 17,222 out of 18,316 (94.0%)

• The girls vaccinated out of schools were 416 out of 597(69.70%).

• Overall coverage was 93%

HPV VACCINATION COVERAGE

CHALLENGES

• Misconception among parents/guardian

• Refusal because of religious belief in three religious schools

• Fund for operational for the 2nd year

LESSON LEARNT

• Community health worker can be used as platform for reaching hard to reach and out of school

• Through micro planning resulted into good vaccination coverage, better resources utilization and avoidance of duplication

• Operational plan correctly resulted into appropriate proper distribution of vaccine and supplies

• Delivering of vaccine in school is cheap and cost effective strategies

• Targeted girls who were already vaccinated can be used as ingredient for change and increase acceptance among girls and community

ROLE OF GAVI AND WHOGAVI

• To provide financial support

• To supply HPV vaccines

WHO

• To provide technique support in – Training– Supportive supervision– Monitoring and evaluation

Thank you