Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries.


Gallagher, KE; Howard, N; Kabakama, S; Mounier-Jack, S; Griffiths, UK; Feletto, M; Burchett, HED; LaMontagne, DS; Watson-Jones, D; (2017) Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries. PLoS One, 12 (6). e0177773. ISSN 1932-6203 DOI: 10.1371/journal.pone.0177773

[img]
Preview
Text - Published Version
License:

Download (1269Kb) | Preview
[img]
Preview
Text - Published Version
License:

Download (1269Kb) | Preview

Abstract

To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery for out-of-school girls attained high coverage. There were limited data on facility-only strategies and little evaluation of strategies to reach out-of-school girls. Early engagement of teachers as partners in social mobilisation, consent, vaccination day coordination, follow-up of non-completers and adverse events was considered invaluable. Micro-planning using school/ facility registers most effectively enumerated target populations; other estimates proved inaccurate, leading to vaccine under- or over-estimation. Refresher training on adverse events and safe injection procedures was usually necessary. Considerable experience in HPV vaccine delivery in LAMICs is available. Lessons are generally consistent across countries and dissemination of these could improve HPV vaccine introduction.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Public Health and Policy > Dept of Global Health and Development
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 28575074
URI: http://researchonline.lshtm.ac.uk/id/eprint/3979932

Statistics


Download activity - last 12 months
Downloads since deposit
9Downloads
14Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item