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RESEARCH ARTICLE

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 E
+ Author Affiliations
- Author Affiliations

A 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.


References


[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 |

[2] Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004; 11 97–107.
CrossRef | PubMed |

[3] Kao JH,  Chen DS. Global control of hepatitis B virus infection. Lancet Infect Dis 2002; 2 395–403.
CrossRef | PubMed |

[4] Shepard CW,  Simard EP,  Finelli L,  Fiore AE,  Bell BP. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 2006; 28 112–25.
CrossRef | PubMed |

[5] Van Damme P,  Kane M,  Meheus A. Integration of hepatitis B vaccination into national immunization programmes. BMJ 1997; 314 1033–6.
PubMed |

[6] Kane MA,  Brooks A. New immunization initiatives and progress toward the global control of hepatitis B. Curr Opin Infect Dis 2002; 15 465–9.
PubMed |

[7] Lugoboni F,  Migliozzi S,  Mezzelani P,  Pajusco B,  Ceravolo R,  Quaglio G. Progressive decrease of hepatitis B in a cohort of drug users followed over a period of 15 years: the impact of anti-HBV vaccination. Scand J Infect Dis 2004; 36 131–3.
CrossRef | PubMed |

[8] Yusuf H,  Daniels D,  Mast EE,  Coronado V. Hepatitis B vaccination coverage among United States children. Ped Infec Dis J 2001; 20 S30–3.
CrossRef |

[9] Goldwater PN. History of hepatitis B vaccination in New Zealand: lessons for Australia? Aust J Public Health 1993; 17 221–5.
CrossRef | PubMed |

[10] Takayama JI,  Iser JP,  Gandelman A. Regional differences in infant immunization against hepatitis B: did intervention work? Prev Med 1999; 28 160–6.
CrossRef | PubMed |

[11] Schmidt RM,  Middleman AB. The importance of hepatitis B vaccination among adolescents. J Adolesc Health 2001; 29 217–22.
CrossRef | PubMed |

[12] Williams A. Reduction in the hepatitis B related burden of disease--measuring the success of universal immunisation programs. Commun Dis Intell 2002; 26 458–60.
PubMed |

[13] Liaw YF,  Leung N,  Guan R,  Lau GKK,  Merican I. Asian-Pacific consensus statement on the management of chronic hepatitis B: An update. J Gastro & Hepatol 2003; 18 239–45.
CrossRef |

[14] Hymel PA. Decreasing risk: impact of HPV vaccination on outcomes. Am J Manag Care 2006; 17 S473–83.


[15] Palmer Beasley R. Development of hepatitis B vaccine. JAMA 2009; 302 322–4.
CrossRef | PubMed |

[16] Wallace LA,  Bramley JC,  Ahmed S,  Duff R,  Hutchinson SJ,  Carman WF, et al. Determinants of universal adolescent hepatitis B vaccine uptake. Arch Dis Child 2004; 89 1041–2.
CrossRef | PubMed |

[17] World Health Organization (WHO), Vaccines & Biologicals. Introduction of hepatitis B vaccine into childhood immunization services: management guidelines. Geneva: WHO; 2001.

[18] Koulova A,  Tsui J,  Irwin K,  Van Damme P,  Biellik R,  Aguado MT. Country recommendations on the inclusion of HPV vaccines in national immunization programmes among high-income countries, June 2006–January 2008. Vaccine 2008; 26 6529–41.
CrossRef | PubMed |

[19] Weekly Epidemiological Record (WER) 118: Human papillomavirus vaccines WHO position paper. WHO 2007; 28(29): 245–60.


[20] Rumbold A, Nickels M. Vulva cancer, HPV and results from the SISTER Study Research. Oral paper, RANZCOG 2008 Indigenous Women’s Health Meeting, 14–16 August 2008. Darwin Convention Centre Darwin, Australia. Available online at: http://www.ranzcog.edu.au/meetingsconferences/pdfs/IWH-darwin2008-program.pdf [verified May 2010].

[21] Senior K. Global aspirations for HPV vaccination. Lancet Infect Dis 2008; 8 150.
CrossRef | PubMed |

[22] Menzies R,  McIntyre P,  Beard F. Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 1999 to 2002. Commun Dis Intell 2004; 28 127–59.
PubMed |

[23] Forster AS,  Marlow LAV,  Wardle J,  Stephenson J,  Waller J. Understanding adolescents’ intentions to have the HPV vaccine. Vaccine 2010; 28 1673–6.
CrossRef | PubMed |

[24] Brabin L,  Roberts R,  Stretch D,  Baxter G,  Chambers G,  Kitchener H, et al. Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort study. BMJ 2008; 336 1056–8.
CrossRef | PubMed |

[25] Colucci R,  Hryniuk W,  Savage C. HPV vaccination programs in Canada. Are we hitting the mark? Report Card on Cancer in Canada 2008; 7–10.


[26] Bill and Melinda Gates Pledge $10 Billion in Call for Decade of Vaccines. Bill & Melinda Gates Foundation: January 29, 2010. Available online at: www.gatesfoundation.org [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 | PubMed |

[28] Innovative partnership: GAVI Alliance. Geneva: GAVI Alliance; 2010. Available online at: http://www.gavialliance.org [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 | PubMed |

[30] Goldstein ST,  Zhou F,  Hadler SC,  Bell BP,  Mast EE,  Margolis HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol 2005; 34 1329–39.
CrossRef | PubMed |

[31] Procurement and pricing of new vaccines for developing countries. GAVI Alliance: IAVI Policy Brief August 2008; 16. Geneva: GAVI Alliance; 2008. Available online at: http://www.gavialliance.org/resources/iavi_policy_brief_procurement.pdf [accessed 3 March 2010].

[32] Ni YH,  Chen DS. Hepatitis B vaccination in children: the Taiwan experience. Pathol Biol 2010; ■ ■–■.
CrossRef | PubMed |

[33] Ni YH,  Huang LM,  Chang MH,  Yen CJ,  Lu CY,  You SL, et al. Two decades of universal hepatitis B vaccination in Taiwan: impact and implication for future strategies. Gastroenterology 2007; 132 1287–93.
CrossRef | PubMed |

[34] Cui FQ,  Wang XJ,  Cao L,  Liang XF,  Lu Y,  Hu YS, et al. Progress in hepatitis B prevention through universal infant vaccination: China, 1997–2006. MMWR Weekly 2007; 56 441–5.


[35] Garland SA,  Hernandez-Avila M,  Wheeler CM,  Perez G,  Harper DM,  Leodolter S, et al. Quadrivalent HPV 6/11/16/18 vaccine: prevention of cervical, vulvar and vaginal disease. N Engl J Med 2007; 356 1928–43.
CrossRef | PubMed |

[36] The FUTURE II Study Group Quadrivalent HPV vaccine prevention of high grade cervical intraepithelial neoplasia. N Engl J Med 2007; 356 1915–27.
CrossRef | PubMed |

[37] Villa L,  Costa RL,  Petta CA,  Andrade R,  Ault K,  Giuliano A, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005; 6 271–8.
CrossRef | PubMed |

[38] Hu DJ,  Vitek CR,  Bartholow B,  Mastro TD. Key issues for a potential human immunodeficiency virus vaccine. Clin Infect Dis 2003; 36 638–44.
CrossRef | PubMed |

[39] Brown DR,  Kjaer SK,  Sigurdsson K,  Iversen OE,  Hernandez-Avila M,  Wheeler CM, et al. The impact of quadrivalent human papillomavirus (HPV; types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease Due to oncogenic nonvaccine HPV types in generally HPV-naive women aged 16–26 years. J Infect Dis 2009; 199 926–35.
CrossRef | PubMed |

[40] A vaccine for women’s health; Preparing the way for a new tool in the fight against cervical cancer. Available online at: http://path.org/ [accessed 4 March 2010].

[41] Herdman C, Demspey M. Introducing HPV Vaccines in Developing Countries: Overcoming the Challenges. PATH Publications: Fact Sheet . Sept 2005; 206. 285.3500|206.285.6619. Available online at: http://www.path.org/publications/details.php?i=1121 [accessed 4 March 2010].

[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 | 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 | 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 | 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 | 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 |

[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 | 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 | 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 | 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 | 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 |

[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 | PubMed |

[56] Meheus A. Teenagers’ lifestyle and the risk of exposure to hepatitis B virus. Vaccine 2000; 18(S1): S26–9.
CrossRef | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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.



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