Routine HPV vaccination: Reflection on delivery strategies based on countries' experiences

Area of Science:

• Public Health
• Vaccinology
• Global Health

Background:

• Low- and middle-income countries (LMICs) struggle with sustained human papillomavirus (HPV) vaccination coverage.
• Existing World Health Organization (WHO) guidelines require alignment with practical implementation experiences for HPV vaccine delivery.

Purpose of the Study:

• To explore challenges and effective strategies for HPV vaccine delivery in LMICs.
• To evaluate current HPV vaccine delivery approaches against WHO guidelines.
• To advocate for updated WHO guidelines based on real-world implementation.

Main Methods:

• Analysis of presentations and discussions from Coalition to Strengthen the HPV Immunization Community (CHIC) symposia.
• Incorporation of field experiences from program implementers and immunization experts.
• Case studies of HPV vaccination delivery in The Gambia, Zambia, Ethiopia, Tanzania, Kenya, and Maldives.

Main Results:

• Diverse delivery strategies are employed, including routinized school-based campaigns, routine health facility services, and targeted outreach for out-of-school girls.
• Routinized campaign mode vaccination shows promise but requires deeper understanding.
• Current strategies highlight the need for broader delivery options.

Conclusions:

• There is a need to better understand and potentially expand routinized campaign-based HPV vaccination delivery.
• Existing WHO HPV vaccine delivery guidelines should be updated to reflect diverse and evolving implementation strategies.
• Updated guidelines are crucial for ensuring comprehensive, cost-effective, and sustainable HPV vaccination programs in LMICs.