在低收入和中等收入国家采用或转向单剂量HPV疫苗接种计划的途径和过程:定性研究
Sunny Roy1, Megan D Wysong1, Erica N Rosser1
1Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
PLOS global public health
|February 5, 2025
概括
低收入和中等收入国家 (LMICs) 面临着采用单剂量人类乳头瘤病毒 (HPVV) 疫苗接种计划的挑战. 本研究概述了LMICs在HPV计划变更时使用的六步决策过程.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 全球卫生政策 全球卫生政策
背景情况:
- 世界卫生组织 (WHO) 建议使用单剂量人类乳头瘤病毒 (HPVV) 疫苗接种计划.
- 这一修订后的时间表的采用是不一致的,特别是在低收入和中等收入国家 (LMICs) 被子宫癌影响不成比例.
- 了解国家层面的决策过程对于公平的疫苗实施至关重要.
研究的目的:
- 描述决策途径和涉及的参与者,促进或阻碍在LMIC中采用单剂量HPVV计划.
- 确定HPV病毒日程表变更的国家决策过程中的关键连续步骤.
主要方法:
- 进行了66次半结构面试,与来自非洲和亚洲的19个LMIC的国家免疫利益相关者进行了半结构面试 (2023年9月 - 2024年2月).
- 根据其HPV程序和日程表的成熟度,采样国家.
- 采用有目的的文本分析来合成定性见解和辨别决策途径.
主要成果:
- 确定了采用或切换到单剂量HPVV计划的六步顺序决策过程.
- 关键步骤包括:WHO/SAGE建议的出现,向卫生部 (MoH) /扩大免疫计划 (EPI) 传播信息,国家免疫技术咨询小组 (NITAG) 审查证据 (成本效益,疾病负担,犹),NITAG审议和建议,卫生部批准,以及机构间协调委员会 (ICC) 的最终授权.
- 突出了整个决策连续过程中各个参与者和机构的角色.
结论:
- 在考虑改变他们的HPV疫苗接种计划时,LMICs遵循一个结构化,多阶段的过程.
- 了解这些连续步骤和参与者的理解对于支持有效实施更新的疫苗接种政策至关重要.
- 解决每个阶段的潜在障碍可以改善高负担国家的单剂量HPVV计划的采用.
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