Vaccination in WHO - European Region

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Liudmila Mosına-HPV Vaccination in WHO - European Region

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Vaccination in WHO - European Region

  1. 1. Comprehensive Cervical Cancer Prevention and Control Meeting 18-20 May 2011 HPV vaccination in WHO European Region Liudmila Mosina Vaccine Preventable Diseases & Immunization Programme, WHO Regional Office for Europe
  2. 2. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 2 Introduction of HPV vaccine, WHO European Region, Jan 2011 HPV Introduced (20) Not introduced 2007: BEL, FRA, DEU, ITA 2008: DEN, GRE, LUX, ROM, SPA, SWI, UNK 2009: NET, NOR, POR, SMR, SVN, MKD 2010: IRE, LVA SWE
  3. 3. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 3 Decision Making (16 countries)  National Immunization Technical Advisory Groups provided recommendations on HPV vaccination  Main criteria used (67% of countries): – Disease burden; – Safety and efficacy of vaccine; – Cost effectiveness (9 countries economic evaluations)  Additional criteria: – Political will – WHO/ECCA recommendations – Acceptance by target group and parents – Insufficiency of opportunistic cervical cancer screening programme to prevent cervical cancer in young women
  4. 4. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 4 Routine and catch up vaccination (15 countries) Routine vaccination of target group: 6 countries Routine and catch up vaccination: 9 countries Age of routine: – Range: 10 – 18 years old – The most frequent: 12-14 years old (69%) Age of catch up: – Range: 13 – 26 years old – The most frequent: 13-18 years old (70%);
  5. 5. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 5 Delivery systems (15 countries)  School vaccination: Norway, Romania, The former Yugoslav Republic of Macedonia, Sweden, UNK  Health facilities (GP, paediatricians, immunization centres) – Denmark, Greece, Italy, Luxemburg, Portugal  Regional strategies (school vaccination and health facilities): Spain, Switzerland  Health facilities (GP, paediatricians, gynaecologists): Belgium, France, Germany  Mass immunization campaigns: The Netherlands Existing systems (11 countries) Alternative systems (4 countries)
  6. 6. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 6 HPV vaccine coverage, 2009 83 81 76 73 59 55 47 44 34 30 30 11 0 10 20 30 40 50 60 70 80 90 POR UNK SPA DEN ITA SWI NET BEL MKD FRA DEU ROM % Sources: WHO/UNICEF JRF, WHO survey, VENICE survey
  7. 7. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 7 Components of success from countries achieving high coverage (1)  Decision making: – Evidence based decision based on NITAG recommendations – Open and honest decision making process  Delivery system: – Adding HPV vaccine into existing immunization delivery system – Implementation of HPV vaccination within National Immunization Programme – Developing strategies for timely administration of subsequent doses
  8. 8. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 8 Components of success from countries achieving high coverage (2)  Effective advocacy and communication prior to introduction: – Development and implementation of advocacy and communication plans – Assessment of perceptions of HPV vaccine among target audiences to develop effective communication strategies. Strategies defined as important by many countries: • Sending letters to families • Education of vaccine providers and health care professionals  Timely response to AEFI and negative publicity: – Preparedness and anticipation – Assessment of baseline levels of diseases which might be linked with vaccination – Provision of single communication message to public  Monitoring of HPV coverage
  9. 9. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 9 Cervical cancer screening programmes  All countries recommended to continue cervical cancer screening programmes  Six countries planned to strengthen their programmes through introduction of organized screening or adding HPV genotyping: Austria, Belgium, Denmark, France, Portugal, and Romania.  Some countries (France, Switzerland, and UNK) conducted surveys to study impact of HPV vaccination on women’s behavior, including participation in cervical cancer screening programme.
  10. 10. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 10 WHO European Region, WB income group classification High income (32) Upper middle income (13) Lower middle income (6) Low income (2)
  11. 11. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 11 Age-standardized cervical cancer mortality rates, WHO European Region, 2008 <=1.9 <=3.7 <=5.9 <=11.8 No data Source: IARC, Globocan 2008
  12. 12. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 12 GAVI eligible countries in WHO European Region GAVI eligible GAVI graduating Non GAVI eligible
  13. 13. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 13 WHO Meeting on Cervical Cancer Prevention  Date: 12-13 October 2011  Venue: Istanbul, Turkey  Participants: representatives of national immunization and cervical cancer screening programmes from 53 Member States  Partners
  14. 14. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 14 Objectives (1)  Review the region’s progress in primarily and secondary cervical cancer prevention; define priorities for future  Review national policies and programmes for introducing HPV vaccines and organized screening within the broader context of cancer control and reproductive health
  15. 15. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 15 Objectives (2)  Share experiences, best practices and lessons learnt among countries in the Region  Create synergy between WHO EURO programmes; coordinate support between partners
  16. 16. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 16 Expected outcomes (1)  Summarize and distribute the experiences and lessons learnt on HPV vaccination form early adopting countries  Define future regional priorities for cervical cancer prevention
  17. 17. 18-20 May 2011Comprehensive Cervical Cancer Prevention and Control Meeting 17 Expected outcomes (2)  Achieve a common understanding and commitment for implementation of comprehensive approach in cervical cancer prevention  Facilitate implementation and adoption of best practices among the countries in the region

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