HPV Vaccination Needs Careful Long Term Planning
A successful HPV vaccination program requires more than just a series of injections, says a public health expert in this week's BMJ.
Careful planning, adequate education, and long term monitoring will be needed, argues Angela Raffle, a consultant in public health at Bristol Primary Care Trust.
Human papillomavirus (HPV) is a common sexually transmitted infection seen most often in young women and adolescents. There are more than 100 types of HPV, some cause only genital warts, but others cause cancers including cervical cancer.
Screening currently reduces deaths from cervical cancer by around 80% but a new jab can offer full protection against HPV strains linked to about 70% of cervical cancers. The UK government is now considering whether girls aged 11 or 12 should be vaccinated, before they become sexually active and can catch HPV.
Raffle believes that the only certain way of determining the long term impact of vaccination will be to follow vaccinated women for several decades, while an accompanying commentary warns that health inequality could increase in poorcountries if universal HPV vaccination is not adopted.
These views are reiterated in an accompanying editorial by Bernard Lo, a Professor of Medicine at the University of California San Francisco.
He discusses the issue of making HPV vaccine mandatory, but argues that a successful vaccination programme requires more than simply increasing uptake. A broader perspective is needed, he says, to tackle the controversial matters of adolescent sexuality, parental control, and protection of children.
Furthermore, physicians need to persuade people who have concerns about the HPV vaccine to trust in and cooperate with other measures to promote adolescent health, he concludes.