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Supporting Single-dose HPV Vaccination

Jhpiego and partners raise awareness about single-dose HPV vaccination for adolescents

As global leaders gather at the World Health Assembly, Jhpiego has joined other global partners in signing onto a statement (see below) to raise awareness about the potential impact of a single-dose human papillomavirus (HPV) vaccine schedule for adolescents, ages 9-14. As the world rallies to recover from disruptions to immunization coverage due to COVID-19 and other global crises, the World Health Organization’s 2022 endorsement of a single-dose HPV vaccination schedule represents a critical opportunity to reach more girls and protect more women against cervical cancer.

Jhpiego’s expertise in immunization is based on 50 years of developing the health workforce and improving health service delivery. Our international partnerships and contributions to global policy, for example with the WHO, Gavi, UNICEF and others, are firmly anchored in the experiences of our staff in some 30 countries across Africa, Asia and the Americas.

Jhpiego has been actively involved in global and country-level efforts to expand vaccination to adolescent and school-age children, especially the HPV vaccine that prevents cervical cancer, and to support routine vaccination for mothers and children.

Read the statement:

In December 2022, the World Health Organization (WHO) endorsed a single-dose HPV vaccination schedule for the primary target age group (9–14 years-old). As a global group of researchers, health advocates, and program implementers, we believe this endorsement represents a critical opportunity to reach more girls and prevent more cases of cervical cancer.
We reaffirm the quality of the evidence used in WHO’s evaluation of a single-dose schedule. Since then, new data from diverse geographies continue to add to the evidence base in support of a single-dose schedule, including but not limited to the following:

  • The randomized, controlled KENya Single-dose HPV vaccine Efficacy (KEN SHE) study in African adolescent girls and young women, launched in 2018, showed that a single dose of HPV vaccination was ~98% effective in preventing new onset persistent HPV 16/18 in a sexually active population (15–20 year-olds). Newly available three-year post-vaccination data shows persisting efficacy.
  • The randomized, controlled Dose Reduction Immunobridging and Safety study (DoRIS) in Tanzania in 9-to 14-year-olds found non-inferior immunogenicity for a single dose compared to historical cohort data from India and from Costa Rica for which 12 and 11 years of single-dose efficacy data are available, respectively. Most recent data from these studies show persistent antibody response for more than a decade post-vaccination: 10 years for the India cohort and 16 years for the Costa Rica cohort.
    While these and other studies continue to gather data, there is sufficient evidence for countries to consider immediate implementation of a single-dose HPV vaccination schedule for the primary target group. Based on a large body of evidence on the persistence of immune response generated by virus-like particle (VLP) vaccines, durability of protection is likely to be long-lived.
    In addition to the strong protection against cervical cancer a single dose of HPV vaccine can provide, a single-dose schedule can expand coverage, reaching more girls and preventing more cases of cervical cancer. A single-dose schedule will lower delivery cost, mitigate supply risk, and expand delivery options, such as co-delivery with other vaccines in campaign settings. The programmatic benefits are all the more critical given the limited uptake to date and challenges with coverage of HPV vaccination, made worse by COVID-related disruptions.
    The scientific and programmatic evaluation of the evidence makes clear that a single-dose schedule holds great public health potential to reach more girls and protect more women against cervical cancer. We stand ready to help countries explore the data and assess their options.
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Cervical Cancer Action for Elimination (CCAE) is a network of organizations working together to
accelerate global progress towards a world free from cervical cancer. CCAE conducts advocacy activities
supporting the three pillars of the WHO global cervical cancer elimination strategy (vaccination,
screening, and treatment). CCAE is currently co-chaired by the American Cancer Society and Cancer
Research UK.

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving
lives and reducing the burden of disease in low- and middle-income countries. We work with our partners
to strengthen the capabilities of governments and the private sector to create and sustain high-quality
health systems that can succeed without our assistance.

The Geneva Learning Foundation (TGLF) is a non-profit implementing its vision to catalyze
transformation through large scale peer and mentoring networks led by frontline actors facing critical
threats to our societies. Our largest peer learning community, network, and platform is in primary health
care (PHC), with a strong focus on supporting Immunization Agenda 2030 (IA2030), the world’s strategy
to save 50 million lives from vaccine-preventable diseases.

The Global Health Advocacy Incubator (GHAI) supports civil society organizations advocating for
public health policies that reduce death and disease. We bring a proven advocacy approach and a global
network of local partners, built on a 25-year track record of success across multiple issues in more than
60 countries. GHAI provides strategic support to advocates working to enact and implement laws that
save lives and is a leading policy advocacy voice on a range of issues.

The International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health is
an academic center dedicated to expanding global access to vaccines by building knowledge and support
for the value of vaccines. For the past 20 years, IVAC has served as a trusted partner for governments,
international agencies, research groups, and non-profit organizations seeking to advance access to lifesaving vaccines for all.

The International Vaccine Institute (IVI) is an international organization committed to harnessing the
unique power of vaccines to tackle poverty-associated infectious diseases and emerging global health
threats. IVI works across the entire vaccine value chain: from the discovery of new vaccines in the
laboratory through pre-clinical and clinical development to their delivery to immunization programs around
the world.

Jhpiego, the Johns Hopkins University affiliate, delivers on the promise of saving lives, improving health
and transforming futures for everyone, everywhere. A trusted partner of governments and local
communities, Jhpiego couples our technical expertise with global evidence and breakthrough innovations
to help countries offer quality, equitable health services through resilient health systems. Across 50 years
and in 150 countries, Jhpiego believes that where a person lives should not determine if they live.

JSI is a global public health consulting organization dedicated to greater health equity and improving the
health of individuals and communities. A recognized global expert for over 35 years, JSI provides
multidimensional technical support to countries worldwide to introduce new vaccines and strengthen
routine immunization services.

Niyel is one of Africa’s leading advocacy, campaigns and public affairs organizations based in Dakar,
Senegal. A woman-led African organization founded in 2008, Niyel has implemented health, agriculture,
sanitation, data governance, artificial intelligence, human rights campaigns, general advocacy capacity
building and organizational management strengthening projects in over 40 countries across 4 continents.

PATH is a global nonprofit dedicated to achieving health equity. With more than 40 years of experience
forging multisector partnerships, and with expertise in science, economics, technology, advocacy, and
dozens of other specialties, PATH develops and scales up innovative solutions to the world’s most
pressing health challenges.

Pathfinder International is a global health organization with locally led, community-driven programs that
support women to make their own reproductive health decisions. Adding cervical cancer prevention to its
program portfolio, Pathfinder collaboratively works with partners and communities to prevent cervical
cancer and envisions a world where no women of reproductive age suffer or die from cervical cancer or
its complications.

RESULTS UK is a movement of passionate, committed people. Together as staff and grassroots
activists, we use our voices to influence political decisions that will bring an end to poverty—specifically
on issues of health, education, and economic opportunity. Our advocacy is built on global solidarity,
partnership, and shared empowerment.

TogetHER For Health is a global partnership igniting the movement to end cervical cancer everywhere
around the world by driving awareness, supporting catalytic programs, and fighting for the political and
financial resources needed to end this disease.

The Union for International Cancer Control (UICC) is the largest and oldest membership organisation
dedicated to taking action against cancer. UICC’s mission is to both unite and support the cancer
community in its efforts to reduce the global cancer burden, promote greater equity and ensure that
cancer control remains a priority on the global health and development agenda.

To add your organizational support to this statement, please contact Hope Randall at hrandall@path.org.

For more information, contact Dr. Christopher Morgan, Technical Director, Innovations, Christopher.Morgan@jhpiego.org