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Major milestones supporting single-dose HPV vaccination
On April 11, the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization concluded that a single dose of human papillomavirus (HPV) vaccine delivers solid protection against HPV. Based on the available evidence, SAGE advised that countries may now choose between a one- or two-dose schedule for 9 to 14-year-old girls and women aged 15 to 20. This is a major step toward reaching the WHO’s global strategy to accelerate the elimination of cervical cancer.
SAGE’s recommendation is based on new evidence from several clinical trials on single-dose HPV vaccination. In Kenya, a randomized controlled clinical trial demonstrated that a single dose of HPV vaccine was about 98 percent effective in preventing persistent HPV-16/18 infections. Other studies in India, Costa Rica, and Tanzania also support the efficacy of single-dose vaccination. This news is promising for countries that have yet to introduce or are struggling to reach eligible populations. Simplified implementation and greatly reduced costs may allow more countries to introduce HPV vaccination or increase coverage.
The Single-Dose HPV Vaccine Evaluation Consortium, convened by PATH, continues compiling and evaluating evidence as it becomes available. Current evidence supports the conclusion that single-dose HPV vaccination gives equivalent or near-equivalent protection to two-dose vaccination. Together with the Consortium, PATH will engage country-level stakeholders to discuss the implications of a schedule change for national programs. In Uganda, for example, the process is multi-step but could make a significant impact and increase coverage.
Visit here for additional background on the evidence for and potential impact of a single-dose regimen.
HPV Vaccine Cost Calculator now available
PATH has updated its suite of Vaccine Cost Calculators with a new tool for HPV vaccines, providing a simple, Excel-based tool for assessing and comparing costs of HPV vaccination programs annually and for a period of 10 years with HPV products available in the global market. Vaccine cost calculators are also available for rotavirus vaccines and pneumococcal conjugate vaccines. The HPV vaccine calculator is available in English (Spanish and French translations coming soon); the rotavirus vaccine and pneumococcal conjugate vaccine calculators are available in English, French, Spanish, and Russian.
As the number of globally available product options for new vaccines has increased, determining which product is the right choice from a cost-perspective has become more complex for country decision-makers. PATH’s Vaccine Cost Calculators can be used by country decision-makers, implementers, technical partners, and any others interested in comparing different vaccine costs, whether the country is eligible for co-funding from Gavi, and regardless of Gavi transition stage. Once users input a limited set of local data, they can compare products and estimate vaccination program costs for different vaccine products, presentations, and target populations and explore multiple vaccine options at a time. 
Building on a JE vaccination partnership to fight COVID-19 in Laos
In Laos, the Ministry of Health (MOH) and PATH are building on a decade of partnership combatting Japanese encephalitis (JE) to strengthen the country’s response to the COVID-19 pandemic. A new project, led by PATH’s Vietnam country office and Laos-based project team members, will continue existing efforts to strengthen immunization systems and promote vaccination while providing technical assistance and support to Laos' upcoming nationwide COVID-19 vaccination campaign. A virtual launch event for these efforts was held on February 14, 2022.
Laos has long partnered with PATH to strengthen its JE vaccination program. With PATH support, Laos became the first country to introduce Gavi-supported JE vaccine in 2015. Since 2020, PATH has worked with the MOH to conduct a JE vaccination catch-up campaign as well as a variety of immunization systems strengthening activities. These include advocacy workshops, e-learning modules, and trainings to educate leaders, health staff, and volunteers about JE, vaccines, and immunization system logistics. In addition, a public immunization education program has helped spread messages on vaccine safety and effectiveness. The new project aims to apply these efforts to improve COVID-19 vaccination.
PATH support for malaria vaccine decision-making in Nigeria
WHO recently recommended RTS,S/AS01, the world’s first malaria vaccine, for children at risk in sub-Saharan Africa and in other regions with moderate to high transmission of malaria caused by Plasmodium falciparum. Shortly after, Gavi, the Vaccine Alliance approved funding for a malaria vaccination program. These milestones pave the way for countries to consider whether to adopt the vaccine and apply for Gavi support, if eligible.
With a new grant from Chevron Corporation, PATH will support the Federal Ministry of Health in Nigeria to inform their adoption decision. PATH will collaborate with national programs within the Ministry to assess the factors likely to shape future vaccine demand and use in Nigeria. PATH will then support Ministry efforts to develop a draft “roadmap” for their decision-making process and possible phased introduction of malaria vaccines. Chevron and PATH view the vaccine adoption decision as key to ensuring that any future introduction of malaria vaccines in Nigeria reaches children in greatest need first.
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