WHO/Europe is working with immunization programmes across the European Region to help them raise awareness about HPV vaccination, address obstacles to high uptake and prepare for HPV vaccine introduction where it is not yet part of the routine immunization programme. As part of this work WHO/Europe has led or collaborated in the production of information materials, including the following resources: Video: HPV and cervical cancer – a personal story Video: How the HPV vaccine works Video: Monitoring the side effects of the HPV vaccine Q&A about the HPV virus and vaccine Talking with patients and parents about HPV vaccination for girls: Information for health care professionals A field guide to qualitative research for new vaccine introduction
To access these and more WHO resources related to HPV go to: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/vaccine-preventable-diseases/human-papillomavirus-hpv2

HLN today released a new version of its ICE Open Source Immunization Evaluation and Forecasting software covering the following changes: HPV updates: (1) Added support for new 2-dose series; recommend based on 2- or 3-dose series accordingly. (2) Ignore (HPV, bivalent (Cervarix)) shots administered to males. (3) Removed minimum age restriction for dose 2 and dose 3 Meningococcal updates: (1) Added absolute minimum age/minimum age of 16 years for dose 2. (2) Changed recommended interval between dose 1 and dose 2 from 3 years to 56 days Please refer to the HPV rules documentation and Meningococcal rules documentation for details. ICE is a fully Open Source, web-services-based product compliant with US-based ACIP clinical rules. It is fully flexible and could be augmented with other rulesets (like WHO) with appropriate interest, collaboration, and funding. For more information or to join the emerging ICE Open Source Community see the ICE project pageor send email to ice@hln.com.

The Indian government suspended research in April 2010 on the feasibility and safety of human papillomavirus (HPV) vaccine in two Indian states (Andhra Pradesh and Gujarat) amid public concerns about its safety. This paper describes cervical cancer and cancer surveillance in India and reviews the epidemiological claims made by the Programme for Appropriate Technology in Health (PATH) in support of the vaccine in these two states. National cancer data published by the Indian National Cancer Registry Programme of state registry returns and the International Agency for Research on Cancer cover around seven percent of the population with underrepresentation of rural, northern, eastern and north-eastern areas. There is no cancer registry in the state of Andhra Pradesh and PATH does not cite data from the Gujarat cancer registries. Age-adjusted cervical cancer mortality and incidence rates vary widely across and within states. National trends in age standardized cervical cancer incidence fell from 42.3 to 22.3 per 100,000 between 1982/1983 and 2004/2005 respectively. Incidence studies report low incidence and mortality rates in Gujarat and Andhra Pradesh. Although HPV prevalence is higher in cancer patients (93.3%) than healthy patients (7.0%) and HPV types 16 and 18 are most prevalent in cancer patients, population prevelance data are poor and studies highly variable in their findings. Current data on HPV type and cervical cancer incidence do not support PATH's claim that India has a large burden of cervical cancer or its decision to roll out the vaccine programme. In the absence of comprehensive cancer surveillance, World Health Organization criteria with respect to monitoring effectiveness of the vaccine and knowledge of disease trends cannot be fulfilled.

http://jrsm.rsmjournals.com/content/105/6/250.full

In collaboration with Merck & Co., Inc. and GSK, PATH Seattle has prepared a list of countries where each of these company's vaccines is licensed and a world map showing the countries where one of the vaccines is licensed for use and the countries where both vaccines are licensed for use.
These two documents can be seen on TechNet21 website:
Global HPV vaccine licensure status: June 2011
Map: Global HPV vaccine licensure status June 2011
Licensure, of course, does not mean that the vaccine in in use in these countries but it does open up the way for introduction.

This message has been cross-posted from HPV Vaccine Global Community of Practice. With many thanks to Robert Steinglass.

Dear Lisa,

I agree with Sarah Mullins that there is a great opportunity to find links with a larger package of interventions, including tetanus vaccination. The following four resources provide some relevant background information.

a) To read about school-based immunization experiences, much of which has been based on administration of tetanus toxoid, documented from Indonesia, Malaysia, Sri Lanka and Tunisia, readers may be interested in visiting the WHO web site at:
http://www.who.int/immunization_delivery/systems_policy/school-based-immunization/en/index.html

b) Hard to locate information from a slide presentation from 2009 on the “Potential Role of School-Based Immunization in Protecting More Children: Results of an e-mail survey” is attached. Again much of the experience is based on administration of tetanus toxoid.

c) Experience in immunizing school-age children and adolescents is summarized in Vaccine 28(5):1138-47 (2009).
Immunizing school-age children and adolescents: Experience from low- and middle-income countries.
Maria Sophia Mackroth, Kathleen Irwin, Jos Vandelaer, Joachim Hombach and Linda O Eckert
http://pubget.com/search?q=authors%3A%22Maria%20Sophia%20Mackroth%22

d) The following excerpt from a BASICS monograph on sustaining neonatal
tetanus elimination (available under the maternal and neonatal tetanus which is available athttp://http://www.immunizationbasics.jsi.com/Resources_DiseaseControl.htm) --
before the advent of HPV vaccine -- might be of some interest: "To sustain the progress made by immunizing both childbearing-age women in high-risk areas and infants, many countries should consider adopting a supplementary population-based approach to immunizations, such as school-age boosters. School-based immunizations are an investment in today’s children that will produce future benefits when these children become parents. In countries with a high female primary school enrollment, school immunizations may be a cost-effective investment for tetanus prevention, especially if they are part of an integrated primary health care strategy that includes health education and the simultaneous administration of anthelmintics, screening and treatment for trachoma, treatment for lymphatic filariasis, group A meningococcal meningitis immunization, typhoid immunization, and others." Source: Steinglass, Robert. 1998. "Using Early Childhood Booster Doses to Maintain the Elimination of Neonatal Tetanus." Based on a paper delivered at the World Health Organization (WHO) Neonatal Tetanus Elimination Technical Consultation, Geneva, 1997. Published for the U.S. Agency for International Development (USAID) by the Basic Support for Institutionalizing Child Survival (BASICS) Project. Arlington, Va.:

Robert

Attachment: school tetanus GIM09 - Session 1 - J Vandelaer.ppt