The WHO Global Advisory Committee on Vaccine Safety reaffirmed the vaccine's safety
The Global Advisory Committee on Vaccine Safety (GACVS), which provides independent, authoritative, scientific advice to WHO on vaccine safety issues, reaffirmed the safety of currently available HPV vaccines at its latest meeting on March 12.
WHO's Strategic Advisory Group of Experts on Immunization (SAGE) recommends administration of the vaccine where the prevention of cervical cancer is a national public health priority and when vaccination is cost-effective and programmatically feasible. These positions have also been endorsed by the PAHO Technical Advisory Group on Vaccine-preventable Diseases.
Since the HPV vaccine became available in 2006, over 170 million doses have been administered worldwide. Studies have found no serious adverse effects in hundreds of thousands of people who have been vaccinated in Australia, Europe, and North America.
The vaccine's impact so far has been encouraging. In the United States, infections by the HPV types targeted by the vaccine have declined by half, and data from Australia and Denmark show a significant reduction in precancerous cervical lesions in vaccinated women.
In the Americas, 20 countries-including Argentina, Canada, Colombia, Mexico, Panama, Paraguay, Peru, the United States, Uruguay and most recently Brazil-offer the HPV vaccine through public immunization programs. Over 80% of adolescent girls in the Americas live in these 20 countries.
Currently available HPV vaccines target the two HPV types (16 and 18) that cause approximately 70% of cervical cancer cases. The virus is transmitted by sexual contact, causing infections that over time can evolve into cervical cancer. Vaccines are highly effective in preventing infection with the virus as long as they are administered before the onset of sexual activity.
PAHO/WHO estimates that 68,818 women in the Americas developed cervical cancer and 28,565 died from the disease in 2012. In Brazil, the National Cancer Institute estimates 15,000 new cases and 4,800 deaths each year.
This year, Brazil plans to vaccinate 5.2 million adolescent girls ages 11 to 13, or more than 20% of all girls in this age group in the Americas. In 2015, Brazil plans to expand the target group to girls 9 to 11, and starting in 2016 to 9-year-old girls. The vaccinations are being given at public and private schools and in the 36,000 vaccination centers of the national health system.
Achieving high rates of coverage is important for the vaccine to fulfill its protective potential. But girls who have been vaccinated should also continue to get cervical cancer screening later in life. Brazil recommends preventive gynecological checkups for early cervical cancer detection for all women starting at age 25.
PAHO supports Brazil's decision to provide the HPV vaccine free of charge to adolescent girls as part of an integrated approach to prevention and control of cervical cancer. "The universal introduction of the HPV vaccine shows the commitment of Brazilian officials and health workers," said Cuauhtémoc Ruiz, head of PAHO/WHO's Expanded Immunization Program.
Key facts about HPV vaccines
- Seventy percent (70%) of cervical cancers worldwide are caused by two HPV types (16 and 18).
- Two vaccines against HPV are prequalified by WHO and licensed in most countries.
- Both vaccines prevent over 95% of cervical pre-cancerous lesions caused by HPV types 16 and 18 and may offer some cross-protection against other less common HPV types that also cause cervical cancer.
- Both vaccines prevent infection and should be administered prior to exposure to HPV.
- The vaccines cannot treat already-existing HPV infection or HPV-associated disease.
- The WHO recommended target group for vaccination is girls ages 9 to 13 who have not yet become sexually active.
- The safety of these vaccines is being closely monitored in scientific studies involving thousands of people in multiple countries, with results that are reassuring.
- HIV-infected individuals can be vaccinated.
- Almost all cases of cervical cancer are caused by persistent HPV infection.
- Most people become infected with HPV shortly after becoming sexually active, and the majority of infections resolve spontaneously. But if infection persists and is not detected and treated in time, cervical cancer can develop.
- Vaccination against HPV does not replace screening tests for cervical cancer such as the Pap smear, the HPV test, and visual inspection with acetic acid (VIA).
PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.
Position paper on the continued safety of HPV vaccination. Global Advisory Committee on Vaccine Safety (WHO). March 12, 2014
Immunization, Vaccines, and Biologicals (WHO)
WHO vaccine position papers
Comprehensive cervical cancer prevention and control
Global Advisory Committee on Vaccine Safety
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