Prioritisation of the human papillomavirus vaccine in a time of constrained supply.
Prioritisation of the human papillomavirus vaccine in a time of constrained supply.
复制标题
在供应紧张的情况下优先考虑人乳头瘤病毒疫苗。
DOI：
10.1016/s2352-4642(20)30038-9
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Schiller,John
中科院分区：
文献类型：
--
作者：
Kreimer,AiméeR;Cernuschi,Tania;Rees,Helen;Saslow,Debbie;Porras,Carolina;Schiller,John
Human papillomavirus causes cancer in women and men at multiple anatomical sites. Annually, there are 630 000 new cancers related to human papillomavirus, of which more than 85% are cancers of the cervix and approximately 90% of these cervical cancersoccurr in lowincome and low-income to middle-income countries. 1, 2 The incidence of cervical cancer is projected to increase for the foreseeable future. In some countries, cervical cancer fatality rates exceed 50% because of the inadequacy of screening, diagnostic tests, and treatment. 1 Although prophylactic vaccines for human papillomavirus are safe and effective, 3 the introduction of these vaccines to many countries with the highest burden of cervical cancer has been delayed, resulting in a lack of access to vaccination for many girls with the greatest need. 4 Many countries that have not yet introduced human papillomavirus vaccines are keen to do so, often with ambitious plans to maximise impact through multiage cohort vaccination. In 2018, the WHO Director General called for a commitment to increase awareness of cervical cancer and eliminate it as a public health problem. The preliminary elimination strategy emphasises the importance of vaccination of adolescent girls as an essential tool to achieve this long-term goal. However, many of these introductory efforts are being limited, or prevented, by a substantial, current shortage of human papillomavirus vaccine. For example, Gavi, The Vaccine Alliance, which financially supports vaccine purchases for lower-income countries, has been unable to procure the needed supply to meet the demands and applications of the countries they subsidise. The anticipated shortfall in vaccine supply is 29 million doses (of the 40 million needed), which resulted in a delay in vaccine introduction to countries currently without the human papillomavirus vaccine, with more delays expected in 2020. 5 Constraints on vaccine supply are anticipated to last until the mid-2020s; however, the extent and duration of the shortfall are highly dependent on the vaccination strategies for human papillomavirus that are implemented worldwide.
