Single Dose of HPV Vaccine is Enough to Protect Against Cervical Cancer
WHO’s Dr Kate O’Brien and SAGE chairperson Dr Alejandro Cravioto

The Human Papillomavirus (HPV), which is the cause of most cervical cancer cases, can be treated with a single vaccine dose instead of the two doses currently being given, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts on Immunization (SAGE).

SAGE chairperson Dr Alejandro Cravioto told a media briefing on Monday that, after reviewing all available evidence, the group concluded that a single vaccine was effective against HPV in girls and women aged nine to 20, but that women aged 21 and over needed two doses given six months apart.

As HPV is generally sexually transmitted, vaccination is also recommended for boys and men who can carry the virus and infect women – and SAGE now also recommends a single dose for younger boys and men too.

Only 13% of HPV target group is vaccinated

The WHO described the new recommendation as a “game-changer” for the prevention of the disease as it would enable more doses of the vaccine to reach more girls.

“The HPV vaccine is highly effective for the prevention of HPV serotypes 16 and 18, which cause 70% of cervical cancer,” said Cravioto. 

“SAGE urges all countries to introduce HPV vaccines and prioritize multi-age cohort catch up of missed and older cohorts of girls. These recommendations will enable more girls and women to be vaccinated and thus preventing them from having cervical cancer and all its consequences over the course of their lifetimes.”

Meanwhile, the WHO described cervical cancer as being “almost entirely preventable” and “a disease of inequity of access”, adding that it was concerned by the slow introduction of the HPV vaccine into immunization programs and low coverage, especially in poorer countries.

In 2020, only 13% of the global target population had received two doses, with WHO citing barriers as challenges of supply, cost and delivering a two-dose regimen to older girls who are not part of childhood vaccination programs. 

Dr Nono Simelela, WHO Assistant Director-General for Strategic Programmatic Priorities: Cervical Cancer Elimination.

WHO Assistant Director-General Dr Nono Simelela said that single-dose recommendation “has the potential to take us faster to our goal of having 90 per cent of girls vaccinated by the age of 15 by 2030”.

“We need political commitment complemented with equitable pathways for the accessibility of the HPV vaccine. Failure to do so is an injustice to the generation of girls and young women who may be at risk of cervical cancer,” added Simelela.

SAGE also recommended that hepatitis A could also be treated with a single vaccine. 

China’s CanSino Bio vaccine expected to get WHO approval

SAGE also evaluated the data on the Chinese CanSino Bio (Ad5-nCOV-S) vaccine, but will only release the outcome of this discussion if the WHO grants the vaccine emergency use listing (EUL) – “hopefully in the next few weeks”, according to Cravioto.

An mRNA based COVID-19 vaccine also developed by the Chinese company was cleared for clinical trials last week. Currently, there are no mRNA vaccines available in China.

WHO’s Director of Immunization, Dr Kate O’Brien, expressed concern that only around 65% of healthworkers globally were vaccinated against COVID-19, and a similar number of people over the age of 60.

In addition, 21 countries had vaccinated less than 10% of citizens, said O’Brien – 14 countries in the African region, four in the eastern Mediterranean region, and then one each in the Americas, the Western Pacific and the Southeast Asian region.

“These are countries that are working really hard to advance their programmes now that supply is no longer the issue,” said O’Brien.

SAGE admitted that there was a lack of data about the efficacy of non-mRNA vaccines’ efficacy against Omicron.

As far as the spread of Omicron in Hong Kong was concerned, Cravioto said the high mortality rate in older people was related to that age group’s reluctance to be infected rather than an indictment on Chinese-produced vaccines. However, he said

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