Real-life Challenges In Implementing Public Strategies For HPV Vaccination In Developing Countries, And Strategies To Increase Immunization Coverage | 24750
Journal of AIDS & Clinical Research
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The implementation of vaccines in public immunization programs is a challenge for public health, especially in developing
countries, whose health systems lack the structure and organization. In those countries, the challenge is not only to supply
health assistance, but to strengthen primary care. Immunization is the most important strategy to improve health indicators.
Brazilian Immunization program is one of the most important immunization strategies all over the world, although there?s
a municipality in Brazil who had implemented an even more complete calendar of immunization. In September, 2010, the
quadrivalent vaccine against Human Papilomavirus (HPV - types: 6,11,16 and 18) was made available for free to resident girls
between 11 and 15 years of age in the municipality of Campos dos Goytacazes, State of Rio de Janeiro, pioneer in Brazil, using
a ?hybrid? strategy, which combined vaccination in schools and public vaccination rooms. In March 2014, this municipality
introduced the same vaccine to boys 11 to 13 years of age. This study aimed to measure the vaccine coverage and the preliminary
effect on the incidence of GW in women, heterosexual men and men who make sex with men, four years after the beginning
HPV vaccination in this municipality. The results showed that the 1st dose reached about 53%, 90.1%, 87.9% and 85% of
coverage, respectively, in 2010, 2011, 2012 and 2013. By using the same model, the complete scheme with the third dose
reached 0%, 65.1%, 66.2% and 62% of coverage. Total Incidence of genital warts before beginning vaccination ranged from
a mean of 40 cases/100.000 (2007-2010) to 25 cases/100.000, three years after the beginning of vaccination. The reduction in
GW in women under 21 years old was about 50%, and in 21-30 years old was about 35%. These data support the decision of
the municipality of Campos dos Goytacazes, State of Rio de Janeiro, Brazil who introduced this vaccine in its population, and
showed that the incidence of GW decreased among women and heterosexual men not vaccinated, associated with the regular
vaccine coverage, pointing to the effect of vaccine program and the possible herd immunity action in heterosexual men.
Charbell Miguel Haddad Kury, a Medical Doctor and Professor of Medicine, graduated from the Medical School of the Municipality of Campos dos Goytacazes,
State of Rio de Janeiro, Brazil in 2003. He is expert in Public Health, from the Medicine School of Campos dos Goytacazes, in 2004. He is Pediatrician infectious
disease specialist from the Jesus Hospital, Rio de Janeiro in 2007. He is also a Professor of Pediatrics of the Medicine Schools of Campos dos Goytacazes and
the Federal University of Rio de Janeiro, Brazil. He has a Master degree in applied microbiology and parasitology from the Fluminense Federal University, in 2013.
He is a Pediatrician and Neonatologist of the St. John the Baptist hospital, municipality of Maca?, State of Rio de Janeiro, Brazil, since 2005 and Coordinator of
Immunization and Health surveillance of the municipality of Campos dos Goytacazes, State of Rio de Janeiro, Brazil, since 2009. He did research on immunization
programs, once the municipality of Campos dos Goytacazes implemented the largest immunization program in early 2009.
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