Vaccines against human papillomavirus in low and middle income countries:
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Cross Mark
Abstract
Abstract
Currently, there is limited data on the immunogenicity and efficacy of human papillomavirus vaccines in Low and
Middle income countries (LMIC). The review aims to summarize the current status from published HPV vaccine
safety, immunogenicity and efficacy studies in low and middle income countries (LMIC). Electronic databases
(PubMed/MEDLINE and HINARI) were searched for peer reviewed English language articles on HPV vaccination in
LMIC that have so far been published from 1st January 2006 up to 30th January 2015. Eligible studies were
included if they had used the bivalent (bHPV) or quadrivalent HPV (qHPV) vaccines in a LMIC and investigated
safety, immunogenicity and/or efficacy. The main findings were extracted and summarized. A total of fourteen
HPV vaccine studies assessing safety, Immunogenicity and efficacy of the bivalent or quadrivalent vaccines in LMIC
were included. There are only ten published clinical trials where a LMIC has participated. There was no published
study so far that assessed efficacy of the HPV vaccines in Sub-Saharan Africa. From these studies, vaccine induced
immune response was comparable to that from results of HICs for all age groups. Studies assessing HPV vaccine
efficacy of the bivalent or quadrivalent vaccine within LMIC were largely missing. Only three studies were found
where a LMIC was part of a multi center clinical trial. In all the studies, there were no vaccine related serious
adverse events. The findings from the only study that investigated less than three doses of the bivalent HPV-16/18
vaccine suggest that even with less than three doses, antibody levels were still comparable with older women
where efficacy has been proven. The few studies from LMIC in this review had comparable safety, Immunogenicity
and efficacy profiles like in HIC. Overall, the LMIC of Africa where immune compromising/modulating situations are
prevalent, there is need for long term immunogenicity as well as surveillance studies for long term clinical effectiveness
after two and three dose regimens.
Keywords: Human papillomavirus vaccines, Immunogenicity, Safety, Efficacy, Low middle income countries
Description
Keywords
Vaccines, human papillomavirus, low and middle income countries, safety, immunogenicity and efficacy