PATH's Cervical Cancer Prevention Action Planner

Planning for HPV vaccine introduction

General aspects of implementation

For any vaccination program, careful planning at the outset can ensure that the target population is reached and coverage is high. Managers who are beginning HPV vaccination programs can make use of routine EPI planning processes found in their country immunization program materials, with the addition of school-specific plans if schools will be used as vaccination sites. General immunization resources are recommended below.

The WHO publication Vaccine Introduction Guidelines covers both policy and programmatic aspects of introducing a new vaccine.

WHO also offers an online resource, the New and Under-utilized Vaccines Implementation (NUVI) website.

Another WHO resource, Immunization in Practice, a Practical Resource Guide for Health Workers, consists of several modules that provide information on topics such as safe injections, holding an immunization session, and monitoring and using data.

PATH’s online Vaccine Resource Library contains a wealth of information, especially on newer vaccines and immunization systems issues.

A good immunization microplanning guide is the WHO publication Microplanning for Immunization Service Delivery Using the Reaching Every District (RED) Strategy, which covers health facility as well as district-level planning.

Immunization Basics is a website provided by USAID that covers most aspects of immunization.

The manual Immunization Essentials, also from USAID, covers delivery of immunization services, cold chain and logistics, communication and dealing with rumors, and behavior change for health workers and caregivers.

Special aspects of HPV vaccination programs

When any new health technology is introduced, policymakers, managers, and health workers must prepare health systems and communities to understand and embrace the intervention. In order to ensure that the HPV vaccination projects would be successful, PATH and its country partners first gathered information on the target audience’s values, attitudes, knowledge, and behaviors that could affect their response to an HPV vaccination program. Research also was undertaken to assess the policy context at national and lower levels, and to evaluate the condition of health systems. Results of this formative research were used to guide development of vaccine delivery strategies, communications strategies (for outreach to communities), and advocacy strategies (for outreach to policymakers). While managers may not be able to carry out extensive formative research when instituting HPV vaccination programs, even simple community research can help them to avoid pitfalls and to craft appropriate strategies. See the publications of formative research results from the PATH HPV vaccine projects for details:

The publication Cervical Cancer, Human Papillomavirus (HPV) and HPV Vaccines: Key Points for Policy-Makers and Health Professionals includes information on HPV vaccination-specific topics such as vaccine delivery strategies, communication and partnerships, and potential impact of vaccination programs.

The Uganda publication for an HPV vaccination program, Bridging Phase for the Delivery of Human Papillomavirus (HPV) Vaccine to Prevent Cervical Cancer: A Field Guide for Health Managers and Service Providers, also is an excellent resource. This manual was written for a particular phase of vaccination in Uganda, known as a bridging phase, but most of the information can be applied to any HPV vaccination program.

The most prominent differences between HPV vaccination and routine immunization programs involve the target population and the venues for delivering vaccine. These differences create challenges such as how best to:

Identify eligible girls and make sure that the correct target group is vaccinated.
Choose the best venues for vaccinating; for example, schools or health clinics.
Communicate the need for HPV vaccination to families and communities.
Train health workers, community leaders, teachers, and others to implement the program.