PATH's Cervical Cancer Prevention Action Planner

Case study: HPV Vaccination in Latin America

Lessons learned from a pilot program in Peru

In 2006, PATH initiated the HPV Vaccines: Evidence for Impact project in order to generate evidence to help policymakers and planners worldwide make informed decisions regarding regional and national vaccine-introduction efforts and international financing for improved cervical cancer prevention. Peru is one of the countries chosen by PATH as a site for the HPV Vaccines project, along with India, Uganda, and Vietnam.

Peru has some of the highest cervical cancer incidence and mortality rates of the Latin American and Caribbean region. Through a demonstration project in 2008–2009 in selected areas of the country, HPV vaccine was made available through schools to all girls aged nine years or older in grade five. The Peru project was implemented by the National Expanded Program for Immunization (ESNI) of the Ministry of Health (MINSA) with technical support from PATH, and evaluated by MINSA/ ESNI, PATH, and the Instituto de Investigación Nutricional (IIN). IIN evaluated vaccine coverage, acceptability, and feasibility of the strategies implemented in the demonstration project, while MINSA/ESNI and PATH collaborated to estimate the associated costs. Some highlights include:

  • Coverage rates were above 80% in all Peru project sites, and loss to follow-up of girls who started the three-dose series was low.
  • Incremental program costs of reaching girls with the HPV vaccine were lower in urban and peri-urban locations than in remote rural areas, since health workers could more easily access schools to reach eligible girls.
  • Vaccinating girls in schools was judged feasible, based on its negligible impact on routine infant immunization coverage.
    Lessons learned from Peru may be applicable to other countries with similar cultural, economic, and health contexts.

Lessons learned report

The publication "HPV Vaccination in Latin America" summarizes helpful lessons for policymakers and program managers looking to design their own HPV vaccination programs.

Photo: PATH/Jenny Winkler

Key resources

Watch videoHPV vaccination video and transcript

Case study: HPV vaccination in Africa

Shaping Strategies to Introduce HPV Vaccines: Formative Research Results from India, Peru, Uganda, and Vietnam (RHO Cervical Cancer website)

HPV delivery strategies that achieved high coverage in low- and middle-income countries (PDF)

Vaccination (RHO Cervical Cancer website)

World Health Organization position paper on human papillomavirus vaccines (PDF)

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