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Open Access 01-12-2018 | Research article

Achieving high uptake of human papillomavirus vaccination in Malaysia through school-based vaccination programme

Authors: Nor Asiah Muhamad, Saidatul Norbaya Buang, Safurah Jaafar, Rohani Jais, Phaik Sim Tan, Normi Mustapha, Noor Aliza Lodz, Tahir Aris, Lokman Hakim Sulaiman, Shahnaz Murad

Published in: BMC Public Health | Issue 1/2018

Abstract

Background

In 2006, 4 years of planning was started by the Ministry of Health, Malaysia (MOH), to implement the HPV (human papillomavirus) vaccination programme. An inter-agency and multi-sectoral collaborations were developed for Malaysia’s HPV school-based immunisation programme. It was approved for nationwide school base implementation for 13-year-old girls or first year secondary students in 2010. This paper examines how the various strategies used in the implementation over the last 7 years (2010–2016) that unique to Malaysia were successful in achieving optimal coverage of the target population.

Methods

Free vaccination was offered to school girls in secondary school (year seven) in Malaysia, which is usually at the age of 13 in the index year. All recipients of the HPV vaccine were identified through school enrolments obtained from education departments from each district in Malaysia. A total of 242,638 girls aged between 12 to 13 years studying in year seven were approached during the launch of the program in 2010. Approximately 230,000 girls in secondary schools were offered HPV vaccine per year by 646 school health teams throughout the country from 2010 to 2016.

Results

Parental consent for their daughters to receive HPV vaccination at school was very high at 96–98% per year of the programme. Of those who provided consent, over 99% received the first dose each year and 98–99% completed the course per year. Estimated population coverage for the full vaccine course, considering also those not in school, is estimated at 83 to 91% per year. Rates of adverse events reports following HPV vaccination were low at around 2 per 100,000 and the majority was injection site reactions.

Conclusion

A multisectoral and integrated collaborative structure and process ensured that the Malaysia school-based HPV immunisation programme was successful and sustained through the programme design, planning, implementation and monitoring and evaluation. This is a critical factor contributing to the success and sustainability of the school-based HPV immunisation programme with very high coverage.

Center for Disease Control and Prevention. Genital HPV infection - fact sheet. 2016. Available at http://www.cdc.gov/std/hpv/stdfact-hpv.htm. Accessed on 13 Jan 2017.

Lin Yang, ShuanghuaXie, Xiaoshuang Feng, Yuheng Chen, Tongzhang Zheng, Min Dai, Cindy Ke Zhou, Zhibin Hu, Ni Li, Dong Hang (2015); Worldwide Prevalence of Human Papillomavirus and Relative Risk of Prostate Cancer. Available at http://www.nature.com/articles/srep14667. Accessed 18 Jan 2017.

WHO 2016; Immunization, Vaccines and biologicals. Available at http://www.who.int/immunization/diseases/hpv/en/. Accessed 18 Jan 2017

Menon S, van den Broeck D, Rossi R, Ogbe E, Mabeya H. Multiple HPV infections in female sex workers in Western Kenya: implications for prophylactic vaccines within this subpopulation; Menon et al. Infect Agents Cancer. 2017;12(2). https://doi.org/10.1186/s13027-016-0114-5.

Ng’andwe C, Lowe JJ, Richards PJ, Hause L, Wood C, Angeletti PC. Thedistribution of sexually-transmitted human papillomaviruses in HIV positiveand negative patients in Zambia. Africa BMC Infect Dis. 2007;7:77. https://doi.org/10.1186/1471-2334-7-77.CrossRefPubMed

Center for Disease Control and Prevention (CDC). Human papilloma virus associated cancers - United States, 2004–2008. MMWR Morb Mortal Wkly Rep. 2012;61:258–61.

World Health Organization. Cervical Cancer at http://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/ Assessed on 30 Oct 2018.

Haghshenas M, Golini-Moghaddam T, Rafiei A, et al. Prevalence and type distribution of high-risk human papillomavirus in patients with cervical cancer: a population-basedstudy. Infect Agent Cancer. 2013;8:20.CrossRef

Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Women's Health. 2015;7:405–14.

10.

De Vuyst H, Alemany L, Lacey C, et al. The burden of human papillomavirus infections and related diseases in sub-Saharan Africa. Vaccine. 2013;31(05):F32–46. https://doi.org/10.1016/j.vaccine.2012.07.092.CrossRefPubMedPubMedCentral

11.

Maranga IO, Hampson L, Oliver AW, et al. Analysis of factors contributing to the low survival of cervical cancer patients undergoing radiotherapy in KenyaHawkins SM, ed. PLoS One. 2013;8(10):e78411. https://doi.org/10.1371/journal.pone.0078411. CrossRefPubMedPubMedCentral

12.

Zaridah S. A review of cervical cancer research in Malaysia. Med J Malaysia. 2014;69:33–41 Available at https://www.ncbi.nlm.nih.gov/pubmed/25417949.PubMed

13.

Azizah A, Norsaleha IT, Noor Hashimah A, Asmah ZA, Mastulu W. Malaysian National Cancer Registry Report 2007–2011. Putrajaya: Malaysia Cancer Statistics, Data and Figure, National Cancer Institute, Ministry of Health; 2017. p. 50–2.

14.

Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, et al. Human papillomavirus and related diseases in MalaysiaSummary Report: ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Malaysia. Summary Report; 2018. Available at http://www.hpvcentre.net/statistics/reports/MYS.pdf. Accessed 14 Dec 2018.

15.

Chesson HW, Ekwueme DU, Saraiya M, Watson M, Lowy DR, Markowitz LE. Estimates of the annual direct medical costs of the prevention and treatment of disease associated with human papillomavirus in the United States. Vaccine. 2012;30(42):6016–9. https://doi.org/10.1016/j.vaccine.2012.07.056 Epub 2012 Aug 4.CrossRefPubMed

16.

Howell-Jones R, Bailey A, Beddows S, et al. Multi-site study of HPV type-specific prevalence in women with cervical cancer, intraepithelial neoplasia and normal cytology, in England. Br J Cancer. 2010;103(2):209–16. https://doi.org/10.1038/sj.bjc.6605747.CrossRefPubMedPubMedCentral

17.

National Cancer Institute 2016; Cancer Screening Overview (PDQ®)–Health Professional Version. Available at https://www.cancer.gov/about-cancer/screening/hp-screening-overview-pdq. Accessed 18 Jan 2017.

18.

World Health Organisation. Human papillomavirus vaccines: WHO position paper, may 2017. Wkly Epidemiol Rec. 2017;92:241–68.

19.

Sharifa Ezat WP, Rozita H, Jamsiah M, Ahmad Zailani Hatta MD, Aqmar Suraya S, Azlin A. National HPV Immunisation Programme: Knowledge and Acceptance of Mothers Attending an Obstetrics Clinic at a Teaching Hospital, Kuala Lumpur. Asian Pacific J Cancer Prev. 2013;14(5):2991–99.

20.

Department of statistics. Malaysia. Population & Demography. Available at: https://www.dosm.gov.my/v1/index.php?r=column/ctwoByCat&parent_id=115&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09. Accessed 30 Aug 2018.

21.

Cheong SM, Mohamad Nor NS, et al. Improvement of health literacy and intervention measurements among low socio-economic status women: findings from the MyBFF@home study. BMC Womens Health. 2018;18(Suppl 1):018–0596. https://doi.org/10.1186/s12905-018-0596-y.CrossRef

22.

Norrafizah J, Nor Asiah M, Suraiya SM, et al. Assessment of health literacy among people in a rural area in Malaysia using newest vital signs assessment. Br J Educ Soc Behav Sci. 2016;16(2):1–7. https://doi.org/10.9734/BJESBS/2016/25737.CrossRef

23.

Ashtarian H, Mirzabeigi E, Mahmoodi E, Khezeli M. Knowledge about cervical cancer and pap smear and the factors influencing the pap test screening among women. Int J Commun Based Nurs Midwifery. 2017;5(2):188–95.

24.

Buang SN, Jahis R. Lessons learned: building the school-based HPV program in Malaysia and opportunities for piggybacking. Bangkok: Asia Dengue Summit Shangri La Hotel; 2016. Available at: https://adva.asia/ads/day2/Rohani-Jahis+Saidatul-Norbaya-Buang.pdf. Accessed 18 Jan 2017

25.

Were E, Nyaberi Z, Buziba N. Perceptions of risk and barriers to cervical cancer screening at Moi teaching and referral hospital (MTRH), Eldoret, Kenya. Afr Health Sci. 2011;11(1):58–64.PubMedPubMedCentral

26.

Sharifa Ezat WP, Syed MA. Affordability of HPV vaccine in developing countries. Malay J Public Health Med. 2011;11(1):1–5.

27.

U.S. Food and Drug Administration. June 8, 2006 Approval Letter - Human Papillomavirus Quadrivalent (Types 6, 11, 16, 18) Vaccine, Recombinant. Available at http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm111283.htm. Accessed 18 Jan 2017.

28.

U.S. Food and Drug Administration. May 5, 2010 Approval letter – Cervarix. Available at http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm212571.htm. Accessed 18 Jan 2017.

29.

Kim JJ, Ortendahl J, Goldie SJ. Cost-effectiveness of HPV vaccination and cervical cancer screening in women over age 30 in the United States. Ann Intern Med. 2009;151(8):538–45.CrossRef

30.

Tota JE, Ramana-Kumar AV, El-Khatib Z, Franco EL. The road ahead for cervical cancer prevention and control. Curr Oncol. 2014;21(2):e255–64. https://doi.org/10.3747/co.21.1720. CrossRefPubMedPubMedCentral

31.

Gandhi G, Lydon P. Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts. BMC Public Health. 2014;14:67. https://doi.org/10.1186/1471-2458-14-67.CrossRefPubMedPubMedCentral

32.

World Health Organization. Immunization, Vaccines and Biologicals; Human papillomavirus (HPV).Available at http://www.who.int/immunization/diseases/hpv/en/. Accessed 18 Jul 2017.

33.

Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination — updated recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2016;65:1405–8. https://doi.org/10.15585/mmwr.mm6549a5.CrossRefPubMed

34.

Isa NM, Baharuddin A, Man S, Chang LW. Bioethics in the Malay-Muslim Community in Malaysia: a study on the formulation of fatwa on genetically modified food by the National Fatwa Council. Dev World Bioeth. 2015;15(3);143–51. https://doi.org/10.1111/dewb.12057. Available at https://umexpert.um.edu.my/file/publication/00002819_107753.pdf. Accessed 17 July 2017.

35.

The Ruling on Using Human Papilloma Virus Vaccine (HPV); The 92th Muzakarah (Conference) of the Fatwa Committee National Council of Islamic Religious Affairs Malaysia held on 15–17 December 2010. Available at http://irep.iium.edu.my/16091/1/HALAL_PHARMACEUTICAL-2011.pdf. Accessed 17 Jul 2017

36.

Hilton S, Hunt K, Langan M, Bedford H, Petticrew M. Newsprint media representations of the introduction of the HPV vaccination programme for cervical cancer prevention in the UK (2005–2008). Soc Sci Med. 2010;70:942–50. https://doi.org/10.1016/j.socscimed.2009.11.027.CrossRefPubMedPubMedCentral

37.

Remes P, Selestinea V, Changaluchac J, Ross DA, Wight D, de Sanjosée S, et al. A qualitative study of HPV vaccine acceptability among health workers, teachers, parents, female pupils, and religious leaders in Northwest Tanzania. Vaccine. 2012;30:5363–7.CrossRef

38.

Sherris J, Friedman A, Wittet S, Davies P, Marc Steben M, Saraiya M. Education, training, and communication for HPV vaccines. Vaccine. 2006;24S3:210–8. https://doi.org/10.1016/j.vaccine.2006.05.124.CrossRef

39.

Kabakama S, Katherine E, Gallagher KE, Howard N, Mounier-Jack S, HED B, et al. Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries. BMC Public HealthBMC series – open, inclusive and trusted. 2016;16:834. https://doi.org/10.1186/s12889-016-3517-8.CrossRefPubMedPubMedCentral

40.

Chaturvedi S. Vaccines. Social mobilization, or any other game changer: polio eradication is an unfinished narrative. Indian J Community Med. 2013;38(2):67–9. https://doi.org/10.4103/0970-0218.112429. CrossRefPubMedPubMedCentral

41.

Weiss WM, Choudhary M, Solomon R. Performance and determinants of routine immunization coverage within the context of intensive polio eradication activities in Uttar Pradesh, India: social mobilization network (SM net) and Core Group polio project CGPP. BMC Int Health Hum Rights. 2013;13(25). https://doi.org/10.1186/1472-698X-13-25.

42.

Buku Panduan PelaksanaanPelalian HPV UntukParamedik. Available at : http://fh.moh.gov.my/v3/index.php/component/jdownloads/send/36-sektor-kesihatan-sekolah/204-hpv?Itemid=0. Accessed 27 Jul 2018.

43.

Kadis JA, McRee AL, Gottlieb SL, Lee MR, Reiter PL, Dittus PJ, et al. Mothers’ support for voluntary provision of HPV vaccine in schools. Vaccine. 2011;29(14):2542–7. https://doi.org/10.1016/j.vaccine.2011.01.067.CrossRefPubMedPubMedCentral

44.

WHO. Human papillomavirus vaccines: WHO position paper, may 2017–recommendations. Vaccine. 2017;35(43):5753–5.CrossRef

45.

Hardt K, Bonanni P, King S, Santos JI, El-Hodhod M, Zimet GD, et al. Vaccine strategies: Optimising outcomes. Vaccine. 2016;34:6691–9.CrossRef

46.

Preiss S, Garçon N, Cunningham AL, Strugnell R, Friedland LR. Vaccine provision: delivering sustained & widespread use. Vaccine. 2016;34:6665–71.CrossRef

47.

Sherris J, Agurto I, Arrossi S, Dzuba I, Gaffikin L, Herdman C, et al. Advocating for cervical cancer prevention. Int J Gynecol Obstet. 2005;89:46–54.CrossRef

48.

Ogembo JG, Manga S, Nulah K, Foglabenchi LH, Perlman S, Wamai RG, et al. Achieving high uptake of human papillomavirus vaccine in Cameroon: lessons learned in overcoming challenges. Vaccine. 2014;32:4399–403.CrossRef

49.

Beer H, Hibbitts S, Brophy S, Rahman MA, Waller J, Paranjothy S. Does the HPV vaccination programme have implications for cervical screening programmes in the UK? Vaccine. 2014;32(16):1828–33. https://doi.org/10.1016/j.vaccine.2014.01.087.CrossRefPubMedPubMedCentral

50.

Setiawan D, Kotsopoulos N, Wilschut JC, Postma MJ, Connolly MP. Assessment of the broader economic consequences of HPV prevention from a government-perspective: a fiscal analytic approachNatarajaseenivasan K, ed. PLoS One. 2016;11(8):e0160707. https://doi.org/10.1371/journal.pone.0160707. CrossRefPubMedPubMedCentral

51.

World Health Organization 2014. Principles and considerations for adding a vaccine to a national immunization programme: From Decision to Implementation and Monitoring. Available at http://apps.who.int/iris/bitstream/10665/111548/1/9789241506892_eng.pdf. Accessed 5 Jun 2017.

52.

World Health Organization. Global Vaccine Safety. The Global Vaccine Safety Initiative (GVSI). 2011. Available at http://www.who.int/vaccine_safety/initiative/en/. Accessed 18 Jul 2017.

53.

Zimet GD, Rosberger Z, Fisher WA, Perez S, Stupiansky NW. Beliefs, behaviors and HPV vaccine: correcting the myths and the misinformation. Prev Med. 2013;57(5):414–8. https://doi.org/10.1016/j.ypmed.2013.05.013.CrossRefPubMed

Title: Achieving high uptake of human papillomavirus vaccination in Malaysia through school-based vaccination programme
Authors: Nor Asiah Muhamad
Saidatul Norbaya Buang
Safurah Jaafar
Rohani Jais
Phaik Sim Tan
Normi Mustapha
Noor Aliza Lodz
Tahir Aris
Lokman Hakim Sulaiman
Shahnaz Murad
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-018-6316-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Achieving high uptake of human papillomavirus vaccination in Malaysia through school-based vaccination programme

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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