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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(12): 926-931
DOI: 10.1055/s-0041-1740279
Original Article
Lower Genital Tract Diseases

School-based HPV Vaccination: The Challenges in a Brazilian Initiative

Vacinação contra o HPV em base escolar: Os desafios de uma iniciativa brasileira
Julio Cesar Teixeira 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Mariana Silva Castro Vianna 
2   Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
,
Diama Bhadra Vale 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Daniella Moretti Arbore 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Thais Helena Wilmers Perini 
2   Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
,
Tulio Jose Tomass Couto 
2   Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
,
Jose Pedroso Neto 
2   Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
,
Luiz Carlos Zeferino 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Abstract

Objective The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city.

Methods A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results.

Results The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested.

Conclusion School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.

Resumo

Objetivo O presente estudo avalia a implantação de um programa de vacinação contra o papilomavírus humano (HPV) em escolas de uma cidade brasileira e o impacto após 2 anos.

Métodos Estudo prospectivo para avaliar a implementação do programa, oferecendo a vacina quadrivalente contra o HPV em duas doses anuais, para meninas e meninos de 9 a 10 anos. O programa foi autorizado pelo Programa Nacional de Imunizações na cidade de Indaiatuba, estado de São Paulo, Brasil, e teve início em 2018. A cobertura anual da primeira dose foi comparada ao ano de 2017, e os eventos que influenciaram os resultados foram descritos.

Resultados O programa convidou 4.878 crianças por meio das escolas (87,1% da população-alvo) e 7,5% recusou a vacinação. Vários eventos concorrentes exigiram ou competiram pelos profissionais de saúde das equipes de vacinação. A cobertura da primeira dose (9 a 10 anos) foi de 16,1% em 2017 e aumentou para 50,5% em 2018 (p < 0,0001). A primeira dose em todas as idades aumentou 78% em 2018 em comparação com 2017 (6.636/3.733). As demandas concorrentes sobre o programa continuaram em 2019, e a cobertura da primeira dose caiu (26,9%). Para 2020, uma lei municipal instituiu a vacinação nas escolas e a criação de equipes dedicadas à vacinação, e estas estratégias aguardam para ser testadas.

Conclusão A vacinação anual contra o HPV em base escolar nas idades de 9 a 10 anos foi viável e aumentou a cobertura vacinal, independentemente do gênero, embora o programa fosse vulnerável a eventos concorrentes.

Keywords

human papillomavirus - HPV vaccine - adolescents - schools - vaccination

Palavras-chave

papilomavírus humano - vacina contra HPV - adolescentes - escolas - vacinação


Publication History

Received: 19 September 2021

Accepted: 03 November 2021

Article published online:
21 December 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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