Determinants of human papillomavirus vaccine acceptability in Latin America and the Caribbean.

Prophylactic human papillomavirus (HPV) vaccines provide promise as a key component of future cervical cancer prevention programs in the Latin America and the Caribbean region. The successful introduction and acceptance of these vaccines will depend on a range of factors including awareness of cervical cancer as a problem, affordability of the vaccine, political will, competition with other vaccines, feasibility of vaccine delivery and acceptability of the vaccine among the range of groups who will influence uptake. While existing data about acceptability from Latin America and the Caribbean is scarce, it is clear that health policymakers, providers and the general public lack knowledge about HPV and cervical cancer. Furthermore, they would value more local epidemiologic data related to cervical cancer. Price is currently a major barrier to vaccine acceptability and a priority for advocacy. More research is required in Latin America and the Caribbean to determine what messages and strategies will work in these communities.

Human papillomavirus vaccine policy and delivery in Latin America and the Caribbean.

Cervical cancer caused by human papillomavirus (HPV) is a major preventable public health problem. Two vaccines are now available for primary prevention of HPV infection and their introduction offers new opportunities to enhance comprehensive cervical cancer prevention and control. Currently, HPV vaccine price is a significant barrier to rapid vaccine introduction and access. Therefore, making evidence-based decisions about whether and how to introduce HPV vaccine into the immunization schedule in the countries of Latin America and the Caribbean (LAC) requires a rigorous analysis of several factors. These include: estimates of disease burden, cost-effectiveness, operational feasibility of reaching a population of adolescent females and other key analyses that have been used in recent years to support the introduction of other vaccines, such as rotavirus and pneumococcal conjugate vaccines. Given the large number of public health priorities that are competing for limited public resources, developing and using a sound evidence base is of particular importance for vaccines, like HPV, which are currently available only at prices higher than other vaccines now in use. HPV vaccination provides the opportunity to dramatically improve women's health and partnerships must also be broad-based and effectively coordinated. This can be achieved by developing programs based on the lessons learned from vaccination strategies used to eliminate rubella and neonatal tetanus and for scaling up influenza vaccination in countries of LAC.

An assessment of the yellow fever vaccination campaign in Trinidad, West Indies

A study was undertaken to assess the effectiveness of a yellow fever vaccination campaign, which had been conducted in Trinidad, West Indies from November, 1978 through 1979. Evaluative tools consisted of: (i) an interview survey in a randomly selected sample of two hundred households, to determine immunization coverage and (ii) a serological study of 232 vaccines to ascertain protection conferred through use of 17D yellow fever vaccination. Results of the household survey indicate that approximately 12.53 per cent of the 1149 persons interviewed had not been vaccinated against yellow fever. In most instances, no substantial reasons could be advanced by respondents for non-immunization. Based on the performance of 13 plaque reduction neutralization tests, all but one of the 232 sera examined from people with a history of immunization posessess adequate humoral immunity to yellow fever. This study has, therefore, shown that the vaccination campaign, under review, was successful in achieving satisfactory protection of immunized persons, and in drastically reducing the number of susceptibles within the population.