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One dose HPV vaccine or two? Up to gov’t to decide, says Merck

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The governor of Quezon said local government units (LGUs) must prioritize health in their budgetary considerations.

“Financing is a major contributor to how well or how poorly a program performs,” said Governor Angelina “Helen” de Luna Tan, who is also a medical doctor, at the 11th HPV Summit on Aug. 30.

Quezon province has started work on contracting a province-wide health system for the delivery of population-based health services. It is also strengthening its service delivery networks for cervical cancer elimination and providing vitamins and supplements to the poor.

“Everyone knows it takes longer for cervical cancer to develop in women with a better immune system,” she said.

Nearly all (99.7%) of cervical cancer is caused by the human papillomavirus (HPV); it is the most common gynecologic malignancy in the Philippines.

The Philippines will also have to decide whether it should offer single-dose HPV vaccination, said Dr. Melvin Kohn, regional director of Medical Affairs Lead for Vaccines of Merck’s Europe office.

The World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE) reported on April 11 that a single-dose HPV vaccine delivers “solid protection” comparable to two-dose schedules.

“The biggest challenge is around durability, and in demonstrating that durability,” Dr. Kohn said, adding that the administration of two doses to provide a “prime boost situation” is a well-established paradigm.

“Without a boost, how do you demonstrate that 20, 30 years down the road, people who have been vaccinated [with a single dose] will still be protected?” he said. “Each country will have to decide that for themselves.”

“There’s a very important role for federal leadership … ,” he added. “You have strong federal leadership, but how that gets to be implemented is complicated across the country.” — Patricia B. Mirasol

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