Overcoming the barriers of HPV vaccination during covid-19 pandemic at Delhi state cancer institute in India

ABSTRACT

Objectives: India alone bears 23% of the global cervical cancer burden. Cervical cancer is the first cancer to be shown to be 100% attributable to a virus;oncogenic human papillomaviruses (HPV), particularly types 16 and 18. In India, the most common oncogenic types are HPV 16 and 18 accounting for more than 90% cases. In India, population-based cervical cancer screening is largely non-existent in most regions due to competing healthcare priorities, insufficient financial resources and a limited number of trained providers. Hence, most of the cases present in advanced stages of the disease, thus leading to increased mortality and reduced survival. Methods: Introduction of HPV vaccination (Cervarix) in Delhi State Cancer Institute offers great promise to reduce the burden of cervical cancer in conjunction with regular screening methods. Two doses of HPV vaccine (Cervarix) given free of cost at DSCI Delhi to adolescent girls aged 9 to 13 years. Even during the COVID-19 pandemic situation, the HPV vaccination program does not hampered, adolescent girls were highly motivated and vaccinated in large numbers at DSCI. Results: During COVID-19 pandemic, over 4000 adolescent girls were vaccinated at DSCI, Delhi, in which around 2800 girls received first dose and 1200 received their second dose of vaccine. This becomes possible through regular community and school-based awareness campaigns run by DSCI. Conclusion: Prevention of cervical cancers with two-dose HPV vaccination and early detection of precancerous cervical lesions of the eligible population through screening and their appropriate treatment with a single-visit 'screen-and-treat' approach appear to be promising for low-middle-income countries including India.