Feasibility of HPV vaccination in Tanzanian schools
This study aimed to determine the feasibility of, and costs associated with, two approaches to delivering school-based human papillomavirus (HPV) vaccination in Tanzania. Funded by the Wellcome Trust, it was led by Deborah Watson-Jones of the London School of Hygiene and Tropical Medicine, with Pieter Remes supervising the qualitative research. 134 schools were selected and randomised to receive one of two delivery strategies: (i) delivering vaccine to one school class (Standard VI) or (ii) vaccine provision to a specific age (12 years). Adverse events were monitored. Data were collected on uptake of the vaccine and the proportion of girls completing all three vaccine doses by delivery strategy. The costs of introducing and scaling up HPV vaccination in schools was estimated.
Vaccine coverage was excellent in the first school-based HPV vaccination project in Tanzania, despite recent problems with school-based health programmes. The commonest reason for not vaccinating was absenteeism from school in all government schools (6.7% of eligible pupils) and parent refusal in private schools (16.5%) and urban government schools (9.3%). Class-based vaccination gave higher coverage compared with age-based vaccination, especially in government schools. There was no evidence that HPV vaccination increased absenteeism rates in selected primary schools. As Tanzania moves towards implementing a national HPV vaccination programme, special attention will be needed to ensure parents at private schools are informed about the importance of HPV vaccination.
Remes P, Selestine V, Changalucha J, Ross D, Wight D, de Sanjose S, Kapiga S, Hayes R, Watson-Jones D. A qualitative study of HPV vaccine acceptability among health workers, teachers, parents, female pupils, and religious leaders in northwest Tanzania. Vaccine 2012;30:5363-5367pubmed open access
Watson-Jones D, Baisley K, Ponsiano R, Lemme F, Remes P, Ross D, Kapiga S, Mayaud P, de Sanjose S, Wight D, Changalucha J, Hayes R. Human Papillomavirus vaccination in Tanzanian schoolgirls: cluster-randomized trial comparing two vaccine-delivery strategies. Journal of Infectious Diseases 2012;206:678-686pubmed open access