演題抄録

International Symposium

開催概要
開催回
第51回・2013年・京都
 

Implementation of HPV Vaccination: The Malaysian Experience

演題番号 : IS2-2

[筆頭演者]
Suresh Kumarasamy:1,2 

1:Gleneagles Penang, Malaysia、2:Penang Medical College, Malaysia

 

Cervical cancer is the third most common cancer among women in Malaysia with an age standardised incidence of 12.2 per 100,000 population. Although pap smear screening was introduced in Malaysia in 1969, there is no organised call recall system and the screening is opportunistic with rates of ever having a pap smear being 26% in 1996 and 43% in 2006. A pilot project on implementing a call recall system carried out between 2008 and 2011 had a low response rate.Malaysia was the first middle-income country in the world to implement a national HPV vaccination program in September 2010. It is a school based vaccination program targeting girls at Year 7 of school (13 years), with clinic based immunisation for out of school 13 year old girls. This program was very successful with 95.9 and 97.9% of parents giving consent for their daughters to be vaccinated and 97.9% and 95.9% of girls with parental consent completed all 3 doses in 2010 and 2011 respectively. In the first 2 years, the bivalent vaccine was used but in March 2012 there was a seamless change to the quadrivalent vaccine. The incidence of side-effects was 0.16% with the most common being central & peripheral nervous system (29.8%), application site (27.0%) and gastrointestinal (17.5%). The reasons for the success of this program included endorsement and recommendation by the medical profession, political will and leadership, involvement of stake holders early, predicting and managing potential risks as well as monitoring implementation closely. Other reasons were "halal" certification of the vaccine to cater for the majority Muslim population and giving sufficient information about the vaccine and its safety to parents. In 2012 a catch up vaccination program was introduced, targeted at girls aged 18 years. The Malaysian HPV vaccination program could be a model for the developing world, where organised and effective screening is unlikely to be successfully implemented in the short term

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