discussion on immunisation

Topic : discussion on immunisation
Discussion of systems for monitoring immunisation programs
Program Delivery and Monitoring and aims to build on your understanding of surveillance systems for monitoring immunisation programs and the challenges of immunisation program delivery.
Human papillomavirus (HPV) vaccines have only been available globally since 2006 and are only the second vaccine to protect against cancer, after the hepatitis B vaccine. The 4-valent HPV vaccine (4vHPV) covers four human papillomavirus types. HPV types 16 and 18 are the most common causes of HPV-associated cancers, while HPV types 6 and 11 are the most common causes of genital warts. The 2-valent HPV vaccine (2vHPV) contains HPV types 16 and 18 only. Prior to the availability of the HPV vaccines, cervical cancer control in Australia included secondary prevention (screening for pre-cancerous lesions) as well as tertiary prevention (cancer treatment and palliative care). Australia has had a National Cervical Screening Program for over two decades, and has relatively low rates of cervical cancer.
HPV immunisation was added to the Australian National Immunisation Program schedule in 2007. At that time a three dose schedule of the 4-valent HPV vaccine (4vHPV) was funded for females aged 12–13 years, delivered through a school-based program. Between 2007 and 2009, a catch-up program targeting women aged 13-26 years was delivered through schools or primary care providers. In 2013, the funded program was extended to include males aged 12-13 years, with a catch-up of males 14-15 years.
By the end of 2011, HPV vaccine had been introduced into the national immunisation schedule of 40 countries, either the 4vHPV or 2vHPV vaccines. HPV vaccine program monitoring and delivery is complex and differs to the delivery and monitoring of routine childhood vaccines.
– What are some of the methods used to monitor coverage in the absence of an immunisation register?
What are the limitations of these systems?
– What are some of the challenges in delivering the HPV vaccine program in Australia? Compare the delivery of the routine HPV vaccine program to school age girls with the delivery of the catch-up program through general practice.
– What methods are being used to monitor the impact of the HPV vaccine on HPV-related disease in Australia? What systems do developing countries need to consider for program monitoring?
– Which other countries have commenced HPV immunisation programs?
The HPV chapter of the Australian Immunisation Handbook is a good starting point for your pre-reading.
Moderators may wish to steer the discussion to HPV surveillance and monitoring issues relevant to other countries such as the USA or Canada or draw on the WHO and other global partner initiatives to steer the discussion to monitoring and surveillance systems in developing countries.
Moderators may want to discuss the difficulties of surveillance of vaccine-preventable diseases and monitoring coverage in low resource countries in general.

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