Current HPV Vaccination Strategies in Brazil

Abstract

Cervical cancer is one of the most preventable and treatable malignancies, however, it still has high incidence and mortality rates, especially in less developed countries. For Brazil, the estimate is more than 16,000 new cases and more than 6000 deaths annually. Despite this, vaccines against HPV (responsible for cervical cancer) are effective and promote a significant decrease in infections and neoplastic lesions of the cervix. As recommended by the World Health Organization, girls aged 9 to 14 should be vaccinated before becoming sexually active. Although the vaccine was developed in 2006, in Brazil immunization only started to be carried out in 2014, initially only for girls between 9 and 11 years old. The present work is an integrative review, with the objective of explaining the current situation of vaccination against HPV throughout the country. Using the PubMed, MED-LINE and Google Scholar databases, a search for scientific articles was carried out during the year 2022, using the descriptors “Vaccine”, “HPV” and “Brazil”, simultaneously selecting 17 articles. The Brazilian recommendations for vaccination against HPV have undergone several strategic changes over time, in the following points: age group and gender of the target population, major site of application of vaccines and number of doses to be applied. Currently, in Brazil, the recommendation for vaccination against HPV is neutral in gender, between 9 and 14 years old and in immunosuppressed people up to 45 years old, with a vaccination schedule of 2 doses with an interval of 6 months between them, and 3 doses for those from 15 years and immunocompromised individual (0 - 2 - 6 months). The tetravalent vaccine offered by public funding continues to be applied at health centers, despite several favorable criticisms of the return of application in schools. Even though the vaccine is available free of charge, studies point to the difficulty in achieving and maintaining vaccination coverage, especially for the second dose. Among the factors that impede success, they cite illiteracy in health generated mainly by social inequality and the lack of educational actions by the government, demonstrating the need to plan effective strategies in this regard.