Adolescence: Guarding Against HPV

GARDASIL VACCINATION:

In Haiti, thousands of girls are vaccinated against HPV, a disease that can cause cervical cancer.

Each year nearly 3,000 women in Haiti develop cervical cancer. Just over half of those women will die as a result of the disease. 

In an effort to combat these preventable deaths, Partners In Health’s sister organization in Haiti, Zanmi Lasante, partnered with the country’s Ministry of Health in late 2009 to pilot the country’s first vaccination project for human papillomavirus (HPV)—the primary cause of cervical cancer.

The project aimed to vaccinate 3,800 girls, between the ages of 10 and 13.

Cervical cancer is overwhelmingly a disease of the poor. For example, the annual mortality rate for the disease in poor countries like Haiti is 54 deaths for every 100,000 women—more than 30 times higher than in the United States. Nearly 80 percent of women who develop cervical cancer live in developing countries, with roughly 275,000 dying as a result of the disease each year. Almost all of these deaths are preventable. 

Introducing a Gardasil campaign in rural Haiti

Gardasil, the HPV vaccine, can save many women’s lives. But delivering it in developing countries—especially post-earthquake Haiti—is not without obstacles.

Gardasil must be administered in three doses over a period of six months. Delivering multiple doses of a vaccine can be difficult because patients face barriers in making follow-up visits. Although studies have established a connection between HPV and cervical cancer and the vaccination is widely available in the U.S., most rural Haitians know little about the virus and the vaccine.

The large number of girls who volunteered to receive the first doses of Gardasil in December 2009 reflected the success of PIH/ZL’s education campaign throughout Haiti’s Central Plateau. In cooperation with schools, community leaders, educators, and local health teams, PIH/ZL raised awareness about cervical cancer, HPV, and the Gardasil vaccine in rural villages and larger towns alike.

 

In post-earthquake Haiti, PIH/ZL delivers HPV vaccine

After the devastating earthquake on January 12, 2010, ZL staff realized it would be even more challenging to locate the 3,806 girls who had received the first dose of Gardasil and administer the second and third doses. The earthquake strained all medical resources, some of the girls had been displaced, and schools that had hosted the vaccine program were closed or overwhelmed by displaced children.

But project leaders decided to proceed. Radio messages and community criers were used to encourage girls who had moved following the earthquake to return to their schools to complete the vaccination regimen. In late February and early March, 2010, Zanmi Lasante launched the outreach effort.

The team administered the third and last dose throughout June, even though the process was delayed by problems with shipping the vaccine and changes to school schedules. As an extra incentive to the girls, ZL staff gave small gifts at the completion of all three doses. 

Of the 3,806 girls who received the first dose, 2,884 girls—over 75 percent—received all three doses of Gardasil. This percentage is higher than rates reported in countries with far more resources, including the U.S.

This pilot program demonstrates that implementation of HPV vaccine is possible in rural Haiti, where cervical cancer affects a disproportionate number of women.

Learn more about PIH/ZL’s Gardasil campaign in Haiti.
Learn more about PIH cervical and breast cancer work across its sites.