Tunisian health officials are reinforcing the long-term effectiveness of the human papillomavirus (HPV) vaccine, with data suggesting protection can last up to 11 years following a single dose. This reassurance comes as Tunisia continues to roll out its national HPV vaccination program, aiming to significantly reduce the incidence of cervical cancer.
The Ministry of Health’s communication strategy regarding the HPV vaccine introduction confirms that studies have demonstrated a consistently high level of antibodies produced by the vaccine, often exceeding those achieved through natural HPV infection. Importantly, these findings apply to individuals vaccinated with a single dose, challenging earlier assumptions about the need for booster shots.
Currently, no scientific evidence supports the necessity of a second vaccine dose to bolster immunity, according to available data. This finding is particularly relevant as vaccination programs worldwide grapple with optimizing resource allocation and maximizing coverage.
Beyond efficacy, safety remains a key consideration. The Ministry of Health has affirmed the vaccine’s safety profile, noting its approval and use for over two decades without reports of serious adverse effects. A common concern regarding vaccines and fertility has also been addressed; officials state the HPV vaccine poses no risk to fertility, unlike surgical interventions sometimes required to treat cervical cancer, which can potentially lead to sterility.
The national vaccination program began on , initially targeting sixth-grade students – typically 12-year-old girls – in both public and private schools. Girls aged 12 who are not enrolled in school are also eligible to receive the vaccine free of charge at primary healthcare centers, as part of a broader national strategy to combat cervical cancer.
The introduction of the HPV vaccine into Tunisia’s national immunization program is a significant public health initiative. Cervical cancer is the 14th most common cancer in Tunisia, largely attributable to high-risk HPV types, particularly HPV 16 and 18. Currently, screening rates are relatively low, with only 17% of women aged 35-60 undergoing Pap-smear testing.
The long-term goals of the vaccination program are ambitious. Tunisia aims to vaccinate 90% of girls aged 15 against HPV by , and to achieve a 70% screening coverage rate for women aged 30 and older. These targets reflect a comprehensive approach to cervical cancer prevention, combining proactive vaccination with ongoing screening efforts.
The need for enhanced screening strategies alongside vaccination is underscored by recent research. A cost-effectiveness analysis conducted using the HPVsim model examined various screening approaches in conjunction with the vaccination program. The study compared maintaining the current Pap-smear strategy, introducing HPV DNA testing once between ages 35-40, introducing HPV DNA testing twice with a five-year interval between ages 35-45, and implementing HPV DNA testing every five years for women aged 35-60. All approaches, when combined with vaccination, were evaluated across different screening coverage rates (15%, 25%, 33%, 50%, and 70%).
The analysis, which considered the perspective of the Tunisian healthcare system, focused on the number of cancer cases averted, total intervention costs, and the cost increase per cancer case averted. The findings will help inform decisions about the most cost-efficient screening strategy to complement the vaccination program.
Modeling studies have also projected substantial reductions in cervical cancer incidence and related deaths following the implementation of the HPV vaccination program. One study estimates a potential decrease of 58-74% in cervical cancer cases and deaths, depending on the extent of cross-protection offered by the vaccine.
Several HPV vaccines – Cecolin, Cervarix, Gardasil-4, and Gardasil-9 – have been assessed for cost-effectiveness in Tunisia. All were found to be cost-effective, with Cecolin identified as the most cost-effective option while Cervarix demonstrated slightly greater health benefits at higher coverage rates. This data provides strong evidence to support the introduction of HPV vaccination as a key component of Tunisia’s public health strategy.
The long-term protection offered by the HPV vaccine, coupled with its established safety profile and cost-effectiveness, positions it as a crucial tool in the fight against cervical cancer in Tunisia. The ongoing national vaccination program, combined with efforts to improve screening rates, represents a significant step towards reducing the burden of this preventable disease.
