Human Papilloma Virus Vaccination in Nepal: An InitialExperience


Cervical cancer is the commonest cancer among women in Nepal. Human papilloma virus (HPV) infection,a recognized cause of cervical cancer, is very common in sexually active women and HPV vaccination has beenrecommended as a prophylactic therapy. If HPV infection is prevented by the HPV vaccination to the adolescentgirls, cervical cancer is also prevented. We received 3,300 vials of quadrivalent human papilloma virus (types 6,11, 16, 18) recombinant vaccine (Gardasil; Merk & Co.) as a gift from the Australian Cervical Cancer Foundation(ACCF) which has a mission to provide life-saving HPV cervical cancer vaccines for women in developingcountries, who cannot otherwise afford vaccination. HPV vaccine was offered to 1,096 of 10 to 26 year aged girlsattending 17 secondary schools. In total, 1,091 (99.5%) received the second dose and 1,089 (99.3%) received thethird dose of the vaccine. The remaining 5 girls at second dose and 2 girls at third dose remained unvaccinated.No serious vaccine related adverse events were reported except mild pain at the injection site in 7.8% of thevaccine recipients. High cost and low public awareness are the key barriers for successful implementation ofthe vaccination program in resource limited developing countries. In conclusion, HPV vaccine is safe with highacceptability in Nepalese school girls. However a large population study for longer follow up is warranted tovalidate the findings of this vaccination program.