Cervical Cancer In India: A Preventable Tragedy That Requires Urgent Attention It is estimated that in India, about 160 million women aged 30-59 years are at risk of developing cervical cancer, with fatality rate of 50 per cent

1. Dr Sharda Jain
Sec General of DGF

3. • Cervical Cancer In India: A Preventable Tragedy That Requires Urgent
Attention
• It is estimated that in India, about 160 million women aged 30-59 years are at
risk of developing cervical cancer, with fatality rate of 50 per cent

4. OBGYNs
Can Make A Difference
Whole Medical Fraternity
can make A Difference

5. Dr. Sharda Jain
We wish you to become
Ambassador too…
Join this Movement

6.  Disease Burden / Ca. cervix impact
 Improved Awareness about Vaccine
– The Silver Lining
 WHO CALL
 Need for Prioritizing HPV Vaccination
 Why vaccinating adolescent girls is important &
should be Top Priority of GOI?
 Post partum vaccination - An Excellent
Opportunity to Save Young Mothers
 Probable questions faced by OBGYN
Discussion Flow

7. Disclaimer
The information and statistics provided here are latest
with respect to the time of publishing this document and
are evolving with time. It is advised to look up on relevant
resources for updated information.
This information does not supersede any local or national
scientific/administrative guidance provided by government
or medical association.

8. Incidence

9. LEGEND,S WORDS NEVER DIE………
Louis Pasteur
(1822-1895)
Why Talk Of Cure ,When You Can Prevent it
Remember
100% preventable Cancer

10. CANCER CERVIX
INDIA 2021
• INDIA is capital of Cervical Cancer
• Every woman is at risk of Cervical Cancer
•1 out of 5 women who die due to Cervical Cancer in the
world is an Indian
• Deaths due cancer CX > Than Pregnancy deaths
Rest of World - 80%
20%
One death in 9 minutes

11. 2011
1
death
In
7
minutes

12. An Airbus-185 full of WOMEN
crashing every day in India

13. HPV Vaccination: forms the Base of
CERVICAL Cancer Control
World Health Organization, United Nations Population Fund. Preparing for the Introduction of HPV Vaccines: Policy and Programme
Guidance for Countries. Geneva, Switzerland: World Health Organization; 2006.
Palliative
care
Cancer treatment
Secondary prevention:
Screening and treatment
of precancers
Primary prevention:
Vaccination

14. To eliminate
in the next 100 years,
implementing an effective
strategy is critical WHO
https://www.who.int/news/item/04-02-2020-to-eliminate-cervical-cancer-in-the-next-100-
years#:~:text=90%2D70%2D90%3A%20a%20triple%20intervention%20by%202030%20and%20beyond&text=Scaling%20up%20screening%20and%20treatment,deaths%2C%20in%20the%20sa
me%20period.
Accessed : 23-Nov-2020
CERVICAL CANCER

15. 90-70-90
Western world
50-90% 80-90% 80-90%

16. 90-70-90
Indian scenario
0- .1% 3% 10%

17. • Vaccinating girls against cancer-causing types of human papillomavirus
(HPV) before the age of 15 is the foundation for bringing every country’s
incidence rate of cervical cancer down to the agreed elimination level.
• Scaling up screening and treatment of cervical pre-cancer lesions at the
same time would reduce mortality by more than one third.
• The evidence shows that when all adult women are NOT screened for
cervical cancer Do at least twice, at ages 35 and 45, abnormalities are
more likely to be detected before they become cancerous.
https://www.who.int/news/item/04-02-2020-to-eliminate-cervical-cancer-in-the-next-100-
years#:~:text=90%2D70%2D90%3A%20a%20triple%20intervention%20by%202030%20and%20beyond&text=Scaling%20up%20screening%20and%20treatment,deaths%2C%20in%20the%20same%20period.
Accessed : 23-Nov-2020
90% vaccination, 70% screening and
90% treatment by 2030

18. WHO’s global strategy towards eliminating cervical cancer aims to
set the world on the right track by 2030
• At this pace, global elimination of cervical cancer is not predicted
until 2120 (100 Years )
If no action is taken, CERVICAL CANCER DEATHS
will rise almost 50% by 2030

19. WHO’s global strategy towards eliminating cervical cancer
aims to set the world on the right track by 2030
Elimination of cervical cancer is possible Within The Lifetime Of
Today’s YOUNGEST GIRLS, but the clock starts now and every
intervention counts

21. HPV Vaccination status
in India
Less than 1% of the eligible women
vaccinated with HPV Vaccine

22. Cervical Cancer Screening practice in India
Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV
Information Centre). Human Papillomavirus and Related Diseases in India. Summary Report 17 June 2019. Executive Summary, Table 1 [
Accessed on 23-Nov 2020]
Cervical cancer screening coverage is a mere 3.1% in
the general female population

23. CERVICAL CANCER is One Such Fatal, but
VACCINE PREVENTABLE DISEASE…
1. Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in India. Summary Report
10 Dec 2018. [Accessed on 25 Jan 2019]
Women lose their lives
to Cervical Cancer
every year in India.
>60,000
>85% of patients from
age group 40+ years- the
productive age group.
~40+
Population immunized
against Cervical
Cancer.
Of all Cervical
Cancer deaths
occur in India.
<1% ~20%
Screening rate.
~3.1%

24. HPV
Vaccination

25. HPV Vaccine-A High Impact Vaccine – As stated by GAVI, WHO
20 Deaths Averted
per 1000 Vaccinated

26. As per WHO, ACOG, OBGYNs play a
critical role in women’s care and should
assess and vaccinate adolescent girls &
young women with HPV vaccine during the
catch-up period*.2
1. Joneja GS, Chopra S, OBGYN and changed lifestyle of women, Med J Armed Forces India. 2012 Jan; 68(1): 2–3
2. Human Papillomavirus Vaccination. ACOG Committee Opinion No. 704. June 2017. ACOG. Committee on Adolescent Health Care. Immunization Expert Work Group. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-
Care/Human-Papillomavirus-Vaccination?IsMobileSet=false. Accessed on 30/10/2019. * 13-26 years
OBGYN to play a PIVOTAL ROLE

27. NURSEStoo can play a critical role
in women’s care and should assess and
vaccinate adolescent girls & young women
with HPV vaccine during the catch-up
period if missed out earlier *
NURSES too can play a PIVOTAL ROLE

28. ADOLESCENT
GIRLS
CENT

29. Recommended HPV Vaccination for ADOLESCENTS as per
WHO, CDC, FOGSI, API
0-6 months 0-6 months 0-2-6 months
Use The Same Brand of Vaccine For The Entire Series

30. Antibodies produced are highest between the ages
of 9 - 15 years Experts are silent on levels.
When she is class V

31. Cervical, Vulvar, Vaginal ,Endometrial, Oral cavity, Anal
Pediatricians call it CANCER VACCINE

32. Four Reasons Why Vaccinating The Adolescent Girls In Important
Higher immune response in
Adolescents vs Young adults1
Immunizing before exposure can
give highest possible (per
protocol) efficacy2,3
High risk of acquiring HPV even
with
First Male Partner4
Cost of immunization is less in
most of the adolescents who just
need 2 doses5
1. Giuliano AR et al. Impact of baseline covariates on the immunogenecity of a quadivalent (types 6, 11, 16 and 18) human papillomavirus like particle vaccine. J Infect Dis. 2007;196:1153–1162
2. Quadrivalent Vaccine against Human Papillomavirus to Prevent High-Grade Cervical Lesions n engl j med 356;19 www.nejm.org may 10, 2007
3. Garland et al; Quadrivalent Vaccine against Human Papillomavirus to Prevent Anogenital Diseases N Engl J Med 2007;356:1928-43
4. Winer et al. J Infect Dis Jan 2008
5. Gardasil PI MSD IN 04/20

33. Exposure to HPV at a Young Age Increases the Risk of Cervical Lesions and Cancer
in Women
3.04
6.29
1.68
2.06
1 1
0
1
2
3
4
5
6
7
CIN Invasive Cervical Cancer
Relative
Risk
Estimatesa
≤17 18–22 ≥23
aMantle-Haenszel estimates adjusted for age only.
1. La Vecchia C et al. Cancer. 1986;58:935–941.
Relative risks for CIN and invasive cancer increase with decreasing age of first sexual intercourse.
Age at First
Intercourse (Years)
(n=206) (n=327)
Reference Population: First intercourse 23 years of age or never
>5 times higher risk
of Invasive cancers if
first intercourse
before 18 yrs
compared to after
22 yrs
33

34. 1. FOGSI 2014 immunization guidelines
2. Census 2011 (https://www.census2011.co.in...as accessed on 25/05/2018)
3. IMS, 10 years HPV market data
0
0
4
Why OBGYNs
should prioritize
HPV vaccination in
girls/women?
REASONS
FOGSI /API recommends vaccinating girls/women at
various stages in their lives with relevant vaccines.1
India has a huge female population aged 9-45 years (367 MN)
who are eligible for HPV vaccination.2 But most of them are not
vaccinated. 3
OBGYNs see, treat and hence know the damage Cervical
Cancer can cause to the woman and ultimately to the family.
1
2
4
OBGYNs have an opportunity for catch up HPV
vaccination, because women come to you with
various complaints throughout their life.
3

35. Reference: 1. Barenson A, Rahman M, Hirth J, et al. A human papillomavirus vaccination program for
low-income postpartum woman. Amrecican Journal of Obstetrics an Gynecology. 2016;215(3):318.et-
318.e9
Counseling and offering the HPV
vaccine to Postpartum Women
could be an Effective strategy to
increase uptake.
IN INDIA - GYNAECOLOGIST SEE
MAJORITY OF GIRLS ONCE THE GIRLS
MARRIED & PRAGNANT

36. 1. Pandey D, Solleti V, Jain G, et al. Human Papillomavirus (HPV) Infection in Early Pregnancy: Prevalence and implications, Infectious diseases in OBGYN, vol 2019
2. Rama, Villa, Pagliusi et al, Opportunity for catch-up HPV vaccination in young women after first delivery, J Epidemiol Community Health 2010;64:610e615
3. Wright, Govindappagari, Pawar et al, Acceptance and Compliance With Postpartum Human Papillomavirus Vaccination, Obstet Gynecol 2012;120:771–82
0
0
4
To counsel and offer
HPV vaccine to
POSTPARTUM
Patients 1
REASONS
HPV infection may occur or persist during pregnancy because of
changes in the hormonal & immune response.1
There is high HPV prevalence in postpartum women and only few
women were positive for one or both oncogenic HPV types, so majority
of this group can still benefit from HPV vaccination.2
Postpartum administration of the HPV vaccine is feasible and is
associated with a high degree of satisfaction among women.3
1
2
4
Post-partum HPV vaccination is associated with favourable rate of vaccine
completion.3
3
Only Gardasil vaccine can
be used & Not Cervarix

37. Your strong recommendation can
"Make A Difference in Life of Girls & Women"
by NOT letting them "Miss an Opportunity"
to protect themselves form
Cervical Cancer.

38. 1) How do I counsel patients for HPV vaccination
especially in the current
COVID-19 scenario?
2) Screening is enough for preventing Cervical
Cancer, then why vaccinate?
3) Postpartum vaccination – isn’t it too late?
4) Do I need to vaccinate my patient if she is already
positive for any HPV serotype?
Probable questions faced by an OBGYN

39. 5. Patients are concerned about safety of qHPV…
How to provide assurance
6. Is qHPV vaccine safe for lactating mothers?
7. Patients are concerned that the disease happens in
later stage of life, then does qHPV have lasting
effectiveness?
8. How do I complete the HPV vaccination schedule if
the vaccination dose is delayed due to lockdown?
Probable questions faced by an OBGYN

40. How do I counsel
patients for HPV
vaccination especially
in the current
COVID scenario?

41. COVID TIME
TELECONSULTATION…
ITS TIME TO ADAPT TO THE NEW NORMAL

42. Overcoming teleconsultation challenges and Protecting
lives from Cervical Cancer
ADAPT EFFECTIVE COUNSELING TECHNIQUES
1. https://vsee.com/blog/top-10-tips-making-telehealth-work-physician-perspective/
2. Gross T, Rahman M, Wright A, et al. Implementation of a postpartum HPV vaccination program in a Southeast Texas hospital: A qualitative study evaluating health care provider acceptance, Matern
Child Health J. 2016 November ; 20(Suppl 1): 154–163. doi:10.1007/s10995-016-2030-0
Maintain a checklist
for points of
discussion or
identify a workflow.1
Include HPV vaccination in
checklist.
You may consider
sharing a patient
education video or
literature immediately
after counselling.
Including HPV vaccination in
the routine “postpartum order
set”
would help the vaccine to be
administered in a similar
fashion to rubella, varicella,
and influenza vaccines.2
Consider Prescribing
HPV vaccination
incase it is not
administered during
discharge to ensure
follow up.
.

43. Counseling for HPV Vaccination should be like
Elevator Speeches, Short and Succinct 15
Second Responses
Short, meaningful words.
No science.
Talk Precise! Talk Quick! Talk Emotional!
Maximum, 15 seconds
(2-4 short sentences)
Make your message
personal and emotional.

44. Ensure Right Choice of Words
Words and phrases to use
Words and phrases to avoid
Today Prevent
cancer
Keep healthy Protect We/I/our Together Benefit Love
Percent Immunity Sexually-
transmitted
Promiscuous
%

45. II. Screening is enough for
preventing Cervical Cancer,
then why vaccinate?

46. True that screening is very important for Cervical cancer prevention, But,
The cervical cancer screening coverage is a mere 3.1% in the general female population in
India1!!
1. Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus
and Related Diseases in India. Summary Report 10 Dec 2018. [Accessed on 25 Jan 2019]
2. Diaz M, Kim JJ, Albero G et al. Health and economic impact of HPV 16 and 18 vaccination and cervical cancer screening in India. British Journal of Cancer (2008) 99, 230 – 238
Impact on cancer reduction*
Vaccination only
Screening only (VIA – 1x, 2x, 3x)
Vaccination followed by screening
(VIA – 1x, 2x, 3x)
*Base case assumes 70% vaccination and screening coverage
Health impact of HPV vaccination followed by cervical cancer screening in India
Combining Screening
and Vaccination has maximum impact on Cervical Cancer reduction1
Once at 40 years Twice at 35, 40 years Thrice at 35, 40, 45 years
13%
52%
21%
56%
29%
61%
44%
Vaccination only
ICMR

47. Human Papillomavirus. CDC. https://www.cdc.gov/hpv/hcp/hpv-important/more-than-screening-infographic.html. Accessed on 30/10/2019.
CDC Advises – Not to Only Rely On Cervical Cancer Screening but
To Protect Woman with HPV Vaccination NOW!!
Precancer for
other HPV related
cancers* (except
Cervical Cancer)
MAY REQUIRE
INVASIVE
TESTING AND
TREATMENT
Cervical cancer is
the only type type
of HPV cancer for
which there is a
RECOMMENDED
SCREENING TEST
90% of HPV
cancer are
PREVENTABLE
WITH HPV
VACCINATION

48. III. Postpartum vaccination –
isn’t it too late?

49. HPV Does Not Discriminate by Age!
1. Muñoz N, et al. J Infect Dis 2004; 190:2077-87.
Cumulative
Risk
of
HPV
Infection
(%)
Cohort of Colombian Women (n = 1,610)
Years
0
10
20
30
40
50
0 1 2 3 4 5
Age at Baseline (years)
15–19
20–24
25–29
30–44
45+
12.4%
21.9%
30.0%
36.9%
42.5%
Women Remain at Risk for Acquiring HPV Infection Throughout Their Lifetime 1

50. Risk of Progression from CIN 1 to CIN 3 and Cancer
Increases with Age1
• 2,490 women with CIN 1 or less were monitored using annual cytology and high-risk HPV tests.
• At a median follow-up of 26.3 months, 47 women (1.9%) had subsequently developed CIN 3, AIS, or cervical cancer.
• Risk of progression to CIN 3 or cancer was associated with high-risk HPV and older age (≥30 years; P=0.045).
Subsequent Risk of CIN 3 or Cancer After Colposcopic Diagnosis of CIN 1 or Less
0.4%
1.7%
2.7%
Retrospective review of Southern California Permanente Medical Group (SCPMG)-Fontana cancer prevention file, a computer-based record of the evaluation and follow-
up of women who attended colposcopy and dysplasia clinics at the SCPMG-Fontana Medical Center between August 1, 1998, and January 1, 2005.
AIS=adenocarcinoma in situ. 1. Pretorius RG et al. Am J Obstet Gynecol. 2006;195:1260–1265.
Risk
of
CIN
3
or
Cancer
(%)
Age (years)
<20 20-29 >30
0.4%
1.7%
2.7%
Risk of progression from
CIN 1 to CIN 3 is
7X HIGHER
for women ≥30 years than
for women <20 years of age

51. Efficacy against
LSIL or Worsea
Effectiveness
against
HPV 6-,11-,16-,18-
related CIN or
condyloma
Efficacy against
ASC-US
High Risk-HPV
Positivea
Future III – Mid-adult Women: Efficacy and Effectiveness of the qHPV Vaccine in Females
24–45 Years of Age through 10 Years
aRelated to HPV types 6/11/16/18.
ASCUS = atypical squamous cells of undetermined significance; CIN = cervical intraepithelial neoplasia; EGL = extragenital lesion; LSIL = low-grade squamous intraepithelial
lesion; VIN = vulvar intraepithelia neoplasia; VAIN = vaginal intraepithelial neoplasia. 1. Castellsagué X, et al. Br J Cancer. 2011;105:28-37; 2. Das et al, LONG-TERM
EFFECTIVENESS OF GARDASIL™ AMONG ADULT
WOMEN IN COLOMBIA.
qHPV Vaccine is Efficacious even in Mid Adult Women
89% Efficacy against
Persistent Infection,
CIN, or EGLa
92%
100%
100%
Randomized, Controlled Trial
(N=3692)
(Years 1-4 Follow-Up)1
Long-Term Extension Trial
(N=685)
(Years 4-10 Follow-Up)2

52. IV. Do I need to vaccinate my
patient if she is already
positive for any HPV
serotype?

53. Efficacy Trial Database for GARDASIL: HPV 6/11/16/18 Status Among Female Subjects at Day 1a
1. Data on file, MSD India. 2. Velicer C et al. Sex Transm Dis. 2009;36:696–703.
The Chance of a Women being Infected with all
4 Types of HPV included in qHPV Vaccine is Very Low
67
Parameter
16–26 Years of Age1
N=20,541
24–45 Years of Age2
N=3,819
Negative to all 4 types (%) 73
Positive to exactly 1 type (%) 20 23
Positive to exactly 2 types (%) 6 7
Positive to exactly 3 types (%) 1.2 2
Positive to all 4 types (%) 0.1 0.1

54. 1. Data on file, MSD India. 2. Velicer C et al. Sex Transm Dis. 2009;36:696–703.
Majority of the sexually active women can get benefit from qHPV vaccination
The Chance of a Women being Infected with All 4 Types of HPV
included in qHPV Vaccine is Very Low
100
90
80
70
30
50
40
30
20
10
0
Woman
Vaccination
with
GARDASIL
(%)
16-26-year-old 24-45-year-old
0.1% infected with
all 4 vaccine types
99.9% of woman
will benefit
0.4% infected with
all 4 vaccine types
99.9% of woman
will benefit
Woman unexposed to any
vaccine-targeted type
Infected with type
Infected with 3 type
Infected with 2 types
Infected with all 4 types

55. V. Patients are Concerned
about Safety of qHPV…
How to Provide Assurance?

56. qHPV vaccine is the result of over 10 years of research
and development
Michelle Vichnin et al - An Overview of Quadrivalent Human Papillomavirus Vaccine Safety - 2006 to 2015; Pediatr Infect Dis J 2015;34:983–991)
Safety has continued to be evaluated in several large post-licensure
surveillance studies - over 15 studies in more than 1 million
preadolescents, adolescents and adults from various countries.
>15 post-licensure studies
~1 million subjects
The safety and efficacy of GARDASIL was established in a clinical
program with 7 phase III clinical trials involving more than 29,000
females and males.
7 phase III studies –
~29,000 subjects

57. ReaffirmedPositiveqHPVSafetyProfilebyHealthAuthorities1,2
> 300 million doses dispensed worldwide (2006-2018)1
1. MSD data on file
2. Papillomavirus Research 2016 (2):9-10.
qHPV Vaccine
World Health
Organization (WHO)
Public Health
Agency of Canada
Centers for Disease
Control and Prevention
Food and Drug
Administration (FDA)
European Medicines
Agency
Medicines & Healthcare
Products Regulatory
Agency of the UK
Therapeutic Goods
Administration of
Australia
International Federation
of Gynecology and
Obstetrics
International
Papillomavirus Society
WHO PHAC CDC
FDA
TGA FIGO
EMA MHRA
IPVS

58. CDC
✓
WHO
✓

59. HPV Vaccines & Infertility

60. • GACVS concluded that the available data do
not support an association between HPV
vaccination and infertility or POI**.
WHO – GACVS* Meeting Extract – 24 Jan 2020
WHO: Human Papillomavirus Vaccines & Infertility. Extract from GACVS meeting of 4-5 December 2019, published in the WHO Weekly
Epidemiological Record of 24 January 2020 https://www.who.int/publications/m/item/human-papilloma-virus-vaccines-and-infertility
Accessed 11 Nov 2020.
* GACVS: Global Advisory Committee on Vaccine Safety. ** POI: Primary Ovarian Insufficiency
✓

61. Genital Warts2
Vulvar/ Vaginal Precancers
(Grade 1- 3)2
Cervical Cancer &
Precancers (Grade 2/ 3)1
99%
98%
100%
HPV induced lesions Protection
1. The Future II Study Group. Lancet 2007; 369: 1861–68
2.Garland SM et al. New Engl J Med. 2007;356:1928–1943.
Efficacy of Quadrivalent/ Bivalant HPV Vaccine:
BIVALANT
cervarix
√
X
√

62. VI. Is HPV Vaccine Safe
for Lactating Mothers?

63. The American College of
Obstetricians and Gynecologists
(ACOG)
ACOG, CDC and WHO Guidelines on
HPV Vaccination during Lactation
1. Human papillomavirus vaccination. Committee opinion no. 704. American college of obstetricians and gynecologists. Obstet Gynecol 2017;129:e173-8
2. https://www.cdc.gov/hpv/hcp/need-to-know.pdf
3. Human papillomavirus vaccines: WHO position paper, May 2017
The HPV vaccine can be given
to postpartum and
breastfeeding women.1
HPV vaccines can safely be
given to women who are
breastfeeding.2
World Health Organization (WHO)
Breastfeeding is not a contraindication
for HPV vaccination. Available evidence
does not indicate an increased risk of
adverse events linked to the vaccine in
either the mothers or their babies after
administration of HPV vaccine to
lactating females.3
Centers for Disease Control
and Prevention (US CDC)

64. VII. Patients are concerned
that the disease happens in
later stage of life, then does
qHPV have lasting
effectiveness?
BOOSTER DOSE X

65. qHPV has Proven EFFECTIVENESS
that Provides LONG-TERM PROTECTION
For age group 24-45 years
*With respect to HPV 6,11,16,18 related CIN or condyloma
Das R. Long-term effectiveness of Gardasil™ among adult women in Colombia. Presented at EUROGIN 2017 European Research Organization on Genital Infection and Neoplasia 2017
International Multidisciplinary
Congress, Amsterdam, The Netherlands. Abstract SS 06-04.
BREAKTHROUGH
cases even after 10 years of vaccination1*

66. VII. How do I complete the HPV
vaccination schedule if the
vaccination dose is delayed due
to lockdown?

67. Guidance for Completing HPV Vaccination Schedule in Case
Vaccination is Delayed during COVID or otherwise
1. Gardasil PI MSD IN 04/20
2. https://www.cdc.gov/hpv/hcp/schedules-recommendations.html as accessed on 9/4/2020
Recommended HPV
vaccination schedule as
per CDC
Points to note if the HCP is
anticipating dose schedule
interruption
0-6 months 0-6 months 0-2-6 months
If the vaccination schedule is interrupted, vaccine doses do not need to be
repeated (no maximum interval)2
All three doses should be given within a 1-year period1,2
2 DOSES – WITHIN 3 YEARS

68. 1. Das R. Long-term effectiveness of Gardasil™ among adult women in Colombia. Presented at EUROGIN 2017 European Research Organization on Genital Infection and Neoplasia 2017 International Multidisciplinary Congress,
Amsterdam, The Netherlands. Abstract SS 06-04.
2. Castellsagué X, et al. Br J cancer. 2011;105:28-37; 2. Das et al, long-term effectiveness of Gardasil™ among adult women in Colombia
3. Gardasil PI MSD IN 04/20
4. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/HPV_vaccines_20/European_Commission_final_decision/WC500196773.pdf
5. WHO position statement 2017
6. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv.pdf
0
0
4
to choose
qHPV Vaccine
REASONS
Proven effectiveness that provides long-term
protection 1
Efficacious even in mid adult women 2
Established evidence in lactating mothers 3
1
2
3
4 Assured post licensure safety profile 4-6

69. While protecting women
GOI not miss out SINGLE
Adolescent Girls – The apt age
with less cost

70. How do I complete the HPV
vaccination / screening /
Treatment targets in Adult
Women?
One dose of vaccination (1) +
Physical VIA / VILI(1-2)
+Cryo or Thermal Ablation(1 )
90-70-90

71. Effective HPV Vaccination + Screening / Counseling and
strong Recommendation is all it takes to PROTECT WOMEN from
CERVICAL CANCER

72. 4
CRORE
1
CRORE

73. Thank
You

74. Thank You