•The vaccine helps the body fight off infection by the Human papillomavirus, which causes more than 95 per cent of cervical cancer cases.
•By February this year, only 1.7 million Kenyan girls had been vaccinated and only 876,800 (27.4 per cent) had received the second jab in February this year.
Image: PSCU
A single dose of the HPV vaccine, currently given to girls for free, may cost Kenyans approximately Sh14,000 if the donor support ends in 2027.
This is according to a modelling by Ministry of Health officials.
Currently, the vaccines are donated to Kenya by the non-profit Gavi, but this support is expected to end in four years' time.
The modelling shows Kenya could avert 137,000 cervical cancer cases by 2029 if the vaccines continue to be available to young people who need them.
However, from 2027, this will come at a higher cost.
“The most cost-effective vaccine had a 100 per cent probability of being cost-effective at a willingness-to-pay threshold of $100 compared to no vaccination,” the study suggests.
The researchers said substantial government funding will be required, possibly exceeding $10 million per year, to reach ambitious coverage targets (90 per cent coverage) and sustain the programme as Kenya graduates from Gavi support.
The vaccine helps the body fight off infection by the Human papillomavirus, which causes more than 95 per cent of cervical cancer cases.
Valerian Mwenda, a medical epidemiologist at the National Cancer Control Programme of the Ministry of Health, who led the research, said: “This study was very timely for Kenya because we are in the process of graduating from Gavi support. The study highlights the value of HPV vaccination and the need for sustained investment in the programme."
"The cost of scaling-up our cervical cancer prevention efforts will be substantial so a reduced schedule or different HPV vaccine should be considered to help reduce costs and improve value for money,” she said.
The research team included the Kenyan Ministry of Health, the Kenya Medical Research Institute, PATH and the London School of Hygiene & Tropical Medicine.
Kenya introduced a HPV vaccine, Gardasil-4®, for girls aged 10 years old in 2019 with support from Gavi, the Vaccine Alliance.
As Gavi support in Kenya may end soon, the research team evaluated the potential impact and cost-effectiveness of the Gardasil vaccine, and available alternatives, to inform policymakers and guide the scaling up of HPV vaccination programmes.
The alternatives available globally, include Cecolin, Cervarix, Gardasil-4, and Gardasil-9.
These vaccines had varying levels of cost-effectiveness and net costs. Notably, the study indicates that alternative products, such as Cecolin or Cervarix, could potentially offer similar or greater health benefits at lower net costs compared to Gardasil-4.
“We found that the product with the most favourable cost-effectiveness (Cecolin without cross-protection, or Cervarix with cross-protection) would be cost-effective at a willingness to pay threshold of $100,” the authors said.
The study, “Impact, cost-effectiveness, and budget implications of HPV vaccination in Kenya”, is published in the Vaccine journal.
The co-authors are head of cancer control programme Mary Nyangasi, and Joan Paula-Bor, of the same programme. Others are Christine Miano of the National Vaccines and Immunisation Programme, Vincent Were of Kemri; Path’s Edward Kariithi, Clint Pecenka and Anne Schuind. The others were Kaja Abbas and Andrew Clark of LSHTM.
The authors said while the discontinuation of donor support presents a significant hurdle, exploring alternative vaccine options and innovative strategies, such as a single-dose approach, could help ensure the continuation of vital cervical cancer prevention efforts in the country.
“As the nation prepares to transition from donor support, stakeholders are urged to collaborate to secure the health and well-being of Kenyan citizens,” they said.
The researchers hope that the findings from this study will guide Kenyan policymakers through future prioritisation, planning and implementation of a national HPV programme.
By February this year, only 1.7 million Kenyan girls had been vaccinated and only 876,800 (27.4 per cent) had received the second jab in February this year.
The Ministry of Health says it targeted to vaccinate 3.2 million girls by June this year.
Most vaccinations have taken place in Bungoma, Siaya, Vihiga, Nyamira, Taita Taveta, Kirinyaga, Nyandarua and Nyeri.
These counties have vaccinated at least 50 per cent of the targeted girls with a single dose.
The lowest vaccination levels are in Wajir, Garissa, Turkana, Isiolo, Mandera, West Pokot, Samburu and Marsabit counties, with only 20 per cent of targeted girls vaccinated.
HPV is most commonly spread during vaginal or anal sex. Only about 20 countries in Africa have introduced the vaccine.