Human papillomavirus (HPV) is a common sexually transmitted infection that can lead to a range of serious health issues, including cervical cancer. While the HPV vaccine is widely available in South Africa, access to the vaccine remains a challenge for many individuals, particularly in rural and low-income areas. Despite these challenges, there are opportunities to integrate HPV vaccination with other adolescent health services, such as family planning and reproductive health services [1]. By doing so, the program could become more effective in preventing HPVrelated diseases and improving health outcomes for adolescents [1].

Furthermore, self-collection for HPV-based cervical screening has emerged as a promising alternative to traditional clinician-collected screening. A recent qualitative evidence metasynthesis has shown that women prefer self-collection due to the convenience and privacy it provides [2]. By increasing access to screening, self-collection could lead to earlier detection of cervical cancer and improved health outcomes for women [2].

To address this issue, Cervi conducted a market research study aimed at exploring the current state of HPV vaccine access and utilization in independent pharmacies in South Africa. Over 135 pharmacies were surveyed to ascertain their support for improving access to the HPV vaccine using an online web prepayment and appointment platform [3,4].

These studies shed light on the challenges associated with HPV infection, the importance of integrating HPV vaccination with other adolescent health services, the potential benefits of self-collection for HPV-based cervical screening, and the efforts made to improve access to the HPV vaccine in South Africa [1-4]. By addressing these issues, it is possible to enhance prevention and early detection of HPV-related diseases, ultimately leading to improved health outcomes for individuals in South Africa.

Regenerate response. However, there are certain differences between the two:

1. Protection against HPV strains: Cervarix protects against two HPV strains (16 and 18) that cause about 70% of cervical cancers, while Gardasil protects against four HPV strains (6, 11, 16, and 18) that cause about 90% of genital warts and approximately 70% of cervical cancers.
2. Dosage and schedule: Cervarix is administered in three doses over a period of six months, while Gardasil is available in two different formulations, one that requires three doses over a period of six months and another that requires two doses over a period of six months.
3. Cost: Cervarix is generally less expensive than Gardasil, although the cost may vary depending on the country and the healthcare system.
4. Age range: Cervarix is recommended for girls and young women aged 9 to 25, while Gardasil is recommended for both boys and girls aged 9 to 45.
5. Protection against other diseases: Gardasil also protects against HPV strains 6 and 11, which cause genital warts, while Cervarix does not (Figure 1).

Figure 1: Provincial responses to Survey.

Overall, both Cervarix and Gardasil are effective vaccines that protect against HPV and related health issues; however the choice of vaccine may depend on factors such as age, cost, and specific protection needed (Figure 2).

Figure 2: How many cervical cancer vaccines do you keep in your fridge at any one time?

Market research study: Findings

1. All the pharmacies that participated in the survey were willing to accept payments in advance for HPV vaccines, which would lower demands on their cashflow to purchase these expensive vaccines.
2. Across the provinces surveyed, over 80% of the pharmacists confirmed that they do indeed offer HPV vaccination services in their pharmacy clinics.
3. Pharmacies indicating that they did offer HPV vaccines, Gardasil represented over 70% of the market share in SA.
4. Currently only 40% of pharmacies administer vaccines based on appointments, most of the pharmacies prefer walk-ins.

Our market research findings indicates that there is strong support for improving access to the vaccine using an online web pre-payment and appointment platform. It is imperative to continue efforts in increasing awareness of the importance of HPV vaccination and to address the barriers to access2021 that exist. Utilising online platforms for pre-payment and appointment scheduling could be the strategy to improve access to the vaccine and increase vaccination rates, particularly in underserved areas.

It is important for policymakers and healthcare providers to consider these developments in HPV screening and prevention, and we anticipate that the findings of this survey will contribute to ongoing efforts to improve HPV vaccine access and utilisation in South Africa and ultimately assist in reducing the challenge of HPV-related health issues.

1. Amponsah-Dacosta E, Blose N, Nkwinika VV, Chepkurui V. Human Papillomavirus Vaccination in South Africa: Programmatic Challenges and Opportunities for Integration With Other Adolescent Health Services. Front Public Health. 2022; 10: 799984.
2. Camara H, Zhang Y, Lafferty L, Vallely A, Guy R, et al. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health. 2021; 21: 1503.
3. Sarier M, Ceyhan AM, Sepin N, Ozel E, Murat Inal M, Kukul E, et al. HPV infection in urology practice. Int Urol Nephrol. 2019; 52: 1-8.
4. Sarier M, Sepin N, Emek M, Konuk EY, Kaplan T, Yuksel BA, et al. Evaluation of the optimal sampling approach for HPV genotyping in circumcised heterosexual men with genital warts. J Infect Chemother. 2023; 29: 475-480.