Nearly 1.5 million teenage girls in some of the world's poorest countries will be protected from cervical cancer as pharmaceutical company Merck & Co. says it will not be able to deliver millions of promised doses of the HPV vaccine this year. You will lose the opportunity.
Merck has given only 18.8 million of the 29.6 million doses it had contracted to supply in 2024 to Gabi, an international organization that helps provide life-saving immunizations to low- and middle-income countries, and UNICEF, which procures vaccines. Gabi said they have notified them that they will be supplied. He said.
This means more than 10 million girls will miss out on the HPV vaccination they expected this year, and 1.5 million of them will be too young to be eligible for the vaccine in the coming years. Because of this, he will probably never be vaccinated.
Merck spokesman Patrick Ryan said the company “experienced a manufacturing disruption” and had to manually store and retest many doses. He did not provide details about the cause of the delay.
“We are acting urgently and rigorously to deploy additional personnel and resources to resolve this issue as quickly as possible,” he said.
Ryan said Merck will deliver the delayed portion in 2025.
He also said the company will ship 30 million vaccine doses to Gavi-supported countries this year. However, about a third of these are doses that were supposed to be delivered in 2023, leaving Gabi with a shortfall of 10.7 million doses.
The delay is a major setback for countries that have already waited years to start vaccinating girls against HPV (human papillomavirus), which causes an estimated 90% of cervical cancers.
According to the World Health Organization, approximately 350,000 women die from cervical cancer each year. 90% of them live in low-income countries, where regular testing for the disease is rare. This vaccine provides her with almost complete protection against HPV infection and is the only vaccine against cancer.
“HPV is the most effective vaccine developed by Gavi. Vaccinating 1,000 girls will prevent 17.4 future deaths,” said Dr. Aurelia Nguyen, Gavi's Chief Program Officer. said. “If there's one vaccine he wants to develop and make effective, this is it.”
WHO recommends vaccination for girls up to the age of 14. The delay means girls who are now 14 years old in countries including Sierra Leone, Burkina Faso and Mozambique will not be eligible for vaccination when these campaigns eventually begin.
The HPV vaccine is linked to sexual activity and is a taboo topic for teenagers in many cultures affected by the delay, and because routine immunizations are given to children outside the usual age range, the vaccination is It's complicated. Both girls and their parents need to be willing to vaccinate, which requires clear messages distributed across a variety of media to drive demand. For the vaccine to be effective, girls must be vaccinated before they become sexually active.
Dr. Nguyen said the health systems in the affected countries are some of the least resourced in the world. She said they were investing in plans for the scrapped HPV campaign, juggling other urgent vaccination needs such as measles and cholera, and could not afford any disruption.
This delay will disrupt carefully laid plans to get vaccinations back up. Most of the vaccination delays have been for so-called “multi-age cohorts,” where countries are targeting unvaccinated girls aged 9 to 14 alongside standard immunization programs for 9-year-olds. We are trying to vaccinate everyone. – year old children, usually carried out at school.
Most high-income countries routinely vaccinate both girls and boys with the HPV vaccine, but global vaccination coverage is only 20 percent.
Gabi has been working to expand HPV vaccination for more than a decade. Many low-income countries had planned programs to start in 2018, but even then Gavi was unable to receive the vaccine. This is because Japan and UNICEF are competing in the global market and suppliers have not increased production to meet Gavi's projected demand.
The version of the Merck HPV vaccine used in the United States costs about $285. UNICEF typically negotiates steep discounts from drug companies, paying between $3 and $5 per dose for the large quantities of vaccines it seeks to procure.
“UNICEF and Gabi have struggled for years to obtain sufficient supplies, but things are finally starting to change,” said Andrew Jones, UNICEF's Deputy Director for Immunization Supplies.
Although UNICEF has contracts with other suppliers, the Gavi program relies on Merck's supplies because of the high demand for Merck's products in different countries. This means the delay will disrupt vaccination campaigns in six countries, many of which have already been forced to postpone repeatedly.
“It's affecting confidence in countries, because for years they've been told they don't have enough supply, but when they finally do have it, countries are campaigning, they're going through politics,” Jones said. We received support from many people, and now the delivery is delayed by six to eight months.” He said.
Merck's Ryan said the company is committed to supporting efforts to vaccinate millions of girls in developing countries with HPV vaccines and has invested more than $2 billion in that effort.
Ryan said the company will distribute the delayed vaccine next year, but Merck has not yet told Gavi when countries can schedule its distribution. That means Merck can't start planning new campaigns yet.
Countries that will not receive vaccinations this year include Mozambique, Sierra Leone, Ivory Coast and Burkina Faso. In addition to routine vaccinations for 9-year-olds, they intended to carry out a multi-age blitz operation aimed at capturing as many girls as possible. The regular program will continue using doses provided by Merck.
Additionally, in Burundi and Asia, Tajikistan was scheduled to receive supplies to begin both multi-age and routine vaccinations later this year, while Cameroon and Liberia were expected to receive supplies to begin both multi-age and routine vaccinations. It was scheduled to be supplied. – Vaccinations will be administered early in the new year. All of these campaigns will be postponed.
Girls who are not vaccinated this year are among the least likely in the world to be screened and treated for cervical cancer, says the director of the HPV vaccine program at a Dakar-based health-focused nonprofit organization. said one Dr. Kathy Ndiaye. Organization path.
“In some countries you can say, 'Okay, I haven't had the vaccine, but if something happens in the future, you can go and get treatment,' but that's not the case with these girls,” Ndiaye said. the doctor says.
This delay also complicates the challenge of maintaining political and community support for HPV vaccination, she said.
“When you have momentum, you want to capitalize on that. If you can create demand from the community, you want to provide and provide what they need,” she said. “Even at a national level, we have to convince them that this is important and that it should be a priority, because they are not aware of cervical cancer, they are not aware of this disease right now. They say, 'No, let's deal with polio, let's deal with polio.''' Dealing with measles is urgent now. ”
Mozambique had planned to launch a multi-age campaign in June. “There is a huge demand and people are asking for it,” said Bethuel, whose global nonprofit focused on health and education is working to support routine immunization in Mozambique through JSI. Dr. Sigauke said.
Merck also said it was unable to deliver 7.7 million vaccine doses to Ethiopia that were scheduled to arrive late last year and will now arrive in June. The country had to cancel school campaigns scheduled for the spring. Instead, the campaign will run later this year and will make girls nostalgic as they age.