Title: Iran’s Health Experts Advocate for HPV Vaccine Inclusion in National Program
In a significant development within Iran’s public health sector, recent statements by the Deputy Minister of Health regarding the HPV vaccine have sparked a robust professional dialogue. While the vaccine is not yet part of the country’s routine immunization schedule, medical experts are actively discussing its potential integration, citing global health standards and the nation’s robust healthcare capabilities.
The Global Standard for Vaccine Adoption
Dr. Ali Motlaq, a hematologist-oncologist and faculty member at Shahid Beheshti University of Medical Sciences, outlined the six key global criteria used to evaluate any vaccine for a national program: disease burden, vaccine efficacy, cost-effectiveness, program feasibility, sustainable supply, and social acceptance. He emphasized that the Human Papillomavirus (HPV) vaccine must be assessed against these rigorous, scientific benchmarks.
1. Assessing the Disease Burden
A common misconception, according to Dr. Motlaq, is evaluating the need based solely on the current rate of cervical cancer. The primary indicator should instead be the prevalence of HPV infection itself. While cervical cancer rates are currently low, studies indicate a significant and concerning prevalence of the HPV virus in Iran.
Dr. Motlaq clarified, “HPV is linked to at least six types of cancer—including cervical, anal, and oropharyngeal—as well as benign conditions like genital warts. These place a considerable combined burden on our health system.” He further cautioned that the cancers seen today are the result of infections from 10-15 years ago, and with changing social behaviors, proactive planning for the future is essential.
2. Undeniable Vaccine Efficacy
The efficacy of the HPV vaccine in preventing related cancers and diseases is well-established. Dr. Motlaq confirmed, citing extensive global research, that the vaccine is over 90% effective, making it one of the most powerful tools in preventive oncology.
3. A Holistic View on Cost-Effectiveness
Cost-benefit analyses must extend beyond cervical cancer to include all HPV-related malignancies and benign diseases. “The treatment costs for genital warts and HPV-related cancers impose a significant financial burden on the health system,” Dr. Motlaq explained. He noted that achieving optimal cost-effectiveness involves negotiating appropriate price thresholds with domestic and international suppliers, a step supported by global studies confirming the vaccine’s cost-effectiveness in diverse economic settings.
4. Feasibility of a National Rollout
Iran possesses one of the region’s strongest healthcare networks, fully capable of administering the HPV vaccine to the target age group of 9-14 year-old girls. The existing infrastructure of health centers and routine vaccination programs provides a ready platform for implementation without major logistical challenges.
5. Ensuring a Sustainable Supply
The concern of a stable vaccine supply is mitigated by the presence of at least two domestic producers within Iran. Furthermore, the adoption of a single-dose strategy for recipients under 20 years of age would further alleviate supply chain pressures, ensuring sustainability.
6. Widespread Social Acceptance
On the matter of social acceptance, Dr. Motlaq pointed to the high existing demand, with many citizens actively seeking the vaccine for themselves and their children. Addressing a common concern, he stated, “Various studies in both developed and developing nations have shown that HPV vaccination does not lead to an increase in high-risk sexual behaviors.” He highlighted that numerous other Muslim-majority nations, including Indonesia, Malaysia, Qatar, Saudi Arabia, and the UAE, have already successfully incorporated the vaccine into their national programs.
The Case for National Inclusion
With 147 countries having included the HPV vaccine in their national programs by the end of 2024, Dr. Motlaq emphasized the need for policy review. A national program is paramount, he argued, because HPV prevalence is often higher in lower socioeconomic groups—populations that cannot afford private sector vaccines yet are central to curbing the virus’s spread. Integrating the vaccine into the national schedule aligns with the principle of universal health coverage, ensuring support for all citizens.
Dr. Motlaq proposed that knowledgeable experts continue dialogue with the Ministry of Health, stressing the viability of a single-dose program and the potential for successful price negotiations with producers to reach a cost-effective threshold for Iran.
Awareness and Screening: Complementary Strategies
Alongside efforts for vaccine inclusion, Dr. Motlaq noted the necessity of continuing public awareness campaigns about preventing HPV infection through informed health choices. He also advocated for the expansion of HPV screening programs within the national health network, supported by the government and insurance organizations, as a critical complementary measure until a nationwide vaccination program is established.