IMMUNISATION WEEK: Why your daughter should get the HPV vaccine

In October 2009, Kenya became the 16th country in Africa to introduce the Human Papilloma Virus (HPV) vaccine into its routine immunisation schedule. This vaccine targeted 800,000 girls aged 10 years. The vaccine is meant to help nip cervical in the bud.

According to the World Health Organization, HPV is medically attributed as the most prominent single contributor to cervical cancer. The virus plays the most central role in the development of this type of cancer. Currently, there are about 100 types of HPV. At least fourteen of these HPV types cause cancer. Two HPV types, known as 16 and 18, cause seventy percent of cervical cancers and cervical lesions.

In Kenya, the Ministry of Health estimates that 5,250 women are diagnosed with cervical cancer. According to the Kenya Human Papillomavirus and Related Cancers Fact Sheet 2018, cervical cancer claims every 3,286 women every year. This translates to about nine cervical cancer deaths every day.

Cervical cancer is currently ranked as the second most common cancer among women in the country. It is also ranked as the topmost common cancer among women aged between 15 and 44 years. Globally, cervical cancer is the fourth most common cancer in women. In 2018 alone, 18.1 million new cases were diagnosed worldwide with 9.6 million deaths reported.

The WHO says that there are three types of HPV vaccines. These include the bivalent, the quadrivalent, and the nonavalent vaccine. “All three vaccines are highly efficacious in preventing infection with virus types 16 and 18, which are together responsible for approximately 70 percent of cervical cancer cases globally,” says the WHO. “The vaccines are also highly efficacious in preventing precancerous cervical lesions caused by these virus types.”

The WHO explains that the quadrivalent vaccine is also highly efficacious in preventing anogenital warts, which is a common genital disease that is almost always caused by infection with HPV types 6 and 11. “The nonavalent vaccine provides additional protection against HPV types 31, 33, 45, 52, and 58,” states the WHO.

Guidelines from the WHO show Kenya was right to target girls aged ten years. “The primary target group for HPV vaccination is young adolescent girls, aged 9-14,” the global health body recommends.  According to the Centre for Disease Control (CDC), though, it is also highly recommended that teens and young adults through the age of 26 years who didn’t start or finish their HPV vaccine schedule also take HPV vaccination.

Why does vaccination target young girls?

The HPV vaccination is most effective when administered to girls before they are sexually active. “Since HPV is a sexually transmitted disease, vaccination has to start before the onset of sexual activity,” Professor Mansoor Saleh, the chairman of the Haematology-Oncology Department at Aga Khan University Hospital, told Healthy Nation in a recent interview. He explains that the vaccine stimulates the human immune response to develop protective antibodies that fight off the virus in case of an infection. “The vaccine targets the HPV subtypes, which are accountable for more than 70 percent of cervical cancers,” he says.

How the vaccines are taken

According to the WHO, the three HPV vaccines are to be administered based on the age of the girl taking the immunisation. For instance, the WHO recommends that:

• Girls who are less than 15 years old at the time of the first dose should take a 2-dose schedule at 0 to 6 months intervals. “If the interval between doses is shorter than 5 months, then a third dose should be given at least 6 months after the first dose,” states the WHO.
• Girls who are 15 years old and above at the time of the first dose should take three HPV doses at intervals of 0, 2, and 6 months.

The CDC adds that the first dose is routinely recommended at ages 11–12 years old. However, vaccination can be started when the girl is aged 9 years. If the first dose was given before the girl’s 15th birthday, they may only need two doses of the vaccine.

There are certain exemptions during which your daughter should not take this vaccine. The CDC states that your daughter shouldn’t take this vaccine if they:

• have ever had a life-threatening allergic reaction to any ingredient of an HPV vaccine, or to a previous dose of the HPV vaccine.
• have an allergy to yeast.
• are pregnant.

The CDC also says after taking this vaccine, your daughter may experience any or a combination of these side effects:

• Pain, redness, or swelling in the arm where the shot was given
• Fever
• Dizziness or fainting
• Headache or feeling tired
• Nausea
• Muscle or joint pain

“Fainting is a common side effect among teenagers. To prevent this from happening when your teen takes the HPV vaccine, let them stay seated or lie down during vaccination, and for 15 minutes after vaccination,” the CDC says.

How effective is the HPV vaccination?

According to the World Health Organization, the HPV vaccination can prevent more than 90 percent of cancers that are caused by HPV infections. This is echoed by the CDC which states that with the administration of the HPV vaccine, infections that cause most HPV cancers and genital warts drop by as much as 88 percent among teenage girls and 81 percent among young adult women. “The HPV vaccination has also reduced the number of cases of pre-cancers of the cervix in young women,” the CDC states.

Interestingly, this vaccine is designed to offer long-term protection. “People who received HPV vaccines were followed for at least about 12 years, and their protection against HPV has remained high with no evidence of decreasing over time,” the CDC states.