Monday, June 3, 2024
[email protected]
London, UK

ollowing my 2 previous publications on the need for female genital cancer screening in Nigeria, I am inclined to write a rejoinder about the recently introduced HPV (Human Papilloma Virus} vaccine in Nigeria. This is to dispel the misconception that is circulating about this vaccine. I have watched and listened with utter discomfort and dismay, video and audio clips in the media about the harmful effects of HPV vaccine. Some have gone as far as claim that the so-called vaccine is designed to lower fertility rate amongst women and in the process reduce the population of certain ethnic groups in Nigeria.

The introduction of a vaccine into the population without adequate prior health education and counselling leaves room for misconception and the emergence of charlatans that purport to know the evil intentions of the government. In the United States and the United Kingdom HPV vaccine has been in use for several years. Families are appropriately counselled through family physicians, schools, health counsellor and the print media about the need for HPV vaccine for the eradication of cancer of the cervix. In the United States, this vaccine is available in grocery stores, for example Walmart to increase the uptake of this vaccine in the population. This vaccine was introduced in Senegal in 2018 and there has been improved uptake since then. The same applies to Ghana, Tanzania and several other sub-Saharan African countries.

What is Human Papilloma Virus (HPV)? This is a sexually transmitted disease that affects the cervix, otherwise known as the neck of the womb, the portion of the uterus that extends into the vagina. It can be transmitted through unprotected sex. HPV is responsible for over 80% of cancer of the cervix. It acts through its effect on the cells of the cervix.

Cancer of the cervix remains the second cause of cancer deaths in Nigeria, after cancer of the breast. Cancer of the cervix is a preventable disease. It can be prevented or detected in its early stage by the application of screening programmes. To the best of my knowledge, there is no government sponsored screening programmes for cancer of the cervix in Nigeria. In my previous publications on this subject, I discussed the need for the introduction of screening programmes in Nigeria with a view to eliminating the scourge of this disease. I am aware there are tertiary centres that treat cancer of the cervix in Nigeria. In my opinion, poor and at-risk individuals cannot afford the high cost of treatment. This makes screening programmes more cost effective. Since HPV is responsible for the majority of cervical cancer, screening for HPV has been incorporated into screening programmes, including pap smears.

The World Health Organization (WHO) has instituted strategies to eradicate cancer of the cervix by the year 2230. His approximates to six years from now. It is obvious that Nigeria cannot meet this target. This strategy includes:

  • 90% of girls are fully vaccinated with HPV vaccine by age 15 years.

  • 70% of women screened with high performance tests.

  • 90% of women identified with the disease are treated early.

It is unfortunate that of the 16 million cases of cervical cancer diagnosed annually, 70% will be in developing countries, notably Sub-Saharan Africa.

HPV vaccine (Gardasil-9, MERCK) is offered to girls aged 11 - 15 years. Boys can be vaccinated but because of scarcity of the vaccine, the emphasis is on girls to protect against HPV infection. Women up to age 45 years can be vaccinated but because of the likelihood of prior infection with the infection, it is of limited effect. HPV vaccine is not used for the treatment of the infection. In the UK, HPV vaccine is offered to 12 - 13 years old girls. The National Health Service (NHS) hopes to eradicate cancer of the cervix by 2040. Only one dose of the vaccine is offered. HPV vaccine does not cause infertility in women. Its complications are mild although it can cause allergic reactions similar to other vaccines.

This vaccine is safe. Since its introduction in 2008, millions of the vaccine have been given and it has significantly reduced the incidence of cancer of the cervix. With the current availability of the vaccine, Nigeria aims to vaccinate up to 7.7 million of girls within the age group 11 - 13 as recommended by the WHO. My advice is for parents to utilize this opportunity to get their daughters vaccinated. It is necessary in addition to advice on safe sex and avoidance of unprotected sex. Also vaccination does not eliminate the need for screening at the appropriate age.

Please do not listen to charlatans and other non-qualified individuals, propagating false and fake news to the general population. Make use of the opportunity while it lasts or you may regret a decision that is not backed by scientifically available data. Successful vaccination ptogramme saves thousands of lives and eradicates cancer of the cervix which remains a preventable disease.

A fellow of the Royal College of Obstetricians & Gynaecologists (FRCOG)

A fellow of the International College of Surgeons (FICS)

He is the author of Update on Female Genital Cancer Screening, Prevention better than cure &

Demystification of Uterine Fibroids. (Both in NigeriaWorld ).