Is HPV Vaccination Safe For Our Girls? By Carl Umegboro
Lagos State is the most populous state, the commercial capital of the country and economic hub of West Africa having held the status of the federal capital territory from 1968 until 1991. By these distinct attributes, Lagos is arguably, a pacesetter, thus nicknamed ‘Centre of Excellence’. It therefore places a high demand on the state to be in the lead of every positive programme that can contribute to the wellbeing of citizens particularly its residents. Unfortunately, the reverse is the case vis-à-vis the recent November 2023 report released by National Primary Health Care Development Agency (NPHCDA) on Human Papillomavirus popularly known as HPV. The Human papillomavirus (HPV) is responsible for about 95% of cervical cancer. HPV is the most common STI (sexually transmitted infection) globally, with an estimated 80% of sexually active individuals infected at some point in their lives. The cervix is the lower part of the uterus (womb), cervical cancer occurs when there is uncontrolled growth of abnormal cells in the cervix.
According to science, HPV causes six types of cancer namely; cervical cancer up to 91%; anal cancer – 91%; vulvar cancer – 69%; virginal cancer – 75%; oropharyngeal cancer – 72%; and penile cancer – 63%. Most HPV infections are asymptomatic; about 90% of the infections may clear within two years, but some infections continue. Infection that continues can progress to cervical cancer with specific types of HPV (particularly types 16 and 18). This progression takes 20 years on average and tends to cause symptoms only after the cancer has reached an advanced stage. It is held that long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer.
In Nigeria, cervical cancer is the second most common cancer in women, accounting for approximately 16% of all female cancers. Globally, Cervical cancer is the fourth most common cancer among women with an estimated 604,000 new cases and 31,421,000 deaths annually. Cervical HPV infection also affects male gender though in very low percentage. Nigeria has a population of 56.2 million women ages 15 years and older who are at risk of developing cervical cancer. According to the World Health Organization (WHO), Nigeria has an estimated 12,075 new cases of cervical cancer and 7,968 deaths from the disease each year. Cervical cancer is the second highest occurring cancer in Nigeria amongst women. Current estimates indicate that every year, 12,075 women are diagnosed with cervical cancer and 7,968 die from the disease. It ranks as the second most frequent cancer among women in Nigeria and the second most frequent cancer among women between 15 and 44 years of age.
Furthermore, about 3.5% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 66.9% of invasive cervical cancers are attributed to HPVs 16 or 18. Human papillomaviruses (HPV) are double-stranded DNA viruses that can cause both benign diseases, precancerous lesions and invasive malignancy. Collectively, there are over 170 types, with 12 currently classified as carcinogenic. HPV-16, HPV-18, HPV-31, HPV-33, HPV-35, HPV-41, HPV-52 and HPV-58 are the most important globally. HPV types are often referred to as “non-oncogenic” (wart-causing) or “oncogenic” (cancer-causing), based on whether they put a person at risk for cancer. Characteristically, HPV infects the basal keratinocytes of genital mucosa, oral mucosa and skin and is predominantly spread by sexual contact and recurring infection may risk carcinogenesis.
As a remedy, HPV vaccination is safe and effective. From verifiable records, more than 135 million doses of HPV vaccines have been distributed since they were licensed, and data continue to show that the vaccines provide safe, effective, and long-lasting protection against cancers caused by HPV. The six HPV vaccines currently pre-qualified by WHO are; Gardasil 4, Cervarix, Cecolin, Walrinvax, Cervavax and Gardasil 9. For instance, Gardasil was studied in clinical trials with more than 29,000 females and males. Also, Cervarix was studied in clinical trials with more than 30,000 females, and were found to be safe and effective in clinical trials. However, common reported AEFIs (Adverse event following immunizations) are: Local effects – redness, local pain and swelling in the injection site. On General effects (seldom) are: dizziness, headaches, fever, muscle pain, joint pain, abdominal pain, diarrhea, nausea, vomiting, general bad feeling and weakness
Now, in a phase cumulative coverage by states for HPV vaccination rate using MAC campaign targets (80% of target point), data as at November 16, 2023 shows as follows: Taraba – 98%, Akwa Ibom – 97%, Nasarawa – 93%, Abia – 93%, Kano – 92%, Bauchi – 87%, Jigawa – 87%, FCT – 84%, Adamawa – 83%, Osun – 82%, Kebbi – 80%, Enugu – 74%, Ogun – 70%, and Lagos – 31%. Source: NPHCDA.
From the above, Lagos record of 31 percent against a target point of 80 percent is not cheering. The question is what happened this time? Could that be a nonchalant attitude or defiance or inadequate information about HPV vaccination. Whilst Taraba, Akwa Ibom, Nasarawa and Abia states struggled for lead in the record, three states that did not meet the target point are Enugu (74%); Ogun (70%) alongside Lagos with 31%. Lagos by its strategic position in the scheme of things in the nation has the highest number of visitors and tourists on a daily basis, and therefore such a poor attention to health issues as this may be dangerous to human existence due to the tendency of transmission of disease from one person to another. This is dangerous.
As a matter of fact, any infectious disease in Lagos can be speedily transmitted to other states and beyond without delay due to the high number of tourists in the state in-and-out every day. The margin between the two states (Enugu and Ogun States) that also didn’t meet the target compared to Lagos is so wide that a question needs to be asked on what happened. Thus, only Lagos policymakers can provide accurate answers. To call a spade a spade, this record is incompatible with the status of ‘Centre of Excellence’ which Lagos is known for. A state like Lagos should lead and not the other way round. People’s health and wellbeing matters, and a stitch in time saves nine!
Umegboro, public affairs analyst and social advocate writes from Abuja via [email protected]
