Every day we continue to chalk up yet another mortality of some sort to Covid-19. From family members to halted projects or lost jobs, we continue to feel the aftershocks of the calamity of the pandemic.
Recently, yet another “victim” who had “succumbed” to Covid has been discovered.
The “victim” is the national immunisation programme for HPV. HPV, or the human papilloma virus, is the major causative agent for cervical cancer. Luckily, this infectious, cancer-causing agent can be prevented via immunisation via a game-changing vaccine which has now been available for more than a few decades now.
Once provided with vaccination (mostly in their early teens), girls stop being infected with the strains of HPV that can lead to them developing cervical cancer. Truly, this has been touted as a game-changer as one of the few ways to actually eliminate an entire cancer altogether.
Malaysia has been one of the few early adopters of the HPV vaccination programme. Thanks to the health ministry’s visionary teams at the time, in 2010, we began giving the vaccine free to 13-year-old secondary school girls. Since they were being given the vaccine at this age, we even saved quite a bit of costs since, at that age, we only needed to give them two doses for complete vaccination instead of the three doses needed for women taking the vaccine at an older age.
Things had been going fine – until Covid-19, of course. The moment schools were closed due to Covid-19, the programme was naturally shut down. However, despite schools coming back on to full strength in terms of classes and other activities, the vaccination programme does not seem to have returned to full strength.
A team from UKM recently published a paper highlighting this, postulating that at least half a million girls may be unvaccinated due to the halt as a result of the pandemic. In addition, social media has also been getting more and more queries from concerned parents on whether their children will get their HPV vaccine shots.
In order to get a clearer picture, the National Cancer Society of Malaysia, NCD Malaysia, the Malaysian Medical Association Public Health Society and other civil society partners ran a quick ground-level survey. Randomly sampling a secondary school at each of the 162 districts of the 13 states and three federal territories of the whole country, it was determined that in 2020, 2021 and 2022; 58.0%, 72.2% and 79.6% of the districts in Malaysia did not report HPV vaccination being done in their secondary schools. (You can read the full policy brief at here).
So why is this entire issue of any relevance? Do we truly need to be worried about whether these girls are vaccinated or not? Is it life threatening? Is this something we even need to be spending on at this time of economic difficulty?
The answer to all these questions, unfortunately, is a yes. Not vaccinating these 13-year old teenage girls mean that we are exposing them to an increased risk of cervical cancer, a life-threatening problem which they may never have had to contend with in their lifetimes … but now again will be hovering over them like a sword of Damocles.
A study modelling the impact of the delay of HPV vaccinations among teenagers in the US projects an increase in up to thousands of new cases of cervical cancer, and an increase in the hundreds of thousands of cases of women developing early pre-cervical cancer lesions.
If the numbers in terms of lives saved alone are not enough, then there is also a huge amount of money that can and should be saved by pushing out the programme as early as we can, especially through a catch-up programme to vaccinate those who have not been vaccinated in this 2020-2022 period.
Vaccinating these 13-year old teenage girls early means that we would only need to give them two doses instead of the three they would require once they turn older than 15 years old. This would mean a huge savings in terms of the hundreds of thousands of doses which would now be additionally required, translating into savings in the millions of ringgit.
So what does the country need to do? Two things. First, reenergise and restart the HPV vaccination programme in secondary schools. Second, organise a catch-up programme for those who have been left behind during the gap years of 2020-2022.
For both of these to happen, additional resources need to be made available, and this is perhaps a timely ask as Budget 2023 is about to be tabled in about one month.
This ask is particularly timely in view of the Global Week for Action on NCDs, which is next week (between Sept 5 and 11) and its theme Invest to Protect.
We need to invest the resources in order to protect our children from the threat of cervical cancer. It was unfortunate that we had to forego the programme during the time of the pandemic. But it is sorely amiss if we continue doing so now.
If you are supportive of this call to restart HPV vaccination, assist by signing a petition at here.
The views expressed are those of the writer and do not necessarily reflect those of FMT.