Challenges of administering HPV vaccination against cervical cancer
Free vaccination against cervical cancer is currently ongoing in 16 states of the federation, including the Federal Capital Territory ( FCT). Unfortunately, the programme in some states is threatened by several challenges such as fake news that the jab is a con - spiracy from the West to reduce the fertility of Nigerian women, corrupt practices, unnecessary delays and out- of- stock syndrome. However, several l ocal and international studies have endorsed the jab to be safe and 99 per cent effective in preventing cervical cancer, writes MUSA ADEKUNLE.
THE plan by the Federal Government to immunise teenage girls against cervical cancer with Human Papillomavirus Vaccine ( HPV) is facing daunting challenges, as there is vaccine hesitancy or outright rejection by some parents due to fears that the jab is associated with contraception/ family planning.
The Guardian investigations revealed that some centres charge fees for the vaccine, which is supposed to be free, while some others easily run out of stock; and making patients wait for longer hours, days and even weeks to get vaccinated.
Indeed, since the introduction of the free dosage of the HPV vaccine into Nigeria’s routine immunisation system, in October 2023, the vaccination exercise has been inundated by a deluge of misinformation and misconceptions, leading to the hesitancy of some people to take the vaccine.
The first phase of the planned nationwide rollout covers 16 states including Abia, Adamawa, Akwa Ibom, Anambra, Bauchi, Bayelsa, Benue, Enugu, Jigawa, Kano, Lagos, Nasarawa, Ogun, Osun, Taraba and the Federal Capital Territory ( FCT).
According to the government, about 7.7 million girls are targeted for the f ree dosage. Though the vaccination programme has been going on since October at different primary healthcare centres across the country, however, some misconceptions about the vaccine are preventing many people from participating in the programme, similar to what was seen during the COVID- 19 vaccination.
There are claims that the West is using the HPV vaccine to reduce the population of Africa, the vaccine is a way to inject HIV into the bodies of young girls so that they could die in the future, and that Nigerian leaders have been sponsored to give up their country to their enemies.
These claims, which are shared on different social media platforms, especially Whatsapp in northern Nigeria, where audio recordings in Hausa are forwarded widely to individuals and groups are causing mass confusion and instilling fear in people.
There’s no evidence to support the claim that the HPV vaccine was introduced to control the population in Nigeria. This is a common myth spread in relation to most other vaccines introduced in the country. The polio and COVID vaccines were also accused of causing infertility, but many of those who took the shot have given birth and continued to be fertile.
Prof Akinyinka Omigbodun of Obstetrics and Gynaecology Department, College of Medicine, University of Ibadan told The Guardian, said that the fight against cervical cancer has been a tortuous one with unexpected turns, recalling that the first notable observation was to suggest that cervical cancer is sexually transmitted and its rarity among nuns in the 19th Century. According to him, it took more than one hundred years after that before it was proved that the human papilloma virus ( HPV) was responsible for more than 99 per cent of all cervical cancers. The next logical step was to find out if the prevention of HPV infection will lead to prevention of cervical intraepithelial lesions ( CIN), the precursors of cervical cancers.
The successful preparation of effective vaccines against the most common strains of HPV about 30 years ago made that type of research feasible. The outcome far exceeded scientists’ expectations. More than 95 per cent of pre- adolescent girls and boys who were vaccinated did not have detectable HPV infection in the subsequent years and practically none of the girls developed CIN.
According to him, “Calling HPV vaccine a game changer does not sufficiently describe its impact on reproductive health, it has made cervical cancer the first highly prevalent cancer that can be prevented by vaccination, and that has been the experience everywhere it has been introduced.
“Its introduction in Nigeria is something that Gynaecological Oncologists ( those of us who specialise in the care of cancers of the female reproductive tract) have been looking forward to. We expect that once more than 70 per cent of all adolescent girls are vaccinated in the country; we can prevent more than 90 per cent of the approximately 12,000 cervical cancers that are diagnosed in Nigerian women every year. That will mean preventing the deaths of nearly 8,000 Nigerian women in the most productive years of their lives. That is more than a “game- changer”, it is a lifeline to Nigerian women,” he added.
Speaking on insinuations that the jab is a conspiracy from the West to reduce fertility of Nigerian women, corrupt practice, Omigbodun, who is Past President, West African College of Surgeons ( WACS) stated that there is always a gap between the stage where scientists prove that a particular intervention is effective in solving a public health problem and when such measures are effectively implemented for the benefit of the public.
He said: “There are always obstacles to public health measures from the human factor. That is why the effective deployment of public health measure cannot be left to scientists or doctors, nurses and other healthcare providers alone; we need to involve those in the humanities ( sociologists, and anthropologists), community leaders and opinion leaders, including those who make the most effective use of social and mass media.
“The HPV vaccine will not be the first to face challenges before its wide acceptance and application. Such challenges were overcome with smallpox vaccination in the 1960s, and more recently, with polio vaccination among infants and under- fives in Nigeria. They will also be overcome with HPV vaccination. The myths and unfounded rumours are many, the most pernicious being that HPV vaccination would make the youth more sexually promiscuous or it could lead to infertility. Research done in other places has shown clearly that this is not the case. “Some of the research we have done here demonstrates very clearly that, with proper health education, young school girls and their parents are very willing to accept HPV vaccination. As for corrupt practices, that is something the health authorities, the Federal Ministry of Health and Social Welfare, the National Primary Healthcare Agency and the State ministries of Health, will need to provide effective field supervision to ensure that such corrupt practices do not take root or impede the rollout of the vaccination.”
The vaccine has also been approved by WHO and the National Agency for Food and Drug Administration and Control ( NAFDAC) for use in Nigeria. Both the Nigeria Centre for Disease Control ( NCDC) and WHO have certified the HPV vaccine as safe. It has been tested not only in Nigeria but in many other countries across the world. People in countries such as the United States, Brazil, and China have all received the vaccine.