HOW SAFE IS HPV VACCINATION FOR GIRLS?

Lagos State is the most populous state in Nigeria. It is also the commercial capital of the country. 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, 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 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 aged 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. Current estimates indicate that every year, 12,075 women are diagnosed with cervical cancer and 7,968 die from the disease. 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 are 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%.

From available data Lagos records 31 percent against a target point of 80 percent. This is not cheering. The question is what happened this time? Could that be a nonchalant attitude or defiance or inadequate information about HPV vaccination?

As a matter of fact, any infectious disease in Lagos can be speedily transmitted to other states and beyond due to the high number of tourists in the state. A state like Lagos should lead and not the other way round. People’s health and wellbeing matters.

Carl Umegboro, Abuja