July 2022, Volume 72, Issue 7

Student's Corner

Fostering the need of HPV Vaccination Programmes in Pakistan

Sareema Eman Akhtar  ( 4th Year MBBS Student, Ziauddin Medical College, Karachi, Pakistan. )
Saad Shakil  ( 4th Year MBBS Student, Ziauddin Medical College, Karachi, Pakistan. )

DOI: https://doi.org/10.47391/JPMA.5371

 

Respected Mam, In Pakistan's female population of 112 million,1 Human Papillomavirus (HPV) has caused devastating results of cervical cancer in females aged fifteen years and older. Being the second most common cancer in females aged fifteen to forty-four years and third most common cancer amongst females, current statistics estimate 5000 victims and 3000 deaths annually due to HPV.2,3 This is becoming a huge burden and needs to be acknowledged.

HPV, a circular double-stranded DNA virus, is a common infection of the reproductive tract. Worldwide accepted strategies to reduce the burden of this deadly virus is through vaccines and screening. Due to the uneven distribution of this lethal virus. there are currently three vaccines available that were approved by Food and Drug Administration (FDA) back in 2006, 2009 and 2014, namely Gardasil, Cervarix, and Gardasil-9, respectively.4  CDC has endorsed the need for two doses of the vaccine. At the age of 11-12, The first dose can also be given at 9 years followed by a second dose with an interval of 6-12 months.5  However, in a developing country like Pakistan, HPV vaccination programmes are still a challenge due to lack of awareness amongst the population and inconsistent efforts by the healthcare system in providing the screening and vaccination strategies. Many other factors are related with this gross burden: the availability of the vaccines, insufficient funds and various collateral factors associated with the spread of rumours through social media. A study recently proved the strength of vaccination at a young age.  It concluded that females’ inoculation at the age of 12 to 13 years significantly reduced the risk of grade 3 cervical intraepithelial neoplasia (CIN).6  Centres for disease and control and prevention (CDC) has stated that the majority of the people who are unvaccinated and sexually active will get HPV during their lives. Therefore, there is an essential need to vaccinate children below the age of fifteen years so that 33,000 of these cancers can be prevented that are caused by this infection.

Since, cervical cancer is a public health problem, a global strategy for its elimination was inaugurated in 2020 by WHO. Despite the worldwide challenges, WHO did not take a step back and continued its challenging efforts. However, situation in Pakistan did not improve. Despite the logistical uncertainties and economic burden to educate our females and children, more importantly, the parents should be aware of severe complications of HPV so that unforeseen future can be healthy and prosperous. Discrimination in knowledge based on gender should be avoided and ample supply of vaccines should be provided to developing countries like Pakistan.

 

Disclaimer: None.

 

Conflict of Interest: None.

 

Funding Disclosure: None.

 

References

 

1.       Pakistan population (2022) live — Countrymeters. [Online] [Cited 2022 Feb 11]. Available from: URL: https://countrymeters.info/ en/Pakistan

2.       Human Papillomavirus and Related Diseases Report PAKISTAN. [Online] [Cited 2021 Nov 5]. Available from: URL: www.hpvcentre.net

3.       II. Complementary data on cervical cancer prevention Figure 2. Estimated coverage of cervical cancer screening in Pakistan, by age and study. [Online] [Cited 2021 Nov 5]. Available from: URL: www.hpvcentre.net

4.       Kombe AJK, Li B, Zahid A, Mengist HM, Bounda G-A, Zhou Y, et al. Epidemiology and Burden of Human Papillomavirus and Related Diseases, Molecular Pathogenesis, and Vaccine Evaluation. Front Public Health 2021; 8: 552028.

5.       HPV Vaccine. Human Papillomavirus (HPV). CDC. [Online] [Cited 2021 Nov 5]. Available from: URL: https://www.cdc.gov/hpv/parents/ vaccine-for-hpv.html

6.       Falcaro M, Castañon A, Ndlela B, Checchi M, Soldan K, Lopez-Bernal J, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet 2021; 398: 2084-92.

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