Cervical cancer: What mothers need to know about HPV vaccination

Damilola John, a 14-year-old girl, is happy that she received the HPV vaccine at the Eti-Osa Local Government Primary Healthcare Centre.

“It doesn’t cause any harm to the girl child; rather, it will prevent having the HPV. I am happy and relieved that I got the HPV vaccine against cervical cancer,” retorted Damilola, who resides in Ajah, a suburb of Lagos State.

Although she is the youngest in her class, Damilola decided to take the HPV vaccine after listening to health talks by nurses at the Eti-Osa local government primary healthcare centre, where her mother sells things.

The nurses were talking to mothers on routine immunisation visits to the health facility about the importance of HPV vaccination and answering their questions about the vaccine.

Damilola declared, “Listening to them, I learned about the usefulness of the vaccine. It is to prevent cervical cancer in the future. I am happy that I took the vaccine. I want other girls to take the vaccination exercise seriously.

Lagos State introduced HPV vaccination on October 30, 2023, as part of the first phase of a country-wide HPV vaccination campaign targeting girls between 9 and 14 years old in schools and the community. Schools and primary health centres across the state were earmarked as vaccination points for wider and faster coverage.

The vaccination is taking place in two phases, starting with 16 states and later on in the other states, merely for convenience and not because HPV or cervical cancer is more prevalent in one part of the country than the other.

Speaking during a two-day media dialogue workshop tagged “Combating the most preventable form of deadly cancer affecting women and girls, a Health Specialist with UNICEF, Dr Ijeoma Agbo, declared that the HPV vaccine remains a crucial preventive step in reducing the possibility of girls and women dying from cervical cancer, the second most common cancer in women in Nigeria.

Dr Agbo stated that HPV is the most common viral infection of the reproductive tract and causes more than 95 percent of cases of cervical cancer.

She added that by merely looking at someone, it is not possible to predict a person with HPV because individuals with HPV may experience no symptoms.

Basically, HPV infects cells in the cervix (the lower part of the womb) and changes the way that they communicate with each other and the way they replicate; in some people, the infected cells multiply in an uncontrolled manner, leading to cancer.

According to Dr Agbo, an estimated 604,000 new cases of cervical cancer and 342,000 deaths from this cancer occurred globally in 2020, with 12,075 cases and 7968 deaths recorded in Nigeria.

She said: “HPV can also cause a range of conditions in men and women, including other types of anogenital cancer (vagina, vulva, anus, penis), head and neck cancers, and genital warts. It accounts for 29.5% of infection-related cancers globally and greater than half of all reported infection-attributable cancers in women.

“This high burden of cervical cancer is attributed to several factors, including poor access to HPV vaccination services, poor screening and treatment services, low awareness, and inadequate access to healthcare, especially in rural areas.”

The Immunisation Programme Coordinator, Lagos State Primary Health Care Board (PHCB), Dr. Adetola Akinpelu, declared in an update on HPV vaccination in Lagos State that the state was targeting 80 percent vaccination of girls between nine and 14 years old by December 2024.

According to him, “So for Lagos State, our target was 1,062,427 girls. These were the girls that fell within the age bracket of 9 years to 14 years. As of today, we have been able to vaccinate 478,528 girls with the HPV vaccine.

“We would assume that being educated would be a factor that would increase the uptake. But we could see that the Etiosa local government performed the lowest. And we would say that ETIOSA is probably the most elitist local government in the state.

“Out of the over 460,000 girls that were vaccinated, we had only 116 reports of reactions. And out of all these, only one was a serious case that required the girl to spend two days in the hospital, but she had been discharged, and she’s fine.”

Former health minister Professor Isaac Adewole declared that the HPV vaccine is the most effective way of preventing cervical cancer, and as such, there is no reason for parents to fear allowing girls to have the vaccine.

Professor Adewole declared: “This vaccine has been in use for over 15 years; it is safe, and no adverse effects have been demonstrated. These vaccinations have no serious side effects other than injection-site soreness, which is common as it is an injection.

“The fact that the vaccination is taking place in two phases, starting with 14 states and later on in the other states, is merely for convenience. It is not because HPV, or cervical cancer, is more prevalent in one part of the country than the other.”

The HPV vaccine is most effective when given to girls before they become sexually active, which is why the World Health Organisation recommends that it be given to girls between the ages of nine and 14, when most are not yet sexually active.

Misinformation and myths have been serious barriers to HPV vaccines. However, Mrs Aderonke Akinola-Akinwole, UNICEF Social and Behaviour Change Specialist, said this must be curtailed by all stakeholders so that every eligible girl, irrespective of location or circumstances, has access to the life-saving intervention.

The distrust in the system and a lot of misinformation that went around even on social media included that the “HPV vaccine promotes sexual promiscuity”; “only girls need the HPV vaccine”; “HPV vaccine is unsafe”; “HPV vaccine is only necessary for sexually active individuals”; and “HPV vaccine is not effective.”

But just one dose of the HPV vaccine provides powerful protection against the virus and cervical cancer—the fourth most common cancer among women. “Together, we are scripting a narrative of hope, resilience, and a healthier Nigeria; it is an opportunity to safeguard girls from the scourge of cervical cancers,” Akinola-Akinwole said.

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