Visiting Consultant dispels daunting HPV concerns

Oct 04, 2017 News

– as Ministry launches national HPV vaccination programme

The side-effects of the Measles, Mumps and Rubella [MMR] vaccine that babies are administered have been found to be more daunting than those associated with the vaccine that can help prevent the Human Papilloma Virus [HPV].

From left: Dr. Vikash Chatrani, Dr. Samantha Kennedy and Dr. Oneka Scott

This state of affairs was emphasised yesterday by visiting Consultant Obstetrician, Gynaecologist, Dr. Vikash Chatrani. Dr. Chatrani, an Associate Lecturer at the University of West Indies, was the keynote speaker when the Ministry of Public Health in collaboration with Merck, Sharpe and Dohme [MSD], held a HPV sensitisation meeting at the Kingston, Georgetown Pegasus Hotel.
The target audience for the meeting were health workers within the public health system. The meeting served as the official countrywide launch of the HPV programme which was first piloted in 2012 by the Ministry of Health.
HPV Dr. Chatrani said, has been found to be responsible for over 95 percent of cervical cancer cases. He noted that while HPV can be transmitted sexually, it can also be transmitted by skin contact.
He moreover noted that, “The same way we know that lung cancer is mainly caused by smoking, we ban smoking [and] we prevent lung cancer. How do we prevent cervical cancer? We prevent HPV transmission…”
Even as he underscored that cervical cancer is the leading cause of cancer deaths here in Guyana, Dr. Chatrani sought to dispel reports that the vaccine has also had adverse effects.
Quoting information from the Centres for Disease Control and Prevention [CDC], Dr. Chatrani said that the side-effects of the MMR vaccine include: fever, mild rash, swelling in the gland, cheek or neck, seizures caused by fever, temporary pain and stiffness in the joints, temporary low platelet count which can cause a bleeding disorder.
There are even more severe problems associated with the MMR vaccine, he revealed. There are serious allergic reaction, deafness, long term seizures, coma and even permanent brain damage.
But according to Dr. Chatrani, these side-effects have not prevented parents in the past from allowing their children from accessing such vaccines.
The symptoms of HPV vaccine include, like most vaccines, soreness, swelling and redness at injection site, fever, nausea and dizziness.
But there were individuals who were opposed to Guyana introducing the HPV vaccine, Gardasil, to school-aged girls to help prevent the virus which is known lead to cervical cancer.

A section of the gathering of health workers and other officials at yesterday’s forum.

An opposing group had opted to make public their concerns by picketing outside the Ministry of Health ahead of the launch of a pilot HPV programme. But according to Dr Chatrani, such moves are not unique to Guyana as similar activities materialised in his home territory [Trinidad] when an HPV vaccination programme was launched there some years ago.
“When you send home a consent form to a parent to sign something for their child to receive [a vaccine], any good parent is going to go and check up the information on the internet…the same thing with the HPV.
But they don’t check the MMR vaccine because at two months and three months, in their minds, the child has to get the vaccine, it has become part of life,” said Dr. Chatrani.
Guyana, according to Focal Point for Adolescent and Health within the Public Health Ministry, Dr. Oneka Scott, has been offering the HPV vaccine for girls between the ages of nine and 16 before their sexual debut.
Although there are some 100 types of the HPV virus, Dr. Scott explained that the vaccine [Gardasil] that is being used here is known to protect girls against types 16 and 18 that are known to cause 70 percent of cervical cancer. The vaccine has also been known to protect against type nine and 10 and even HPV type six and 11 which cause about 90 percent of genital warts.
In Trinidad, the HPV vaccine is being offered to males and females even beyond the teenage stipulation Guyana has embraced.
Even as she spoke about the importance of the HPV vaccine, Dr. Scott questioned, “If you had a chance to prevent suffering for a patient would you not? If you had a chance to prevent cancer would you not? That is for you to internalise…If you had that decision to make for your daughter and then maybe later on for your Guyanese son, to protect them against HPV would you not?
“Or would we wait until they fall into that state that we have that says that 27 out of 100,000 of our women die…That’s one too many women,” Dr. Scott asserted yesterday.
According to Dr. Samantha Kennedy, who spoke on behalf of Minister within the Ministry of Public Health, Dr. Karen Cummings, based on statistics approximately two-thirds of all cases of cervical cancer occurred among women below 60 years of age and the highest percentage among the 15 – 39 year age group.
Dr. Kennedy was at the time making reference to the Ministry of Public Health’s Surveillance Report [2003-2012] which was completed by Dr. Morris Edwards who was able to secure his information from the Cancer Registry.
“The data demonstrated that a mere four percent of cervical cancer occurring among Guyanese women over a 10-year period were diagnosed at stage one. The majority of the patients were diagnosed at stage four which contributed to the average annual mortality [27 per 100,000],” Dr. Kennedy explained.
It was in light of alarming global statistics presented by the World Health Organisation, Dr. Kennedy said that the Technical Advisory Group on immunisation in 2016 recommended that all countries in the Americas introduce the HPV vaccine.
In adherence, the Public Health Ministry followed the recommendation by the Pan American Health Organisation/World Health Organisation and was among the first countries in the Caribbean to pilot the HPV vaccination programme.
The evaluation of the pilot, accord to Dr. Kennedy, demonstrated very high uptake for the first dose of the vaccine and a very low uptake for the second and third doses of the vaccine. She however did not venture to correlate concerns about the vaccine with the low uptake.
She did stress, “The administration of the vaccine to girls is part of a comprehensive plan that was developed by the Ministry of Public Health to reduce the mortality due to cervical cancer.”
With the launch of the countrywide HPV programme, the goal is to achieve a minimum of 95 percent coverage of the target population.
But even with the vaccine being administered nationally, Dr. Kennedy said that efforts should continue to educate adolescents on safe sexual practices and other risk factors of cervical cancer.