IN making a concerted call for “more robust education among parents, students, and females to ensure greater uptake of the human papillomavirus (HPV) vaccine, several Jamaican health officials say the fight against cervical cancer is more of an uphill task because of post-COVID anti-vaccination sentiments.

In fact, according to Dr Anna-Kay Taylor Christmas, gynaecologic oncologist at Victoria Jubilee Hospital, Jamaica is “one of the worst in the Caribbean” as far as HPV vaccine take-up is concerned, with only four per cent vaccination as of 2022.

“We are aiming for 90 per cent. Trinidad is at 22 per cent, Belize is at 54 per cent, and Dominica is at 83 per cent, and there are other Caricom countries, so what is our excuse? We need to treat the HPV vaccine like measles, mumps, and rubella [vaccines] and so help our girls to not have to suffer and die from a disease that’s preventable,” Taylor Christmas said at last Thursday‘s sitting of the Jamaica Observer Press Club held at the newspaper’s Beechwood Avenue headquarters in St Andrew in observance of Cervical Awareness Month.

In 2017, the Ministry of Health and Wellness embarked on a programme to vaccinate Jamaican girls against HPV after a 2010 study it conducted revealed that two types of HPV were found to be present in 10.5 per cent of the general population. As the vaccine has proven to be more effective when administered before contact with the virus, the programme targets girls ages nine to 14 years old.

Last Thursday, Jamaica Cancer Society Executive Director Roshane Reid-Koomson said while the entity currently offers pap smear screenings and not the vaccine, it is very aware of the pushback against the jab.

“The promotion of the HPV vaccine is very important to this cause. There is a new thrust in the schools to vaccinate children. When those messages and information come to the school and they are channelled through the PTA [Parent Teacher Association] and in the WhatsApp groups, they are frowned upon, so a greater campaign is needed to encourage persons,” she said.

“We are still getting pushback for HPV vaccines, but we support it wholeheartedly at the Jamaica Cancer Society, and it will be better for our patients and their families if they are vaccinated, so we support the push for vaccination,” Reid-Koomson said.

“Another thing we support wholeheartedly, too, is getting your pap smear done, whether annually or every three years, whatever the frequency of it is. Our message for Cervical Awareness Month is ‘Open up, Get your Pap’. We believe in vaccination, but we don’t offer vaccination at the Jamaica Cancer Society, what we offer is the pap smear,” Reid-Koomson added.

In the meantime, matron at University Hospital of the West Indies, Nurse Shailendra Murdock, rubbished counter-arguments that the push for the vaccine was encouraging early sexual encounters and promiscuity.

“In any case, any vaccine, you want it before exposure. We are not telling anybody to go out and have sex; in fact, we are telling our teenagers to delay sex until they are fully grown. We want them to be onboard so that when they become adults and are exposed to HPV they have a better fighting chance,” she said.

Noting that cervical cancer is probably the only disease of the category for which there is a vaccine, she said: “The HPV, the virus is the cause, 71 per cent are caused by two types of HPV — types 16 and 18. The vaccines that we have now are geared towards types 16 and 18, along with other strains. There is one particular type [of vaccine] that covers seven strains. Once we get that, we advocate it for our teenagers — young teenagers. The Government had started with first and second form [students], where you get the 11 to 12 year olds, that’s when your immune system is better.”

She also said that boys should not be exempt.

“I’d love to see the boys start getting it as well, boys are affected by HPV, but not as common. If you stop the spread of HPV, then no woman will have cervical cancer. When they get their vaccine onboard and they now have a whole immune response, when they become adults and get exposed to HPV they are all ready for this HPV, ready to fight it off, so they will not have an abnormal smear because of these HPV types,” said Nurse Murdock.

Meanwhile, gynaecologic oncologist Dr Natalie Medley said research has shown that vaccination at an early age is 98 per cent more effective.

“You get a better result from the vaccine if it’s given before you are exposed, hence pushing for it to be given at a younger age,” she said, noting that Jamaica has “a lot of work to do” to measure up to the World Health Organization’s Cervical Cancer Elimination Initiative by 2030.

“There are three targets each country should try to achieve by 2030: one is vaccination, 90 per cent of girls by age 15, at least one dose of the vaccine; 70 per cent screening through the HPV test [which is more accurate than the pap smear]; and the third target is that 90 per cent of women with cancer or pre-cancer should be treated,” she pointed out.

“We don’t want to be playing catch up with treatment because it’s very expensive, and most women present late when they need radiotherapy [or] chemotherapy, which is very expensive. So if we, as a nation, focus on trying to improve the screening and the vaccination for those first two targets by 2030, we would be on our way to eliminating cervical cancer. Right now we are at 15.7 per 100,000 [in Jamaica],” said Medley.

There are more than 200 types of HPV and about 12 that lead to cancer, two of which are responsible for causing 70 per cent of the cancers. HPV is mostly transmitted sexually but can also be transmitted by fomites, which, when, for example, an infected individual uses a washcloth in their private area, can be passed to another individual who uses it, as it remains on the item.

Jamaica reportedly has the highest death rate from cervical cancer in the Caribbean and the Western Hemisphere.

TAYLOR CHRISTMAS…we need to treat the HPV vaccine like measles, mumps and rubella [vaccines] (Photo: Naphtali Junior)

MURDOCK…if you stop the spread of HPV, then no woman will have cervical cancer (Photo: Naphtali Junior)