Group to provide HPV vaccine to as many girls as possible

Originally published on Malaysiakini by Indra Sathiabalan. Published: Jan 14, 2024

In conjunction with Cervical Health Awareness Month in January, two doctors attached to the National Cancer Society Malaysia (NCSM) spoke about “Leaving No One Behind: Eliminating Cervical Cancer in Malaysia” programme.

The Parliamentary Special Select Committee on Health, NCSM, and the Health Ministry launched this programme on Nov 24 last year.

Under this programme, 300,000 doses of the Human Papillomavirus (HPV) vaccine worth RM90 million (donated by pharmaceutical company MSD) are being given free of charge to teenagers and women from disadvantaged and vulnerable communities in each of the 222 parliamentary constituencies in Malaysia.

According to NCSM, cervical cancer is the third most common cancer among women in Malaysia and more than 40 percent of such cases are diagnosed late, such as at stages three or four, with only about 30 percent of patients surviving five years after their diagnosis.

HPV vaccination can reduce the risk of cervical cancer by up to 95 percent, and by vaccinating the entire community, this cancer can, in theory, be eliminated.

Vaccinating school girls

Since 2010, the ministry has been providing the HPV vaccine to 13-year-old girls in schools nationwide.

The programme was temporarily suspended during the Covid-19 pandemic from 2020 to 2022 when schools were closed. However, the ministry will be back on track this year ensuring the administration of the HPV vaccine to school girls across the country.

“No One Left Behind” complements the ministry’s HPV vaccination programme in schools.

NCSM president Dr Saunthari Somasundaram (above, left) said it is still on the two-dose programme that was decided by the ministry, and therefore has enough to provide for 150,000 young women aged between 13 to 20.

“Those who will be getting these vaccinations are Orang Asal, single mothers, girls in reform centres and prisons, those who dropped out of school and those who missed their vaccinations previously.

“Also, those who are disabled, chronically ill, those who don’t or can’t attend school for whatever reason and those who live in rural communities where the vaccination rollout might not have happened,” said Saunthari.

She said basically, they are targeting those who are not eligible for the ministry’s programme.

High success rate

The ministry’s HPV vaccination exercise has been well received and, according to Saunthari, has a 90 percent vaccination rate. The students have to fill in consent forms which are then signed by their parents and guardians.

“Globally, Malaysia has one of the highest successes when it comes to the cervical cancer vaccination programme. In terms of people who adopt it, in terms of those who get vaccinations, we are at the top,” she said.

The World Health Organization even bestowed the country with an award for its success.

Saunthari said ideally the vaccine should be administered to girls between the ages of nine and 14. Guidelines say women can receive the vaccine up to the age of 45.

“We look at it in terms of efficacy or how it works. You have the greatest efficacy if you have never been exposed to the things you’ve never been exposed to. That is why we try to vaccinate the younger population before anybody has any sexual activity or any sexual exposure,” said Saunthari.

According to NCSM, more than 95 percent of cervical cancer is due to HPV.

There are so many subtypes of the HPV viruses and the vaccine can help protect its recipient against about 90 percent of infectious genital warts, and about 70 percent of all cervical cancers.

Logistical issues

Saunthari noted that initially, three doses of vaccination were required when the vaccine was first introduced. It was later reduced to two.

New research shows that one dose is sufficient to last the recipient a lifetime.

She said volunteers face logistical issues in getting to those who need to be vaccinated.

“The logistics when it comes to vaccinations, of getting out to people and then finding the same people again to get them vaccinated within a certain period.

“There are a lot of costs associated with them. There is a lot of manpower and resources associated with this,” she said.

So far, NCSM and its partners are working on getting the information out there, dealing with enquiries and dispelling myths about the vaccination, as well as carrying out the vaccination exercise.

“We divided the programme into three periods. The first is getting people to realise this is a concerning and urgent issue that we cannot drag our feet on.

“The longer we wait, there will be more and more girls who are not being vaccinated, and they are going to be exposed to the virus.

“It is the health communications aspect of it, getting it out there, getting people to realise that you know this is something that needs to be done,” Saunthari said.

So they have to reach out to the public, and leaders within a certain community and get medical professionals on board to carry out the vaccinations.

That brings us to the second stage.

Vaccination hesitancy

“Post-Covid, I think there is a little bit more vaccine hesitancy now. Everybody’s sick and tired of the whole idea of vaccinations because even though we have been vaccinated, people can still get Covid-19.

“So it’s important we can reach out to people, change their behaviour and their thought process on vaccine hesitancy. People are now also worried about the side effects of vaccines. There’s all this false information post-Covid,” Saunthari said.

She said the HPV vaccine does have its side effects but the incidence of people experiencing them is very low.

“The vaccine has been out there now for nearly 20 years. It has been well received and in terms of side effects it is very minimal.”

To make sure everyone gets the right information, NCSM wants to set up a call centre for people to contact them if they have any questions.

The third stage, Saunthari said, is the health delivery services, which is the actual vaccination aspect.

Ensuring equal distribution

NCSM managing director Dr Murallitharan Munisamy said the pilot programme for the third stage is scheduled to kick off at the end of January.

The common perception is that everything gets rolled out in urban settings like Kuala Lumpur, while the rest of the country just falls behind.

To ensure that does not happen in this case, NCSM has to make sure the 300,000 they have for the 150,000 young women is equally distributed across the country, in every state.

They will be collaborating with the ministry and the parliamentary special select committee as well as the parliamentarians in terms of who they will approach in each state.

“We are targeting these very difficult-to-reach populations. We will be meeting representatives at each political constituency, at the district level, we’re calling meetings and briefing all the NGOs and the government agencies,” he said.

He added that women’s health groups are also being roped in to help.

What they want to do is compile a list of names of girls in these vulnerable groups mentioned earlier by authority figures, such as the Prisons director-general or the Department of Orang Asli Development, in the case of the Orang Asli.

The public can get more information about cervical cancer, the HPV vaccine, and the programme’s journey.

They can also contribute monetarily or their time towards this programme by visiting the website.