…It is safe, effective against cervical cancer — UNICEF

By Chioma Obinna

Cervical cancer, the second most common in Nigerian women with 12,075 cases, 7,968 deaths annually, is preventable with HPV vaccination. However, low access and misinformation hinder its effectiveness.

The World Health Organisation, WHO, in 2022 reported that the high burden was based on 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.

Regrettably, the disease which could be eliminated through effective vaccination has been enmeshed in myths and misconceptions denying millions of Nigerian girls access to life saving vaccines. Good Health Weekly writes.

Folake Dapo, 12, like many other innocent young girls in Lagos State may have been troubled by mere mentioning of HPV vaccination, especially now that the state has rolled out it drums to vaccinate over 1 million girls before the end of the year.

Their fears may not be unconnected with deadly rumours being peddled by people assumed to know better. The rumour messages range from a WhatsApp voice note circulated several times across the platform with the speaker using the Yoruba dialect to inform the public discouraging caregivers from taking the HPV vaccine as it is an attempt to reduce the African population, another video tagging the exercise as ” Evil agenda collaborator! Warning yoruba girls from the evil agenda.  Some of the message say parents should worry about plans by the Federal Ministry of Health, (FMOH) to administer Gardasil HPV vaccine for young girls in schools among other messages.  Folake, a student of one of the public secondary school in Okota area of Lagos, is currently in dilemma to receive the vaccine as her parents have warned her not to take the vaccine.

“I am worried because I don’t know what to do when it gets to my turn and what to tell my parents if I am given in school. My mummy had warned me, including my sisters, not to participate in the exercise, “she said.

But unlike Damilola, 14, who took the HPV vaccine.  Her mother who sells at the Health centre where she took the vaccine informed her about the exercise and supported her.

“Before I took it I was afraid. Now I am no longer afraid.  I heard about it from the health centre. My mother sells things at the centre. The usefulness of the vaccine is to prevent cancer infection. I am glad I took the vaccine.”

She urged other girls of her age to take the vaccine and live above the rumours being spread ignorantly.

“I have heard about the rumours because my mother sells here, I come here also, whenever I am here, I hear the nurses talking about it when she wants to vaccinate a teenager. I wanted to take It last year, but I was scared of injections and because of the rumours,” she said.

In a country where thousands of cases are diagnosed every year, experts say the introduction of the HPV vaccine is essential to prevent cervical cancer and reduce the burden of the disease while myths and misconceptions derails the campaign leading to reduction of Trust, hesitancy in uptake, rejections, increase in the outbreak of vaccine-preventable diseases and increase in child morbidity and mortality.

Dispelling these myths and misconceptions during a two-day dialogue in Lagos, themed: “Combating the most Preventable Form of Deadly Cancer Affecting Women and Girls through Vaccination,”   UNICEF, Social and Behavioural Change Specialist, Aderonke Akinola-Akinwole explained that HPV is a common virus that can lead to cervical cancer; and vaccination offers the best protection, adding that the vaccine is safe, effective, and provides long-term protection against cervical cancer.

In her presentation titled: Demystifying and debunking myths and conceptions around HIV Vaccines, she said: “Myths one: Depopulation: if it happens and the government keeps building social amenities for the use of her citizens – who will use them?

“Myth two: Promoting infertility: Vaccines are introduced after quality assurance – Local agencies like NAFDAC have certified it safe. It is not new. Some mothers took it as girls and they have children today.

“Myth three: Severe adverse events: Normally, the body may react upon the receipt of vaccines and sometimes may but every side event will wane within 48 hours.

“Myth four: “Promoting promiscuity amongst girls: The vaccines are not just for girls but the issue of availability and prioritisation underpin the target of girls.

Myth Five: Ineffectiveness of vaccines: The HPV vaccine is just like other vaccines which have reduced and sometimes eliminated diseases, respectively. E.g. WPV, Smallpox, COVID-19

“Myth six: Virgins as prey: It is targeting the female gender because of the high burden of cervical cancer in Nigeria and vaccine availability.”Aderonke stressed the importance of early vaccination of girls aged 9-14 years before potential exposure to the virus, adding that vaccinating against HPV is an act of protecting not just the individual but the entire community. She said prevention is better/cheaper than cure as vaccinating against HPV is cheaper than treating cervical cancer. “For early diagnosis and treatment, women of reproductive age and above are encouraged to go for screening, adding that ending misconception will get protection for girls, families, and the world.

She tasked journalists to help stop the rumours by responding with the correct messages and facts.  “As the life wire of information is to provide correct, consistent, and continuous information on the scourge of cervical cancers and the effectiveness of HPV vaccines, influence policymakers through advocacy reporting and human-centred storytelling to improve demand for HPV vaccines. Educate the public by leveraging regular channels of interaction with caregivers and adolescent girls. Provide platforms for technical experts to contribute to conversations around promoted behaviours and debunk myths, misconceptions and misinformation about the vaccine.

In his presentation entitled: “Human Papilloma Virus Vaccine Introduction into RI in Lagos State” the Immunisation Programme Coordinator, Lagos State Primary Health Care Board, Dr Akinpelu Adetola confirmed that the HPV Vaccine roll-out in Lagos was also affected by the rumour messages.

He said the Introduction of HPV into Routine Immunsation, (RI) was planned for and implemented in Lagos state, however, the result was not as expected by the state due to the rumours that sprang up during the implementation, which affected the coverage of the state.

He said there has been continuous engagement with schools, religious bodies and influential members of the communities to improve their knowledge of Cervical cancer and the need for the HPV vaccine and also for quick resolution of rejections at the local government level.

He said the campaign faced huge distraction due to rumour messages spread on WhatsApp, social media, and through religious groups and the messages falsely claimed the HPV vaccine is population control, causes infertility, or forces vaccination.

He listed some of the messages to include; a WhatsApp voice note with the speaker using the Yoruba dialect to inform the public discouraging caregivers from taking the HPV vaccine, a video tagging the campaign as “Evil agenda collaborator! Please they should keep warning Yoruba girls from this evil agenda” and a webinar organised by a foundation for Africa cultural heritage and association of concern mothers to discourage parent from given consent to schools, a Tag – “Sacrificial Virgin, the danger of HPV vaccine among others.”

Akinpelu said the main goal of the vaccination is to reduce morbidity and mortality of cervical cancer by providing HPV vaccine, HPVV, to girls aged 9-14 years and targeting a population of 1,062427 in the state.

He said they planned to vaccinate at least 80 percent of girls aged 9-14 years by December 2024, achieve routine HPVV coverage of at least 69 percent for girls aged 9 years by December 2025, achieve a minimum of 4 percent annual increase in routine HPVV coverage from December 2026, disseminate information on primary, secondary and tertiary preventive measures across the 57 LGAs/LCDAs.

Speaking, UNICEF’s Health Specialist, Dr. Ijeoma Agbo, explained that vaccination against HPV is effective in preventing persistent infections with high-risk HPV types, which are the primary cause of cervical cancer.

She said in countries that have introduced the vaccine against human papillomavirus (HPV), after 5–8 years, cancer-causing HPV prevalence was reduced by 83% among girls aged 13–19, and the prevalence of precancerous lesions decreased by 51 percent among girls aged 15–19.

Agbo said the vaccine has been demonstrated to be safe and effective, and long-term follow-up studies have shown that vaccinated individuals have a significantly lower risk of developing cervical cancer.