Central government has included a US based quadrivalent vaccine, Gardasil in the national immunisation program
As the UT administration launches a fresh push to vaccinate girls against cervical cancer, Human Papillomavirus (HPV) vaccine hesitancy persists, fuelled by the contentious history of Gardasil vaccine in India. To combat the high burden of cervical cancer, India’s second most common cancer in women, the central government launched a nationwide free HPV vaccination campaign on February 28. The initiative targets girls aged 14, providing a single-dose free of cost vaccine in government hospitals to reduce cancer incidence.
Central government has included a US based quadrivalent vaccine, Gardasil in the national immunisation program. Despite the free availability of vaccine in Government Multi Specialty Hospital (GMSH-16), low response has been seen. On the launch of campaign, only 13 girls came forward for the vaccine. The reason for its unpopularity remains the online campaign calling it harmful and lacking a long term placebo controlled trial of the vaccine to show its efficacy. Gardasil, a vaccine manufactured by Bill Gates owned company Merck & Co. has been engulfed with controversies in India. In 2013, a parliamentary standing committee report on Gardasil vaccine trials had found serious ethical, consent and regulatory violations.
Debunking the misinformation around HPV vaccine, Dr Bhawna Rai, professor, department of radiotherapy and oncology, PGIMER emphasised on getting girls HPV vaccine as India ranks fourth in cervical cancer related morbidity and it can be reduced by this vaccine. “Cervical cancer is the second most common cancer among women in India.” Dr Rai explained, “human papillomavirus is transmitted through sexual contact and there is no usage of vaccine once the person has been exposed to these viruses. So, it is ideal to give vaccine before one becomes sexually active. Vaccine builds the immunity, by creating antibodies which prevent human papillomaviruses from making carcinogenic changes. Gardasil vaccine included in immunisation program protect against four strains of human papillomaviruses, these are HPV 16, 18 that are responsible for 80% of cervical cancers and strains 6 and 11.”
Dr Rashmi Bagga, professor, department of obstetrics and gynaecology, PGIMER added all females including those having HPV vaccinated, should do Pap smear every three years till the age of 65. Pap smear is a routine five minute screening for cervical cancer that detects precancerous, abnormal cells or HPV in cervix. The test cost ₹100 in PGI.
India accounts for 25% of global cervical cancer deaths. In the world, one in every five women who suffers from cervical cancer is from India and the nation ranks fourth in cervical cancer-related morbidity.
Dr Shweta Tehlan, senior consultant of gynaec, oncology and robotic surgery in Fortis hospital explained, “Gardasil has been in use for more than 15 years and multiple trials on its efficacy has been done. The vaccine helps in building antibodies against these viruses. The vaccine is recommended between 9 to 14 years of age as antibodies response is high in teenage. The vaccine is being given in countries like United Kingdom, Canada, and Australia, etc. World Health Organisation has recommended the single dosage of Gardasil. The vaccine can be given upto age 45 but its effectiveness reduces with age. For younger girls, one dosage of HPV vaccine is enough.”
